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Chun SW, Somers ME, Burgener EB. Highly effective cystic fibrosis transmembrane conductance (regulator) modulator therapy: shifting the curve for most while leaving some further behind. Curr Opin Pediatr 2024; 36:290-295. [PMID: 38411576 DOI: 10.1097/mop.0000000000001338] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
PURPOSE OF REVIEW Traditional cystic fibrosis (CF) care had been focused on early intervention and symptom mitigation. With the advent of highly effective cystic fibrosis transmembrane conductance regulator (CFTR) modulator therapy (HEMT), in particular, the approval of elexacaftor/tezacaftor/ivacaftor in 2019, there has been a dramatic improvement in outcomes in CF. The purpose of this article is to review the benefits, limitations, and impact of HEMT as well as discuss the new implications, challenges, and hope that modulators bring to people with CF (pwCF). RECENT FINDINGS HEMT has demonstrated sustained improvement in lung function, nutrition, quality of life, and survival for over 90% of pwCF. As HEMT has delivered such promise, there is a small but significant portion of pwCF who do not benefit from HEMT due to ineligible mutations, intolerance, or lack of accessibility to modulators. SUMMARY HEMT has significantly improved outcomes, but continued research is needed to understand the new challenges and implications the era of HEMT will bring, as well as how to provide equitable care to those who are unable to benefit from HEMT.
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Affiliation(s)
- Stanford W Chun
- Division of Pediatric Pulmonology & Sleep Medicine, Department of Pediatrics, Children's Hospital of Los Angeles, Keck School of Medicine at University of Southern California, Los Angeles
| | - Maya E Somers
- Division of Infectious Disease & Geographic Medicine, Department of Medicine, Stanford University, Stanford, California, USA
| | - Elizabeth B Burgener
- Division of Pediatric Pulmonology & Sleep Medicine, Department of Pediatrics, Children's Hospital of Los Angeles, Keck School of Medicine at University of Southern California, Los Angeles
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2
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Szabo MM, Foushee SE, McPheeters CM, O'Hagan AR, Ramirez AM, O'Reilly EA. Impact of elexacaftor/tezacaftor/ivacaftor on respiratory colonization in an adult cystic fibrosis clinic. Am J Med Sci 2024; 367:337-342. [PMID: 38336262 DOI: 10.1016/j.amjms.2024.02.001] [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: 07/18/2023] [Revised: 11/16/2023] [Accepted: 02/01/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND Little research has been completed on the correlation between cystic fibrosis (CF) modulator therapy and its effect on respiratory cultures in CF patients. This study evaluated the effect of elexacaftor/tezacaftor/ivacaftor (ETI) on respiratory colonization with Pseudomonas aeruginosa. METHODS This single center, IRB approved, retrospective chart review compared patient data two years immediately prior to ETI initiation with patient data two years post-initiation from January 2017-December 2022. Patients were included in the study if they were at least 18 years old with a diagnosis of CF and had at least one month of ETI dispensed, at least one sputum culture obtained, and were currently on ETI. Those who had not been seen since ETI initiation or received a bilateral lung transplant were excluded. The primary outcome was rate of patients with respiratory colonization post-ETI. Colonization was defined as two or more positive P. aeruginosa cultures in a 12-month period. Decolonization was defined as three consecutive negative P. aeruginosa cultures after previous colonization. Key secondary outcomes included average time to discontinuation of mucolytic therapy and relative risk of pulmonary exacerbation. RESULTS A significant reduction (p<0.001) in colonization with P. aeruginosa was observed with 49 patients in the pre-ETI group compared to 25 in the post-ETI group meeting the definition of colonization (n=79). Average time to discontinuation of mucolytic therapy was 14 months (p=0.002). Relative risk of pulmonary exacerbation was 4.80 (p<0.001). CONCLUSIONS ETI use resulted in reduced colonization with P. aeruginosa, discontinuation of mucolytic therapy, and decreased frequency of pulmonary exacerbation.
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Affiliation(s)
- Michelle M Szabo
- PGY-2 Ambulatory Care Pharmacy Resident, UofL Health-UofL Hospital, Louisville, KY, USA
| | - Sarah E Foushee
- Clinical Pharmacy Specialist, UofL Health-UofL Hospital, Louisville, KY, USA
| | | | - Adrian R O'Hagan
- Adult Cystic Fibrosis, University of Louisville, Louisville, KY, USA
| | - Allan M Ramirez
- Adult Cystic Fibrosis, University of Louisville, Louisville, KY, USA
| | - Emily A O'Reilly
- Clinical Coordinator, Specialty Pharmacy Accreditation and Outcomes, UofL Health-UofL Hospital, Louisville, KY, USA.
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3
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Zemke AC, Hilliam Y, Stapleton AL, Kimple AJ, Goralski JL, Shaffer AD, Pilewski JM, Senior BA, Lee SE, Cooper VS. Elexacaftor-tezacaftor-ivacaftor decreases pseudomonas abundance in the sinonasal microbiome in cystic fibrosis. Int Forum Allergy Rhinol 2024; 14:928-938. [PMID: 37837613 DOI: 10.1002/alr.23288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 09/15/2023] [Accepted: 09/23/2023] [Indexed: 10/16/2023]
Abstract
BACKGROUND Chronic rhinosinusitis (CRS) is common in individuals with cystic fibrosis (CF) and is marked by chronic inflammation and episodes of infection that negatively impact quality of life. Several studies have shown that elexacaftor-tezacaftor-ivacaftor (ETI) improves symptoms and examination findings in CF-CRS. The current study determines the effect of ETI on the sinonasal microbiota in CF. METHODS Sinonasal samples were collected under endoscopic visualization before and after starting ETI. Samples were subjected to 16S amplicon sequencing and sequences were processed with the QIIME2 pipeline with subsequent analysis using the vegan R-package. RESULTS Twenty-nine individual baseline samples and 23 sample pairs pre-/post-ETI were available. At baseline, the cohort had samples dominated by Staphylococcus, and alpha diversity was lower than that of a published reference set of individuals without sinonasal disease. Individuals with prior sinus surgery had lower alpha diversity as measured by Shannon Index, Observed Richness, and Faith's phylogenetic diversity Index. Beta diversity differed between individuals with and without allergic rhinitis, with higher Staphylococcus abundance in those with allergic rhinitis. No change in alpha or beta diversity was seen after a median of 9 months on ETI. With ETI, the Pseudomonas genus and the genus containing Burkholderia decreased in samples containing these taxa at baseline. Pseudomonas abundance decreased with treatment as measured by qPCR. Core sinonasal microbiome members Staphylococcus, Corynebacterium, and Streptococcus were unchanged, while Moraxella increased with ETI. CONCLUSIONS Treatment with ETI leads to a reduction in Pseudomonas abundance within the sinonasal microbiome of individuals with Pseudomonas at baseline.
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Affiliation(s)
- Anna C Zemke
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Yasmin Hilliam
- Department of Microbiology & Immunology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Amanda L Stapleton
- Department of Otolaryngology-Head & Neck Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Adam J Kimple
- Department of Otolaryngology-Head & Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Jennifer L Goralski
- Division of Pulmonary Diseases & CCM, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Amber D Shaffer
- Department of Otolaryngology-Head & Neck Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Joseph M Pilewski
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Brent A Senior
- Department of Otolaryngology-Head & Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Stella E Lee
- Department of Otolaryngology-Head & Neck Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Division of Otolaryngology-Head & Neck Surgery, Department of Surgery, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Vaughn S Cooper
- Department of Microbiology and Molecular Genetics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Chastek B, Carrera A, Landis C, Snyder D, Abedinzadeh L, Bancroft T, Nesheim J, Kennelly M, Staskin D. Real-World Adherence to and Persistence with Vibegron in Patients with Overactive Bladder: A Retrospective Claims Analysis. Adv Ther 2024; 41:2086-2097. [PMID: 38520502 DOI: 10.1007/s12325-024-02824-x] [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: 12/21/2023] [Accepted: 02/15/2024] [Indexed: 03/25/2024]
Abstract
INTRODUCTION Vibegron is a β3-adrenergic receptor agonist approved for overactive bladder (OAB). This analysis assessed real-world adherence and persistence with vibegron in patients with OAB, along with demographics and clinical characteristics associated with adherence and persistence. METHODS This retrospective study used the Optum Research Database to identify patients treated with vibegron from April 2021 to August 2022 (identification period). Patients had ≥ 60 days of continuous pharmacy coverage in a commercial or Medicare Advantage plan following the index fill (follow-up). Adherence was assessed as proportion of days covered (PDC) from index to end of follow-up and was defined as PDC ≥ 80%. Persistence was measured as days to discontinuation of therapy (30-day gap) or end of follow-up. Data for adherence and persistence are presented descriptively. Characteristics associated with adherence and persistence were analyzed using multivariable models among patients with medical and pharmacy benefits during the 90 days before index (baseline). RESULTS Overall, 9992 patients had a vibegron claim during the identification period; 9712 had ≥ 2 months of follow-up. Mean (SD) age was 74.2 (10.7) years; 68.2% were female. Mean (SD) PDC was 0.64 (0.34). Median (95% confidence interval) persistence was 142 (132-153) days. Of the 5073 patients who were ≥ 18 years old with continuous baseline pharmacy and medical benefits ≥ 90 days before index, 2497 (49.2%) were adherent. Patients were more likely to be adherent and persistent if they received a greater days' supply for the index fill and had baseline medication count ≥ 6. Patients were more likely to discontinue if their index copay was > $45. CONCLUSION Nearly half of the patients initiating vibegron were adherent. Factors associated with adherence and persistence were more likely to be related to prescribing practices than patient characteristics. These results suggest it may be best to follow up with patients approximately 4 to 5 months after initiating treatment with vibegron.
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Affiliation(s)
| | - Adam Carrera
- Sumitomo Pharma America, Inc. (Formerly Urovant Sciences, Inc.), 84 Waterford Dr, Marlborough, MA, 01752, USA.
| | | | - Daniel Snyder
- Sumitomo Pharma America, Inc. (Formerly Urovant Sciences, Inc.), 84 Waterford Dr, Marlborough, MA, 01752, USA
| | - Laleh Abedinzadeh
- Sumitomo Pharma America, Inc. (Formerly Urovant Sciences, Inc.), 84 Waterford Dr, Marlborough, MA, 01752, USA
| | | | - Jeffrey Nesheim
- Sumitomo Pharma America, Inc. (Formerly Urovant Sciences, Inc.), 84 Waterford Dr, Marlborough, MA, 01752, USA
| | | | - David Staskin
- Tufts University School of Medicine, Boston, MA, USA
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Fujii H, Tsuchiya M, Watanabe D, Otsuka R, Hirate D, Takahashi K, Go M, Kudo T, Shimomura K, Ando Y, Tani S, Takahashi T, Hayashi K, Chin M, Matsunami N, Takahashi M, Hasegawa A, Uchida T, Hashimoto H, Kubo A, Matsuhashi N, Suzuki A, Nishimura J, Inui N, Iihara H. The emerging emetogenicity of trifluridine/tipiracil (TAS‑102) from patient self-reporting: a multicenter, prospective, observational study. Support Care Cancer 2024; 32:291. [PMID: 38630197 DOI: 10.1007/s00520-024-08498-z] [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: 12/22/2023] [Accepted: 04/11/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND Trifluridine/tipiracil (TAS-102) is an oral anticancer drug with adequate efficacy in unresectable colorectal cancer, but frequently also induces chemotherapy-induced nausea and vomiting (CINV). To investigate the occurrence of CINV and antiemetic therapy in patients with colorectal cancer treated with TAS-102 (JASCC-CINV 2001). METHODS We conducted a multicenter, prospective, observational study in patients with colorectal cancer who received TAS-102 without dose reduction for the first time. Primary endpoint was the incidence of vomiting during the overall period. Secondary endpoints were the incidence of nausea, significant nausea, anorexia, other adverse events (constipation, diarrhea, insomnia, fatigue, dysgeusia) and patient satisfaction. Patient diaries were used for primary and secondary endpoints. All adverse events were subjectively assessed using PRO-CTCAE ver 1.0. and CTCAE ver 5.0. RESULTS Data from 100 of the 119 enrolled patients were analyzed. The incidence of vomiting, nausea, and significant nausea was 13%, 67%, and 36%, respectively. The incidence of vomiting in patients with and without prophylactic antiemetic therapy were 20.8% and 10.5%, respectively. Prophylactic antiemetics were given to 24% of patients, of whom 70% received D2 antagonists. Multivariate Cox proportional hazards analysis showed that experience of CINV in previous treatment tended to be associated with vomiting (hazard ratio [HR]: 7.13, 95% confidence interval [CI]: 0.87-58.5, P = 0.07), whereas prophylactic antiemetic administration was not (HR: 1.61, 95 CI: 0.50-5.21, P = 0.43). With regard to patient satisfaction, the proportion of patients who were "very satisfied," "satisfied," "slightly satisfied" or "somewhat satisfied" was 81.8%. CONCLUSIONS The low incidence of vomiting and high patient satisfaction suggest that TAS-102 does not require the use of uniform prophylactic antiemetic treatments. However, patients with the experience of CINV in previous treatment might require prophylactic antiemetic treatment.
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Affiliation(s)
- Hironori Fujii
- Department of Pharmacy, Gifu University Hospital, Gifu, Japan
| | | | - Daichi Watanabe
- Department of Pharmacy, Gifu University Hospital, Gifu, Japan
- Innovative and Clinical Research Promotion Center, Gifu University Hospital, Gifu, Japan
| | - Ryo Otsuka
- Department of Pharmacy, National Cancer Center Hospital, Tokyo, Japan
| | - Daisuke Hirate
- Department of Pharmacy, Teine Keijinkai Hospital, Hokkaido, Japan
| | | | - Makiko Go
- Department of Pharmacy, Ogaki Municipal Hospital, Gifu, Japan
| | - Toshihiro Kudo
- Department of Medical Oncology, Osaka International Cancer Institute, Osaka, Japan
| | | | - Yosuke Ando
- Department of Pharmacotherapeutics and Informatics, Fujita Health University, Aichi, Japan
| | - Shinya Tani
- First Department of Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Takao Takahashi
- Department of Gastroenterological Surgery, Pediatric Surgery, Gifu University Graduate School of Medicine, Gifu, Japan
- Department of Surgery, Seino Kosei Hospital, Gifu Seino Medical Center, Gifu, Japan
| | | | - Miki Chin
- Department of Pharmacy, National Cancer Center Hospital, Tokyo, Japan
| | - Naomi Matsunami
- Department of Pharmacy, Teine Keijinkai Hospital, Hokkaido, Japan
| | - Masaya Takahashi
- Department of Pharmacy, Osaka City University Hospital, Osaka, Japan
| | - Akiko Hasegawa
- Department of Medical Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Takashi Uchida
- Department of Pharmacy, Miyagi Cancer Center, Miyagi, Japan
| | | | - Akiko Kubo
- Department of Pharmacy, National Cancer Center Hospital, Tokyo, Japan
| | - Nobuhisa Matsuhashi
- Department of Gastroenterological Surgery, Pediatric Surgery, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Akio Suzuki
- Department of Pharmacy, Gifu University Hospital, Gifu, Japan
- Laboratory of Advanced Medical Pharmacy, Gifu Pharmaceutical University, Gifu, Japan
| | - Junichi Nishimura
- Department of Medical Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Naoki Inui
- First Department of Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Hirotoshi Iihara
- Department of Pharmacy, Gifu University Hospital, Gifu, Japan.
- Patient Safety Division, Gifu University Hospital, Gifu, Japan.
- Laboratory of Community Pharmaceutical Practice and Science, Gifu Pharmaceutical University, Gifu, Japan.
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Fountzilas C, Witkiewicz A, Chatley S, Fitzpatrick V, Zonneville J, Alruwaili M, Rosenheck H, Mager D, Wang J, Krishnamurthy A, Switzer B, Attwood K, Puzanov I, Iyer R, Bakin A. YIA24-003: A Phase I Study of TAS102 Plus Talazoparib in Advanced Colorectal (CRC) and Esophagogastric (EGC) Adenocarcinomas. J Natl Compr Canc Netw 2024; 22:YIA24-003. [PMID: 38579886 DOI: 10.6004/jnccn.2023.7124] [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] [Subscribe] [Scholar Register] [Indexed: 04/07/2024]
Affiliation(s)
| | | | - Sarah Chatley
- 1Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | | | | | | | | | - Donald Mager
- 3University at Buffalo, State University of New York, Buffalo, NY
| | - Jianxin Wang
- 1Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | | | | | | | - Igor Puzanov
- 1Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | - Renuka Iyer
- 1Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | - Andrei Bakin
- 1Roswell Park Comprehensive Cancer Center, Buffalo, NY
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7
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Dohna M, Voskrebenzev A, Klimeš F, Kaireit TF, Glandorf J, Pallenberg ST, Ringshausen FC, Hansen G, Renz DM, Wacker F, Dittrich AM, Vogel-Claussen J. PREFUL MRI for Monitoring Perfusion and Ventilation Changes after Elexacaftor-Tezacaftor-Ivacaftor Therapy for Cystic Fibrosis: A Feasibility Study. Radiol Cardiothorac Imaging 2024; 6:e230104. [PMID: 38573129 DOI: 10.1148/ryct.230104] [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] [Indexed: 04/05/2024]
Abstract
Purpose To assess the feasibility of monitoring the effects of elexacaftor-tezacaftor-ivacaftor (ETI) therapy on lung ventilation and perfusion in people with cystic fibrosis (CF), using phase-resolved functional lung (PREFUL) MRI. Materials and Methods This secondary analysis of a multicenter prospective study was carried out between August 2020 and March 2021 and included participants 12 years or older with CF who underwent PREFUL MRI, spirometry, sweat chloride test, and lung clearance index assessment before and 8-16 weeks after ETI therapy. For PREFUL-derived ventilation and perfusion parameter extraction, two-dimensional coronal dynamic gradient-echo MR images were evaluated with an automated quantitative pipeline. T1- and T2-weighted MR images and PREFUL perfusion maps were visually assessed for semiquantitative Eichinger scores. Wilcoxon signed rank test compared clinical parameters and PREFUL values before and after ETI therapy. Correlation of parameters was calculated as Spearman ρ correlation coefficient. Results Twenty-three participants (median age, 18 years [IQR: 14-24.5 years]; 13 female) were included. Quantitative PREFUL parameters, Eichinger score, and clinical parameters (lung clearance index = 21) showed significant improvement after ETI therapy. Ventilation defect percentage of regional ventilation decreased from 18% (IQR: 14%-25%) to 9% (IQR: 6%-17%) (P = .003) and perfusion defect percentage from 26% (IQR: 18%-36%) to 19% (IQR: 13%-24%) (P = .002). Areas of matching normal (healthy) ventilation and perfusion increased from 52% (IQR: 47%-68%) to 73% (IQR: 61%-83%). Visually assessed perfusion scores did not correlate with PREFUL perfusion (P = .11) nor with ventilation-perfusion match values (P = .38). Conclusion The study demonstrates the feasibility of PREFUL MRI for semiautomated quantitative assessment of perfusion and ventilation changes in response to ETI therapy in people with CF. Keywords: Pediatrics, MR-Functional Imaging, Pulmonary, Lung, Comparative Studies, Cystic Fibrosis, Elexacaftor-Tezacaftor-Ivacaftor Therapy, Fourier Decomposition, PREFUL, Free-Breathing Proton MRI, Pulmonary MRI, Perfusion, Functional MRI, CFTR, Modulator Therapy, Kaftrio Clinical trial registration no. NCT04732910 Supplemental material is available for this article. © RSNA, 2024.
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Affiliation(s)
- Martha Dohna
- From the Department of Diagnostic and Interventional Radiology (M.D., A.V., F.K., T.F.K., J.G., D.M.R., F.W., J.V.C.), German Center for Lung Research (DZL), Biomedical Research in Endstage and Obstructive Lung Disease (BREATH) (A.V., F.K., T.F.K., J.G., S.T.P., F.C.R., G.H., F.W., A.M.D., J.V.C.), Department for Pediatric Pneumology, Allergology and Neonatology (S.T.P., G.H., A.M.D., J.V.C.), and Department of Respiratory Medicine (F.C.R.), Hannover Medical School, Carl-Neuberg-Str 1, 30625 Hannover, Germany; and European Reference Network on Rare and Complex Respiratory Diseases (ERN-LUNG), Frankfurt, Germany (F.C.R.)
| | - Andreas Voskrebenzev
- From the Department of Diagnostic and Interventional Radiology (M.D., A.V., F.K., T.F.K., J.G., D.M.R., F.W., J.V.C.), German Center for Lung Research (DZL), Biomedical Research in Endstage and Obstructive Lung Disease (BREATH) (A.V., F.K., T.F.K., J.G., S.T.P., F.C.R., G.H., F.W., A.M.D., J.V.C.), Department for Pediatric Pneumology, Allergology and Neonatology (S.T.P., G.H., A.M.D., J.V.C.), and Department of Respiratory Medicine (F.C.R.), Hannover Medical School, Carl-Neuberg-Str 1, 30625 Hannover, Germany; and European Reference Network on Rare and Complex Respiratory Diseases (ERN-LUNG), Frankfurt, Germany (F.C.R.)
| | - Filip Klimeš
- From the Department of Diagnostic and Interventional Radiology (M.D., A.V., F.K., T.F.K., J.G., D.M.R., F.W., J.V.C.), German Center for Lung Research (DZL), Biomedical Research in Endstage and Obstructive Lung Disease (BREATH) (A.V., F.K., T.F.K., J.G., S.T.P., F.C.R., G.H., F.W., A.M.D., J.V.C.), Department for Pediatric Pneumology, Allergology and Neonatology (S.T.P., G.H., A.M.D., J.V.C.), and Department of Respiratory Medicine (F.C.R.), Hannover Medical School, Carl-Neuberg-Str 1, 30625 Hannover, Germany; and European Reference Network on Rare and Complex Respiratory Diseases (ERN-LUNG), Frankfurt, Germany (F.C.R.)
| | - Till F Kaireit
- From the Department of Diagnostic and Interventional Radiology (M.D., A.V., F.K., T.F.K., J.G., D.M.R., F.W., J.V.C.), German Center for Lung Research (DZL), Biomedical Research in Endstage and Obstructive Lung Disease (BREATH) (A.V., F.K., T.F.K., J.G., S.T.P., F.C.R., G.H., F.W., A.M.D., J.V.C.), Department for Pediatric Pneumology, Allergology and Neonatology (S.T.P., G.H., A.M.D., J.V.C.), and Department of Respiratory Medicine (F.C.R.), Hannover Medical School, Carl-Neuberg-Str 1, 30625 Hannover, Germany; and European Reference Network on Rare and Complex Respiratory Diseases (ERN-LUNG), Frankfurt, Germany (F.C.R.)
| | - Julian Glandorf
- From the Department of Diagnostic and Interventional Radiology (M.D., A.V., F.K., T.F.K., J.G., D.M.R., F.W., J.V.C.), German Center for Lung Research (DZL), Biomedical Research in Endstage and Obstructive Lung Disease (BREATH) (A.V., F.K., T.F.K., J.G., S.T.P., F.C.R., G.H., F.W., A.M.D., J.V.C.), Department for Pediatric Pneumology, Allergology and Neonatology (S.T.P., G.H., A.M.D., J.V.C.), and Department of Respiratory Medicine (F.C.R.), Hannover Medical School, Carl-Neuberg-Str 1, 30625 Hannover, Germany; and European Reference Network on Rare and Complex Respiratory Diseases (ERN-LUNG), Frankfurt, Germany (F.C.R.)
| | - Sophia T Pallenberg
- From the Department of Diagnostic and Interventional Radiology (M.D., A.V., F.K., T.F.K., J.G., D.M.R., F.W., J.V.C.), German Center for Lung Research (DZL), Biomedical Research in Endstage and Obstructive Lung Disease (BREATH) (A.V., F.K., T.F.K., J.G., S.T.P., F.C.R., G.H., F.W., A.M.D., J.V.C.), Department for Pediatric Pneumology, Allergology and Neonatology (S.T.P., G.H., A.M.D., J.V.C.), and Department of Respiratory Medicine (F.C.R.), Hannover Medical School, Carl-Neuberg-Str 1, 30625 Hannover, Germany; and European Reference Network on Rare and Complex Respiratory Diseases (ERN-LUNG), Frankfurt, Germany (F.C.R.)
| | - Felix C Ringshausen
- From the Department of Diagnostic and Interventional Radiology (M.D., A.V., F.K., T.F.K., J.G., D.M.R., F.W., J.V.C.), German Center for Lung Research (DZL), Biomedical Research in Endstage and Obstructive Lung Disease (BREATH) (A.V., F.K., T.F.K., J.G., S.T.P., F.C.R., G.H., F.W., A.M.D., J.V.C.), Department for Pediatric Pneumology, Allergology and Neonatology (S.T.P., G.H., A.M.D., J.V.C.), and Department of Respiratory Medicine (F.C.R.), Hannover Medical School, Carl-Neuberg-Str 1, 30625 Hannover, Germany; and European Reference Network on Rare and Complex Respiratory Diseases (ERN-LUNG), Frankfurt, Germany (F.C.R.)
| | - Gesine Hansen
- From the Department of Diagnostic and Interventional Radiology (M.D., A.V., F.K., T.F.K., J.G., D.M.R., F.W., J.V.C.), German Center for Lung Research (DZL), Biomedical Research in Endstage and Obstructive Lung Disease (BREATH) (A.V., F.K., T.F.K., J.G., S.T.P., F.C.R., G.H., F.W., A.M.D., J.V.C.), Department for Pediatric Pneumology, Allergology and Neonatology (S.T.P., G.H., A.M.D., J.V.C.), and Department of Respiratory Medicine (F.C.R.), Hannover Medical School, Carl-Neuberg-Str 1, 30625 Hannover, Germany; and European Reference Network on Rare and Complex Respiratory Diseases (ERN-LUNG), Frankfurt, Germany (F.C.R.)
| | - Diane Miriam Renz
- From the Department of Diagnostic and Interventional Radiology (M.D., A.V., F.K., T.F.K., J.G., D.M.R., F.W., J.V.C.), German Center for Lung Research (DZL), Biomedical Research in Endstage and Obstructive Lung Disease (BREATH) (A.V., F.K., T.F.K., J.G., S.T.P., F.C.R., G.H., F.W., A.M.D., J.V.C.), Department for Pediatric Pneumology, Allergology and Neonatology (S.T.P., G.H., A.M.D., J.V.C.), and Department of Respiratory Medicine (F.C.R.), Hannover Medical School, Carl-Neuberg-Str 1, 30625 Hannover, Germany; and European Reference Network on Rare and Complex Respiratory Diseases (ERN-LUNG), Frankfurt, Germany (F.C.R.)
| | - Frank Wacker
- From the Department of Diagnostic and Interventional Radiology (M.D., A.V., F.K., T.F.K., J.G., D.M.R., F.W., J.V.C.), German Center for Lung Research (DZL), Biomedical Research in Endstage and Obstructive Lung Disease (BREATH) (A.V., F.K., T.F.K., J.G., S.T.P., F.C.R., G.H., F.W., A.M.D., J.V.C.), Department for Pediatric Pneumology, Allergology and Neonatology (S.T.P., G.H., A.M.D., J.V.C.), and Department of Respiratory Medicine (F.C.R.), Hannover Medical School, Carl-Neuberg-Str 1, 30625 Hannover, Germany; and European Reference Network on Rare and Complex Respiratory Diseases (ERN-LUNG), Frankfurt, Germany (F.C.R.)
| | - Anna-Maria Dittrich
- From the Department of Diagnostic and Interventional Radiology (M.D., A.V., F.K., T.F.K., J.G., D.M.R., F.W., J.V.C.), German Center for Lung Research (DZL), Biomedical Research in Endstage and Obstructive Lung Disease (BREATH) (A.V., F.K., T.F.K., J.G., S.T.P., F.C.R., G.H., F.W., A.M.D., J.V.C.), Department for Pediatric Pneumology, Allergology and Neonatology (S.T.P., G.H., A.M.D., J.V.C.), and Department of Respiratory Medicine (F.C.R.), Hannover Medical School, Carl-Neuberg-Str 1, 30625 Hannover, Germany; and European Reference Network on Rare and Complex Respiratory Diseases (ERN-LUNG), Frankfurt, Germany (F.C.R.)
| | - Jens Vogel-Claussen
- From the Department of Diagnostic and Interventional Radiology (M.D., A.V., F.K., T.F.K., J.G., D.M.R., F.W., J.V.C.), German Center for Lung Research (DZL), Biomedical Research in Endstage and Obstructive Lung Disease (BREATH) (A.V., F.K., T.F.K., J.G., S.T.P., F.C.R., G.H., F.W., A.M.D., J.V.C.), Department for Pediatric Pneumology, Allergology and Neonatology (S.T.P., G.H., A.M.D., J.V.C.), and Department of Respiratory Medicine (F.C.R.), Hannover Medical School, Carl-Neuberg-Str 1, 30625 Hannover, Germany; and European Reference Network on Rare and Complex Respiratory Diseases (ERN-LUNG), Frankfurt, Germany (F.C.R.)
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Song W, Ye L, Tang Q, Lu X, Huang X, Xie M, Yu S, Yuan Z, Chen L. Rev-erbα attenuates refractory periapical periodontitis via M1 polarization: An in vitro and in vivo study. Int Endod J 2024; 57:451-463. [PMID: 38279698 DOI: 10.1111/iej.14024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 01/04/2024] [Accepted: 01/07/2024] [Indexed: 01/28/2024]
Abstract
AIM Rev-erbα has been reported to regulate the healing of inflammatory lesions through its effect on the immune system in a variety of inflammatory disease. Moreover, the balance of macrophages polarization plays a crucial role in immune response and inflammatory progression. However, in refractory periapical periodontitis (RAP), the role of Rev-erbα in inflammatory response and bone resorption by regulating macrophage polarization remains unclarified. The aims of the present study were to investigate the expression of Rev-erbα in experimental RAP and to explore the relationship between Rev-erbα and macrophage polarization through the application of its pharmacological agonist SR9009 into the in vivo and in vitro experiments. METHODOLOGY Enterococcus faecalis-induced RAP models were established in SD rats. Histological staining and micro-computed tomography scanning were used to evaluate osteoclastogenesis and alveolar bone resorption. The expression of Rev-erbα and macrophage polarization were detected in the periapical tissues from rats by immunofluorescence, flow cytometry, and western blots. Furthermore, immunohistochemical staining and enzyme-linked immunosorbent assay were performed to explore the relationship between Rev-erbα and inflammatory cytokines related to macrophage polarization. RESULT Compared to healthy periapical tissue, the expression of Rev-erbα was significantly down-regulated in macrophages from inflammatory periapical area, especially in Enterococcus faecalis-induced periapical lesions, with obvious type-1 macrophage (M1)-like dominance and the production of pro-inflammatory cytokines. In addition, Rev-erbα activation by SR9009 could induce type-2 macrophage (M2)-like polarization in periapical tissue and THP1 cell line, followed by increased secretion of anti-inflammatory cytokines IL-10 and TGF-β. Furthermore, intracanal application of SR9009 reduced the lesion size and promoted the repair of RAP by decreasing the number of osteoclasts and enhancing the formation of mineralized tissue in periapical inflammatory lesions. CONCLUSIONS Rev-erbα played an essential role in the pathogenesis of RAP through its effect on macrophage polarization. Targeting Rev-erbα might be a promising and prospective therapy method for the prevention and management of RAP.
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Affiliation(s)
- W Song
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China
| | - L Ye
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China
| | - Q Tang
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China
| | - X Lu
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China
| | - X Huang
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China
| | - M Xie
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China
| | - S Yu
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China
| | - Z Yuan
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China
| | - L Chen
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China
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Li J, Gong X, Liu X, Liu X, Szeto K, Chen X. Evaluation of the cardiac safety of parsaclisib, a selective PI3Kδ inhibitor, in patients with previously treated B-cell malignancies: Results from the CITADEL-101 study. Pharmacol Res Perspect 2024; 12:e1165. [PMID: 38407508 PMCID: PMC10895684 DOI: 10.1002/prp2.1165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 02/27/2024] Open
Abstract
Parsaclisib, a potent and selective phosphatidylinositol 3 kinase δ inhibitor, has been investigated for the treatment of B-cell malignancies and studied in patients with autoimmune diseases and myelofibrosis. The CITADEL-101 study (NCT02018861) assessed safety, tolerability, and preliminary efficacy of parsaclisib in patients with relapsed or refractory non-Hodgkin lymphoma. This study evaluated the cardiac safety of parsaclisib as monotherapy based on data from 72 patients enrolled in the CITADEL-101 study. Time-matched pharmacokinetic and ECG measurements were collected at specified times for 69 patients receiving monotherapy in doses of 5, 10, 15, 20, 30, and 45 mg once daily. Based on the categorical outlier analysis, no dose-dependent effect was observed on the incidence of outliers in QT interval corrected for heart rate (HR) by Fridericia's method (QTcF), HR, or cardiac conduction. Based on central tendency analysis, the least square means (LSMs) (90% confidence interval [CI]) of ΔQTcF from the central tendency analysis ranged from -6.83 (-18.8 to 5.19) to 4.75 ms (0.410-9.09) across dose groups (below 20 ms, the threshold of large QT effects) and was not considered dose dependent. Moreover, the LSMs of ΔHR, ΔPR interval, and ΔQRS interval were minor. From the concentration-ΔQTcF analyses, the predicted ΔQTcF (90% CI) for all dose levels was between 0.365 (-1.75 to 2.48) and 7.87 ms (0.921-14.8), with the highest upper limit of CIs well below 20 ms, and therefore, a large QT/QTc effect was ruled out up to the highest dose level (45 mg) investigated. Overall, parsaclisib at the dose ranges studied did not reveal concentration-dependent effects on change in QTcF and did not have a significant effect on HR or cardiac conduction.
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Affiliation(s)
- Jia Li
- Incyte CorporationWilmingtonDelawareUSA
- Present address:
TakedaCambridgeMassachusettsUSA
| | | | - Xing Liu
- Incyte CorporationWilmingtonDelawareUSA
| | - Xiang Liu
- Incyte CorporationWilmingtonDelawareUSA
| | - Ke Szeto
- Incyte CorporationWilmingtonDelawareUSA
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10
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Graziano S, Boldrini F, Pellicano GR, Milo F, Majo F, Cristiani L, Montemitro E, Alghisi F, Bella S, Cutrera R, Fiocchi AG, Quittner A, Tabarini P. Longitudinal Effects of Elexacaftor/Tezacaftor/Ivacaftor: Multidimensional Assessment of Neuropsychological Side Effects and Physical and Mental Health Outcomes in Adolescents and Adults. Chest 2024; 165:800-809. [PMID: 37925143 DOI: 10.1016/j.chest.2023.10.043] [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: 05/04/2023] [Revised: 10/01/2023] [Accepted: 10/20/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND Italy initiated elexacaftor/tezacaftor/ivacaftor (ETI) for people with cystic fibrosis (pwCF) in July 2021. It has led to dramatic improvements in lung function, BMI, sweat chloride, and respiratory symptoms. However, few data are available on side effects or effects on a broad range of outcomes. RESEARCH QUESTION How does ETI affect mental health, cognitive processing, neuropsychological side effects, GI symptoms, and health-related quality of life over time? STUDY DESIGN AND METHODS This was a prospective, "real-world" longitudinal study. Participants were recruited consecutively and evaluated at initiation (T0) and after 1 month, 3 months, and 6 months of starting treatment. Assessments included depression (nine-item Patient Health Questionnaire), anxiety (seven-item Generalized Anxiety Disorder), cognition (Symbol Digit Modalities Test), GI Symptom Tracker, and health-related quality of life (Cystic Fibrosis Questionnaire-Revised). Based on literature, an ad hoc questionnaire was developed to assess side effects: insomnia, headache, memory problems, "brain fog," and concentration problems. Following descriptive analyses, longitudinal data were analyzed by using mixed models for repeated measures, controlling for age and sex when appropriate. RESULTS Ninety-two consecutive pwCF (female/male, 46/46; mean age, 25.4 years) participated. FEV1 increased initially and then remained stable. BMI also increased significantly from T0 to 6 months (P < .01). Depression improved from T0 to 1 month (P < .001); however, no changes in anxiety were found. Cognitive processing improved from T0 to subsequent assessments. Positive changes were reported on the GI Symptom Tracker for stools and adherence challenges, although no changes were found for abdominal pain and digestion. Side effects occurred in 10% to 29%, with no reduction over time; insomnia increased significantly across time. Female participants reported more side effects than male participants (ie, insomnia, headache, concentration problems, brain fog). INTERPRETATION This prospective study evaluated the effects of ETI using multiple measures. Significant improvements were found in many domains; however, side effects were reported by a substantial proportion of pwCF, with no improvements over time. Female participants reported more side effects than male participants. pwCF should be followed up systematically to assess the frequency of side effects after starting this new modulator.
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Affiliation(s)
- Sonia Graziano
- Psychology Unit, Child & Adolescent Psychiatry Unit, Allergy Division, Bambino Gesù Children's Hospital IRCCS, Rome, Italy.
| | - Francesca Boldrini
- Psychology Unit, Child & Adolescent Psychiatry Unit, Allergy Division, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Gaia Romana Pellicano
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University, Rome, Italy
| | - Francesco Milo
- Psychology Unit, Child & Adolescent Psychiatry Unit, Allergy Division, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Fabio Majo
- Pneumology and Cystic Fibrosis Unit, Allergy Division, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Luca Cristiani
- Pneumology and Cystic Fibrosis Unit, Allergy Division, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Enza Montemitro
- Pneumology and Cystic Fibrosis Unit, Allergy Division, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Federico Alghisi
- Pneumology and Cystic Fibrosis Unit, Allergy Division, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Sergio Bella
- Pneumology and Cystic Fibrosis Unit, Allergy Division, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Renato Cutrera
- Pneumology and Cystic Fibrosis Unit, Allergy Division, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Alessandro Giovanni Fiocchi
- Translational Research in Pediatric Specialties Area, Allergy Division, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | | | - Paola Tabarini
- Psychology Unit, Child & Adolescent Psychiatry Unit, Allergy Division, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
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Tartaglia G, Fuentes I, Patel N, Varughese A, Israel LE, Park PH, Alexander MH, Poojan S, Cao Q, Solomon B, Padron ZM, Dyer JA, Mellerio JE, McGrath JA, Palisson F, Salas-Alanis J, Han L, South AP. Antiviral drugs prolong survival in murine recessive dystrophic epidermolysis bullosa. EMBO Mol Med 2024; 16:870-884. [PMID: 38462666 PMCID: PMC11018630 DOI: 10.1038/s44321-024-00048-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 02/16/2024] [Accepted: 02/19/2024] [Indexed: 03/12/2024] Open
Abstract
Recessive dystrophic epidermolysis bullosa (RDEB) is a rare inherited skin disease characterized by defects in type VII collagen leading to a range of fibrotic pathologies resulting from skin fragility, aberrant wound healing, and altered dermal fibroblast physiology. Using a novel in vitro model of fibrosis based on endogenously produced extracellular matrix, we screened an FDA-approved compound library and identified antivirals as a class of drug not previously associated with anti-fibrotic action. Preclinical validation of our lead hit, daclatasvir, in a mouse model of RDEB demonstrated significant improvement in fibrosis as well as overall quality of life with increased survival, weight gain and activity, and a decrease in pruritus-induced hair loss. Immunohistochemical assessment of daclatasvir-treated RDEB mouse skin showed a reduction in fibrotic markers, which was supported by in vitro data demonstrating TGFβ pathway targeting and a reduction of total collagen retained in the extracellular matrix. Our data support the clinical development of antivirals for the treatment of patients with RDEB and potentially other fibrotic diseases.
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Affiliation(s)
- Grace Tartaglia
- Department of Pharmacology, Physiology, and Cancer Biology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Ignacia Fuentes
- DEBRA Chile, Santiago, Chile
- Departamento de Biología Celular y Molecular, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile
- Centro de Genética y Genómica, Facultad de Medicina Clínica Alemana, Universidad de Desarrollo, Santiago, Chile
| | - Neil Patel
- School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, PA, USA
| | - Abigail Varughese
- Department of Pharmacology, Physiology, and Cancer Biology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Lauren E Israel
- Department of Pharmacology, Physiology, and Cancer Biology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Pyung Hun Park
- Department of Pharmacology, Physiology, and Cancer Biology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Michael H Alexander
- Department of Pharmacology, Physiology, and Cancer Biology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Shiv Poojan
- Department of Pharmacology, Physiology, and Cancer Biology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Qingqing Cao
- Department of Pharmacology, Physiology, and Cancer Biology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Brenda Solomon
- Department of Pharmacology, Physiology, and Cancer Biology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Zachary M Padron
- Department of Pharmacology, Physiology, and Cancer Biology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Jonathan A Dyer
- Department of Dermatology, University of Missouri School of Medicine, Columbia, MO, USA
| | - Jemima E Mellerio
- St. John's Institute of Dermatology, King's College London (Guy's Campus), London, UK
| | - John A McGrath
- St. John's Institute of Dermatology, King's College London (Guy's Campus), London, UK
| | - Francis Palisson
- DEBRA Chile, Santiago, Chile
- Servicio de Dermatologia, Facultad de Medicina Clínica Alemana-Universidad de Desarrollo, Santiago, Chile
| | | | - Lin Han
- School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, PA, USA
| | - Andrew P South
- Department of Pharmacology, Physiology, and Cancer Biology, Thomas Jefferson University, Philadelphia, PA, USA.
- The Joan and Joel Rosenbloom Research Center for Fibrotic Diseases, Thomas Jefferson University, Philadelphia, PA, USA.
- Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA.
- Department of Otolaryngology Head and Neck Surgery, Thomas Jefferson University, Philadelphia, PA, USA.
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12
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Wang W, Guo X, Zhang C, Ning T, Ma G, Huang Y, Jia R, Zhou D, Cao M, Zhang T, Yao L, Yuan J, Chen L. Prusogliptin (DBPR108) monotherapy in treatment-naïve patients with type 2 diabetes: A randomized, double-blind, active and placebo-controlled, phase 3 study. Diabetes Obes Metab 2024; 26:1321-1332. [PMID: 38221859 DOI: 10.1111/dom.15433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 12/13/2023] [Accepted: 12/14/2023] [Indexed: 01/16/2024]
Abstract
AIM This study aimed to assess the efficacy and safety of prusogliptin (DBPR108), a novel and highly selective dipeptidyl peptidase-4 inhibitor, in individuals with type 2 diabetes who had not been using glucose-lowering agents regularly for the 8 weeks before the screening period. MATERIALS AND METHODS In this multicentre, randomized, double-blind, phase 3 study, adult patients with type 2 diabetes were randomly assigned to receive either DBPR108 100 mg, sitagliptin 100 mg, or placebo once daily during the initial 24-week double-blind treatment period, followed by a 28-week open-label extension period during which all patients received DBPR108 100 mg once daily. The primary endpoint was the mean change in glycated haemoglobin (HbA1c) levels from baseline to week 24. RESULTS In total, 766 patients were enrolled and received DBPR108 100 mg (n = 462), sitagliptin 100 mg (n = 152), or placebo (n = 152). The mean age of all patients was 54.3 ± 10.5 years, with 58% being men. The median duration of type 2 diabetes was 0.38 (0.02, 2.65) years, and the mean HbA1c (SD) at baseline was 7.94% (0.62), 7.88% (0.61) and 7.83% (0.59) for DBPR108, sitagliptin and placebo groups, respectively. At week 24, the least square mean (SE) changes from baseline in HbA1c were -0.63% (0.04%) for DBPR108, -0.60% (0.07%) for sitagliptin and -0.02% (0.07%) for placebo. The mean treatment difference between DBPR108 and placebo was -0.61% (95% CI -0.77% to -0.44%), and between DBPR108 and sitagliptin was -0.03% (95% CI -0.19% to 0.13%). These results indicate that DBPR108 was superior to placebo and non-inferior to sitagliptin. DBPR108 also significantly reduced fasting and postprandial plasma glucose levels and had little effect on body weight. The mean (SD) changes in HbA1c from baseline to week 52 were -0.50% (0.97%) for the DBPR108 group, -0.46% (0.96%) for the sitagliptin group and -0.41% (0.95%) for the placebo group. The incidence of adverse events was comparable across all three groups. CONCLUSIONS DBPR108 showed superiority to placebo and non-inferiority to sitagliptin in terms of glycaemic control over the initial 24 weeks in treatment-naïve patients with type 2 diabetes. Furthermore, its efficacy was sustained for up to 52 weeks.
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Affiliation(s)
- Wei Wang
- Department of Endocrinology, Peking University First Hospital, Beijing, China
| | - Xiaohui Guo
- Department of Endocrinology, Peking University First Hospital, Beijing, China
| | - Cheng Zhang
- Department of Endocrinology, Chongqing University Three Gorges Hospital, Chongqing, China
| | - Tao Ning
- Department of Endocrinology, Baotou Central Hospital, Baotou, China
| | - Guoqing Ma
- Department of Endocrinology, The Second Affiliated Hospital of Heilongjiang University of Traditional Medicine, Harbin, China
| | - Yanli Huang
- CSPC Zhongqi Pharmaceutical Technology (Shijiazhuang) Co., Ltd., Shijiazhuang, China
| | - Rui Jia
- CSPC Zhongqi Pharmaceutical Technology (Shijiazhuang) Co., Ltd., Shijiazhuang, China
| | - Deai Zhou
- CSPC Zhongqi Pharmaceutical Technology (Shijiazhuang) Co., Ltd., Shijiazhuang, China
| | - Mengya Cao
- CSPC Zhongqi Pharmaceutical Technology (Shijiazhuang) Co., Ltd., Shijiazhuang, China
| | - Tianhao Zhang
- CSPC Zhongqi Pharmaceutical Technology (Shijiazhuang) Co., Ltd., Shijiazhuang, China
| | - Lingli Yao
- CSPC Zhongqi Pharmaceutical Technology (Shijiazhuang) Co., Ltd., Shijiazhuang, China
| | - Jing Yuan
- CSPC Zhongqi Pharmaceutical Technology (Shijiazhuang) Co., Ltd., Shijiazhuang, China
| | - Ling Chen
- CSPC Zhongqi Pharmaceutical Technology (Shijiazhuang) Co., Ltd., Shijiazhuang, China
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Persson M, Vikingsson S, Kronstrand R, Green H. Characterization of neurotransmitter inhibition for seven cathinones by a proprietary fluorescent dye method. Drug Test Anal 2024; 16:339-347. [PMID: 37489044 DOI: 10.1002/dta.3547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 06/28/2023] [Accepted: 07/04/2023] [Indexed: 07/26/2023]
Abstract
Many new psychoactive substances (NPS) are stimulants, and information about their potency and abuse potential is often lacking. To start addressing this need, a method measuring the inhibition of the dopamine, serotonin, and norepinephrine transporters (DAT, SERT, and NET) by stimulant drugs was developed. The use of a proprietary fluorescent dye mixture and three cell lines (CHO-K1, HEK 293, and MDCK), each expressing a single transporter, allowed for a semiautomated, one-pot determination of inhibition in a 384-well format. The method was validated using well characterized stimulants, including cocaine, amphetamine, 3,4-methylenedioxymethamphetamine (MDMA), α-PVP, and fluoxetine and performed similarly to other methods. Seven synthetic cathinones all showed highest potency for DAT inhibition, followed by NET and SERT. The rank potency for DAT inhibition IC50 (nM) was MPHP (4.53) > 4Cl-α-PVP (8.05) > 3F-α-PVP (12.7) > α-PiHP (13.4) > N-ethylpentylone (16.9) > N-ethylhexedrone (44.5) > 4-methylpentedrone (261). All but 4-methylpentedrone were more potent than amphetamine (257) and cocaine (111). The DAT/SERT inhibition ratio for the cathinones was in the range from 5.02 for 4-methylpentedrone to >3730 for α-PiHP, compared to 1.64 for cocaine and >4030 for α-PVP. All seven substances had inhibition profiles similar to those of potent stimulants with high abuse potential.
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Affiliation(s)
- Mattias Persson
- Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, Linköping, Sweden
| | - Svante Vikingsson
- Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, Linköping, Sweden
- Division of Clinical Chemistry and Pharmacology, Department of Biomedical and Clinical Sciences, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden
- Center for Forensic Science Advancement and Application, RTI International, Research Triangle Park, North Carolina, USA
| | - Robert Kronstrand
- Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, Linköping, Sweden
- Division of Clinical Chemistry and Pharmacology, Department of Biomedical and Clinical Sciences, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden
| | - Henrik Green
- Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, Linköping, Sweden
- Division of Clinical Chemistry and Pharmacology, Department of Biomedical and Clinical Sciences, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden
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Godier E, Kazour F, Gal DL, Gohier B. A Case of Elexacaftor/Tezacaftor/Ivacaftor-Induced Depressive Symptoms and Suicidal Thoughts. Prim Care Companion CNS Disord 2024; 26:23cr03649. [PMID: 38579254 DOI: 10.4088/pcc.23cr03649] [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] [Subscribe] [Scholar Register] [Indexed: 04/07/2024] Open
Affiliation(s)
- Edouard Godier
- Adult Psychiatry and Addictology Unit, Angers University Hospital (CHU Angers), France
- Corresponding author: Edouard Godier, MD, CHU Angers - 4 rue Larrey 49100, Angers, France
| | - François Kazour
- Adult Psychiatry and Addictology Unit, Angers University Hospital (CHU Angers), France
| | - Dewi Le Gal
- Adult Psychiatry and Addictology Unit, Angers University Hospital (CHU Angers), France
| | - Bénédicte Gohier
- Adult Psychiatry and Addictology Unit, Angers University Hospital (CHU Angers), France
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15
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Yacoub A, Borate U, Rampal RK, Ali H, Wang ES, Gerds AT, Hobbs G, Kremyanskaya M, Winton E, O'Connell C, Goel S, Oh ST, Schiller G, McCloskey J, Palmer J, Holmes H, Hager S, Assad A, Erickson-Viitanen S, Zhou F, Daver N. Phase 2 study of add-on parsaclisib for patients with myelofibrosis and suboptimal response to ruxolitinib: final results. Blood Adv 2024; 8:1515-1528. [PMID: 38290135 DOI: 10.1182/bloodadvances.2023011620] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 01/12/2024] [Accepted: 01/12/2024] [Indexed: 02/01/2024] Open
Abstract
ABSTRACT Ruxolitinib reduces spleen volume, improves symptoms, and increases survival in patients with intermediate- or high-risk myelofibrosis. However, suboptimal response may occur, potentially because of signaling via the phosphoinositide 3-kinase (PI3K)/protein kinase B pathway. This phase 2 study evaluated dosing, efficacy, and safety of add-on PI3Kδ inhibitor parsaclisib for patients with primary or secondary myelofibrosis with suboptimal response to ruxolitinib. Eligible patients remained on a stable ruxolitinib dose and received add-on parsaclisib 10 or 20 mg, once daily for 8 weeks, and once weekly thereafter (daily-to-weekly dosing; n = 32); or parsaclisib 5 or 20 mg, once daily for 8 weeks, then 5 mg once daily thereafter (all-daily dosing; n = 42). Proportion of patients achieving a ≥10% decrease in spleen volume at 12 weeks was 28% for daily-to-weekly dosing and 59.5% for all-daily dosing. Proportions of patients achieving ≥50% decrease at week 12 in Myelofibrosis Symptom Assessment Form and Myeloproliferative Neoplasms Symptom Assessment Form symptom scores were 14% and 18% for daily-to-weekly dosing, and 28% and 32% for all-daily dosing, respectively. Most common nonhematologic treatment-emergent adverse events were nausea (23%), diarrhea (22%), abdominal pain and fatigue (each 19%), and cough and dyspnea (each 18%). New-onset grade 3 and 4 thrombocytopenia were observed in 19% of patients, each dosed daily-to-weekly, and in 26% and 7% of patients dosed all-daily, respectively, managed with dose interruptions. Hemoglobin levels remained steady. The addition of parsaclisib to stable-dose ruxolitinib can reduce splenomegaly and improve symptoms, with manageable toxicity in patients with myelofibrosis with suboptimal response to ruxolitinib. This trial was registered at www.clinicaltrials.gov as #NCT02718300.
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Affiliation(s)
- Abdulraheem Yacoub
- Department of Internal Medicine, University of Kansas Cancer Center, Westwood, KS
| | - Uma Borate
- Department of Medicine, Oregon Health & Science University, Portland, OR
| | - Raajit K Rampal
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Haris Ali
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| | - Eunice S Wang
- Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | - Aaron T Gerds
- Department of Hematology and Medical Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH
| | - Gabriela Hobbs
- Department of Medicine, Massachusetts General Hospital, Boston, MA
| | - Marina Kremyanskaya
- Department of Hematology/Oncology, Icahn School of Medicine at Mount Sinai, Manhattan, NY
| | - Elliott Winton
- Department of Hematology Oncology, Emory University, Atlanta, GA
| | - Casey O'Connell
- Jane Anne Nohl Division of Hematology, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Swati Goel
- Department of Medical Oncology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY
| | - Stephen T Oh
- Department of Medicine, Washington University School of Medicine, St. Louis, MO
| | - Gary Schiller
- Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - James McCloskey
- Department of Leukemia, John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, NJ
| | - Jeanne Palmer
- Division of Hematology/Medical Oncology, Mayo Clinic Hospital, Phoenix, AZ
| | - Houston Holmes
- Hematology and Medical Oncology, Texas Oncology/Baylor-Sammons Cancer Center, Dallas, TX
| | - Steven Hager
- C CARE, California Cancer Associates for Research & Excellence, Inc, Fresno, CA
| | - Albert Assad
- Oncology Drug Development, Incyte Corporation, Wilmington, DE
| | | | - Feng Zhou
- Biostatistics, Incyte Corporation, Wilmington, DE
| | - Naval Daver
- Leukemia Department, University of Texas MD Anderson Cancer Center, Houston, TX
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16
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Shin HD, Song IH, Lee SH, Kim HS, Lee TH, Eun HS, Kim SH, Lee BS, Chae HB, Kim SH, Song MJ, Ko SY, Kim SB. Comparison of Glecaprevir/Pibrentasvir and Sofosbuvir/Ledipasvir in Patients with Hepatitis C Virus Genotype 1 and 2 in South Korea. Korean J Gastroenterol 2024; 83:111-118. [PMID: 38522854 DOI: 10.4166/kjg.2023.141] [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] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 01/15/2024] [Accepted: 02/04/2024] [Indexed: 03/26/2024]
Abstract
Background/Aims This study compared the effectiveness and safety of glecaprevir/pibrentasvir (GLE/PIB) and sofosbuvir/ledipasvir (SOF/LDV) in real-life clinical practice. Methods The data from genotype 1 or 2 chronic hepatitis C patients treated with GLE/PIB or sofosbuvir + ribavirin or SOF/LDV in South Korea were collected retrospectively. The analysis included the treatment completion rate, sustained virologic response at 12 weeks (SVR12) test rate, treatment effectiveness, and adverse events. Results Seven hundred and eighty-two patients with genotype 1 or 2 chronic hepatitis C who were treated with GLE/PIB (n=575) or SOF/LDV (n=207) were included in this retrospective study. The baseline demographic and clinical characteristics revealed significant statistical differences in age, genotype, ascites, liver cirrhosis, and hepatocellular carcinoma between the GLE/PIB and SOF/LDV groups. Twenty-two patients did not complete the treatment protocol. The treatment completion rate was high for both regimens without statistical significance (97.7% vs. 95.7%, p=0.08). The overall SVR12 of intention-to-treat analysis was 81.2% vs. 80.7% without statistical significance (p=0.87). The overall SVR12 of per protocol analysis was 98.7% vs. 100% without statistical significance (p=0.14). Six patients treated with GLE/PIB experienced treatment failure. They were all male, genotype 2, and showed a negative hepatitis C virus RNA level at the end of treatment. Two patients treated with GLE/PIB stopped medication because of fever and abdominal discomfort. Conclusions Both regimens had similar treatment completion rates, effectiveness, and safety profiles. Therefore, the SOF/LDV regimen can also be considered a viable DAA for the treatment of patients with genotype 1 or 2 chronic hepatitis C.
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Affiliation(s)
- Hyun Deok Shin
- Department of Gastroenterology, Dankook University College of Medicine, Cheonan, Korea
| | - Il Han Song
- Department of Gastroenterology, Dankook University College of Medicine, Cheonan, Korea
| | - Sae Hwan Lee
- Department of Gastroenterology, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Hong Soo Kim
- Department of Gastroenterology, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Tae Hee Lee
- Department of Gastroenterology, Konyang University College of Medicine, Daejeon, Korea
| | - Hyuk Soo Eun
- Department of Gastroenterology, Chungnam University College of Medicine, Daejeon, Korea
| | - Seok Hyun Kim
- Department of Gastroenterology, Chungnam University College of Medicine, Daejeon, Korea
| | - Byung Seok Lee
- Department of Gastroenterology, Chungnam University College of Medicine, Daejeon, Korea
| | - Hee Bok Chae
- Department of Gastroenterology, Chungbuk University College of Medicine, Cheongju, Korea
| | - Seok Hwan Kim
- Department of Gastroenterology, College of Medicine, The Catholic University of Korea, Daejeon, Korea
| | - Myung Joon Song
- Department of Gastroenterology, College of Medicine, The Catholic University of Korea, Daejeon, Korea
| | - Soon Yeong Ko
- Department of Gastroenterology, Konkuk University College of Medicine, Chungju, Korea
| | - Suk Bae Kim
- Department of Gastroenterology, Dankook University College of Medicine, Cheonan, Korea
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17
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Lou Y, Cheng M, Cao Q, Li K, Qin H, Bao M, Zhang Y, Lin S, Zhang Y. Simultaneous quantification of mirabegron and vibegron in human plasma by HPLC-MS/MS and its application in the clinical determination in patients with tumors associated with overactive bladder. J Pharm Biomed Anal 2024; 240:115937. [PMID: 38198885 DOI: 10.1016/j.jpba.2023.115937] [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: 10/18/2023] [Revised: 12/01/2023] [Accepted: 12/22/2023] [Indexed: 01/12/2024]
Abstract
Mirabegron and vibegron, both newly identified beta-3 adrenergic agonists, have significantly improved the quality of life for patients suffering from overactive bladder. In order to comprehensively assess the plasma exposure levels of these agents, the development of a rapid and highly sensitive bioanalytical method becomes imperative. The primary objective of this study was to establish a robust high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) method for the concurrent quantification of mirabegron and vibegron in human plasma. The analytes were extracted from a 100 μL plasma sample through protein precipitation, employing 300 μL of methanol. Subsequently, samples underwent separation and quantification using a Waters XBridge C18 column (2.1 × 100 mm, 3.5 µm), with a mobile phase consisting of 0.1% formic acid in water and 0.1% formic acid in acetonitrile. The mass analysis was conducted using positive electrospray ionization (ESI+) operated in a multiple reaction monitoring (MRM) mode. The proposed method was meticulously validated in accordance with the guidelines set forth by the U.S. Food and Drug Administration (FDA) for bioanalytical method validation. The regression equations demonstrated exceptional linearity for both mirabegron (r² ≥ 0.994) and vibegron (r² ≥ 0.996) across the concentration range of 0.5 - 200 ng/mL. Furthermore, the assay exhibited accuracy (inter-day relative error ≤ 6.90%) and precision (inter-day coefficient of variation ≤ 8.88%). The average recoveries of the analytes were found to range from 81.94% to 102.02%, with mean matrix effects falling within the range of 89.77% to 110.58%. As a result, this method was deemed highly suitable for the precise determination of the concentrations of both mirabegron and vibegron in the context of therapeutic drug monitoring and bioequivalence studies.
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Affiliation(s)
- Yutao Lou
- Clinical Pharmacy Center, Department of Pharmacy, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou 310014, China
| | - Mengting Cheng
- Clinical Pharmacy Center, Department of Pharmacy, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou 310014, China
| | - Qin Cao
- Graduate Training Base (Ningbo), Wenzhou Medical University, Ningbo 315300, China
| | - Kening Li
- Clinical Pharmacy Center, Department of Pharmacy, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou 310014, China
| | - Hui Qin
- Clinical Pharmacy Center, Department of Pharmacy, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou 310014, China
| | - Meihua Bao
- Hunan key laboratory of the research and development of novel pharmaceutical preparations, School of Pharmaceutical Science, Changsha Medical University, Changsha 410219, China
| | - Yuan Zhang
- Zhejiang Provincial People' s Hospital Bijie Hospital, Bijie, 551799, China
| | - Sisi Lin
- Clinical Pharmacy Center, Department of Pharmacy, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou 310014, China.
| | - Yiwen Zhang
- Clinical Pharmacy Center, Department of Pharmacy, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou 310014, China; Key Laboratory of Endocrine Gland Diseases of Zhejiang Province, Hangzhou 310014, China; Zhejiang Provincial Clinical Research Center for malignant tumor, Hangzhou 310014, China.
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18
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Ferreira FC, Amaral MD, Bacalhau M, Lopes-Pacheco M. PTI-801 (posenacaftor) shares a common mechanism with VX-445 (elexacaftor) to rescue p.Phe508del-CFTR. Eur J Pharmacol 2024; 967:176390. [PMID: 38336013 DOI: 10.1016/j.ejphar.2024.176390] [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: 08/22/2023] [Revised: 01/05/2024] [Accepted: 02/01/2024] [Indexed: 02/12/2024]
Abstract
The deletion of a phenylalanine at position 508 (p.Phe508del) in the CFTR anion channel is the most prevalent variant in people with Cystic Fibrosis (CF). This variant impairs folding and stability of the CF transmembrane conductance regulator (CFTR) protein, resulting in its defective trafficking and premature degradation. Over the last years, therapeutic accomplishments have been attained in developing small molecules that partially correct p.Phe508del-CFTR defects; however, the mechanism of action (MoA) of these compounds has only started to be uncovered. In this study, we employed biochemical, fluorescence microscopy, and functional assays to examine the efficacy and properties of PTI-801, a newly developed p.Phe508del-CFTR corrector. To exploit its MoA, we assessed PTI-801 effects in combination with low temperature, genetic revertants of p.Phe508del-CFTR (the in cis p.Val510Asp, p.Gly550Glu, p.Arg1070Trp, and 4RK) and other correctors. Our results demonstrated that PTI-801 rescues p.Phe508del-CFTR processing, PM trafficking, and channel function (upon agonist stimulation) with greater correction effects in combination with ABBV-2222, FDL-169, VX-661, or VX-809, but not with VX-445. Although PTI-801 exhibited no potentiator activity on low temperature- and corrector-rescued p.Phe508del-CFTR, this compound displayed similar behavior to that of VX-445 on genetic revertants. Such evidence associated with the lack of additivity when PTI-801 and VX-445 were combined indicates that they share a common binding site to correct p.Phe508del-CFTR defects. Despite the high efficacy of PTI-801 in combination with ABBV-2222, FDL-169, VX-661, or VX-809, these dual corrector combinations only partially restored p.Phe508del-CFTR conformational stability, as shown by the lower half-life of the mutant protein compared to that of WT-CFTR. In summary, PTI-801 likely shares a common MoA with VX-445 in rescuing p.Phe508del-CFTR, thus being a feasible alternative for the development of novel corrector combinations with greater capacity to rescue mutant CFTR folding and stability.
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Affiliation(s)
- Filipa C Ferreira
- Biosystems & Integrative Sciences Institute (BioISI), Faculty of Sciences, University of Lisbon, 1749-016, Lisbon, Portugal
| | - Margarida D Amaral
- Biosystems & Integrative Sciences Institute (BioISI), Faculty of Sciences, University of Lisbon, 1749-016, Lisbon, Portugal
| | - Mafalda Bacalhau
- Biosystems & Integrative Sciences Institute (BioISI), Faculty of Sciences, University of Lisbon, 1749-016, Lisbon, Portugal
| | - Miquéias Lopes-Pacheco
- Biosystems & Integrative Sciences Institute (BioISI), Faculty of Sciences, University of Lisbon, 1749-016, Lisbon, Portugal.
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19
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Kurumiya E, Iwata M, Kasuya Y, Tatsumi K, Honda T, Murayama T, Nakamura H. Eliglustat exerts anti-fibrotic effects by activating SREBP2 in TGF-β1-treated myofibroblasts derived from patients with idiopathic pulmonary fibrosis. Eur J Pharmacol 2024; 966:176366. [PMID: 38296153 DOI: 10.1016/j.ejphar.2024.176366] [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: 09/08/2023] [Revised: 12/29/2023] [Accepted: 01/29/2024] [Indexed: 02/05/2024]
Abstract
Idiopathic pulmonary fibrosis (IPF) is a progressive chronic lung disease. Myofibroblasts play a critical role in fibrosis. These cells produce the extracellular matrix (ECM), which contributes to tissue regeneration; however, excess ECM production can cause fibrosis. Transforming growth factor-β (TGF-β)/Smad signaling induces ECM production by myofibroblasts; therefore, the inhibition of TGF-β/Smad signaling may be an effective strategy for IPF treatment. We recently reported that miglustat, an inhibitor of glucosylceramide synthase (GCS), ameliorates pulmonary fibrosis by inhibiting the nuclear translocation of Smad2/3. In the present study, we examined the anti-fibrotic effects of another GCS inhibitor, eliglustat, a clinically approved drug for treating Gaucher disease type 1, in myofibroblasts derived from patient with IPF (IPF-MyoFs). We found that eliglustat exerted anti-fibrotic effects independent of GCS inhibition, and inhibited TGF-β1-induced expression of α-smooth muscle actin, a marker of fibrosis, without suppressing the phosphorylation and nuclear translocation of Smad2/3. RNA sequencing analysis of eliglustat-treated human lung fibroblasts identified sterol regulatory element-binding protein 2 (SREBP2) activation. Transient overexpression of SREBP2 attenuated the TGF-β1-induced increase in the expression of Smad target genes in IPF-MyoFs, and SREBP2 knockdown nullified the inhibitory effect of eliglustat on TGF-β1-induced expression of α-SMA. These results suggested that eliglustat exerts its anti-fibrotic effects through SREBP2 activation. The findings of this study may contribute to the development of novel therapeutic strategies for IPF treatment.
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Affiliation(s)
- Eon Kurumiya
- Laboratory of Chemical Pharmacology, Graduate School of Pharmaceutical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8675, Japan
| | - Mayuu Iwata
- Laboratory of Chemical Pharmacology, Graduate School of Pharmaceutical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8675, Japan
| | - Yoshitoshi Kasuya
- Deprtment of Biomedical Science, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan; Department of Biochemistry and Molecular Pharmacology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - Koichiro Tatsumi
- Department of Respirology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - Takuya Honda
- Laboratory of Chemical Pharmacology, Graduate School of Pharmaceutical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8675, Japan
| | - Toshihiko Murayama
- Laboratory of Chemical Pharmacology, Graduate School of Pharmaceutical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8675, Japan
| | - Hiroyuki Nakamura
- Laboratory of Chemical Pharmacology, Graduate School of Pharmaceutical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8675, Japan.
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20
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Kito Y, Kawakami H, Mitani S, Nishina S, Matsumoto T, Tsuzuki T, Shinohara Y, Shimokawa H, Kumanishi R, Ohta T, Katsuya H, Kawakami T, Nishina T, Hasegawa H, Akiyoshi K, Chiba Y, Yamazaki K, Hironaka S, Muro K. Trifluridine/Tipiracil Plus Bevacizumab for Vulnerable Patients With Pretreated Metastatic Colorectal Cancer: A Retrospective Study (WJOG14520G). Oncologist 2024; 29:e330-e336. [PMID: 37950903 PMCID: PMC10911898 DOI: 10.1093/oncolo/oyad296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 10/19/2023] [Indexed: 11/13/2023] Open
Abstract
BACKGROUND Trifluridine/tipiracil (FTD/TPI) plus bevacizumab has shown clinical benefit for metastatic colorectal cancer (mCRC) refractory to standard therapy. However, few data have been available for patients with pretreated mCRC who are intolerant of intensive therapy (vulnerable). METHODS We performed a multicenter retrospective study (WJOG14520G; TWILIGHT) of FTD/TPI plus bevacizumab for vulnerable patients with pretreated mCRC. Eligibility criteria included previous chemotherapy (although patients treated with all key cytotoxic agents, a fluoropyrimidine, oxaliplatin, and irinotecan, were excluded) and intolerance of full-dose combination therapy with oxaliplatin or irinotecan at the start of FTD/TPI plus bevacizumab. RESULTS The median age of 93 evaluable patients was 79 years (range, 21-90). Intolerance of intensive therapy was attributable to an older age in 60 (65%) patients, serious concomitant disease in 24 (26%) patients, and a poor performance status in 19 (20%) patients. FTD/TPI plus bevacizumab was administered as second-line treatment in 74 (80%) patients and as third- or fourth-line treatment in 19 (20%) patients. The objective response rate was 4.9% (95% confidence interval [CI], 1.4%-12.2%), and the disease control rate was 67.9% (95% CI, 56.6%-77.8%). With a median follow-up time of 21.6 months, median overall survival and progression-free survival were 18.6 months (95% CI, 12.1-23.2) and 6.3 months (95% CI, 5.0-8.3), respectively. Neutropenia of grade ≥3 developed in 50 (54%) patients, whereas 2 (2%) patients experienced febrile neutropenia, and no treatment-related death was observed. CONCLUSION Our data show the potential efficacy and acceptable safety profile of FTD/TPI plus bevacizumab for vulnerable patients with pretreated mCRC.
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Affiliation(s)
- Yosuke Kito
- Department of Medical Oncology, Ishikawa Prefectural Central Hospital, Ishikawa, Japan
| | - Hisato Kawakami
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Seiichiro Mitani
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Shinichi Nishina
- Department of Medical Oncology, Kurashiki Central Hospital, Okayama, Japan
| | - Toshihiko Matsumoto
- Department of Medical Oncology, Kobe City Medical Center General Hospital, Hyogo, Japan
| | - Takao Tsuzuki
- Department of Internal Medicine, Japanese Red Cross Society Himeji Hospital, Hyogo, Japan
| | - Yudai Shinohara
- Department of Hematology/Oncology, Japan Community Healthcare Organization Kyushu Hospital, Fukuoka, Japan
| | - Hozumi Shimokawa
- Department of Hematology/Oncology, Japan Community Healthcare Organization Kyushu Hospital, Fukuoka, Japan
| | - Ryosuke Kumanishi
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Aichi, Japan
| | - Takashi Ohta
- Department of Clinical Oncology, Kansai Rosai Hospital, Hyogo, Japan
| | - Hiroo Katsuya
- Division of Hematology, Respiratory Medicine, and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Takeshi Kawakami
- Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Tomohiro Nishina
- Department of Gastrointestinal Medical Oncology, National Hospital Organization Shikoku Cancer Center, Ehime, Japan
| | - Hiroko Hasegawa
- Department of Gastroenterology and Hepatology, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Kohei Akiyoshi
- Department of Medical Oncology, Osaka City General Hospital, Osaka, Japan
| | - Yasutaka Chiba
- Clinical Research Center, Kindai University Hospital, Osaka, Japan
| | - Kentaro Yamazaki
- Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Shuichi Hironaka
- Department of Medical Oncology, Kyorin University Faculty of Medicine, Tokyo, Japan
| | - Kei Muro
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Aichi, Japan
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21
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Abed A, Greene MK, Alsa’d AA, Lees A, Hindley A, Longley DB, McDade SS, Scott CJ. Nanoencapsulation of MDM2 Inhibitor RG7388 and Class-I HDAC Inhibitor Entinostat Enhances their Therapeutic Potential Through Synergistic Antitumor Effects and Reduction of Systemic Toxicity. Mol Pharm 2024; 21:1246-1255. [PMID: 38334409 PMCID: PMC10915795 DOI: 10.1021/acs.molpharmaceut.3c00926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 01/24/2024] [Accepted: 01/24/2024] [Indexed: 02/10/2024]
Abstract
Inhibitors of the p53-MDM2 interaction such as RG7388 have been developed to exploit latent tumor suppressive properties in p53 in 50% of tumors in which p53 is wild-type. However, these agents for the most part activate cell cycle arrest rather than death, and high doses in patients elicit on-target dose-limiting neutropenia. Recent work from our group indicates that combination of p53-MDM2 inhibitors with the class-I HDAC inhibitor Entinostat (which itself has dose-limiting toxicity issues) has the potential to significantly augment cell death in p53 wild-type colorectal cancer cells. We investigated whether coencapsulation of RG7388 and Entinostat within polymeric nanoparticles (NPs) could overcome efficacy and toxicity limitations of this drug combination. Combinations of RG7388 and Entinostat across a range of different molar ratios resulted in synergistic increases in cell death when delivered in both free drug and nanoencapsulated formats in all colorectal cell lines tested. Importantly, we also explored the in vivo impact of the drug combination on murine blood leukocytes, showing that the leukopenia induced by the free drugs could be significantly mitigated by nanoencapsulation. Taken together, this study demonstrates that formulating these agents within a single nanoparticle delivery platform may provide clinical utility beyond use as nonencapsulated agents.
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Affiliation(s)
- Anas Abed
- The
Patrick G Johnston Centre for Cancer Research, School of Medicine,
Dentistry and Biomedical Sciences, Queen’s
University Belfast, 97 Lisburn Road, Belfast BT9 7AE, United Kingdom
- Pharmacological
and Diagnostic Research Centre, Faculty of Pharmacy, Al-Ahliyya Amman University, Amman 19111, Jordan
| | - Michelle K. Greene
- The
Patrick G Johnston Centre for Cancer Research, School of Medicine,
Dentistry and Biomedical Sciences, Queen’s
University Belfast, 97 Lisburn Road, Belfast BT9 7AE, United Kingdom
| | - Alhareth A. Alsa’d
- Pharmacological
and Diagnostic Research Centre, Faculty of Pharmacy, Al-Ahliyya Amman University, Amman 19111, Jordan
- School
of Pharmacy, Queen’s University Belfast, 97 Lisburn Road, Belfast BT9 7BL, United Kingdom
| | - Andrea Lees
- The
Patrick G Johnston Centre for Cancer Research, School of Medicine,
Dentistry and Biomedical Sciences, Queen’s
University Belfast, 97 Lisburn Road, Belfast BT9 7AE, United Kingdom
| | - Andrew Hindley
- Clinical
Haematology, Belfast City Hospital, 97 Lisburn Road, Belfast, BT9 7AB, United Kingdom
| | - Daniel B Longley
- The
Patrick G Johnston Centre for Cancer Research, School of Medicine,
Dentistry and Biomedical Sciences, Queen’s
University Belfast, 97 Lisburn Road, Belfast BT9 7AE, United Kingdom
| | - Simon S McDade
- The
Patrick G Johnston Centre for Cancer Research, School of Medicine,
Dentistry and Biomedical Sciences, Queen’s
University Belfast, 97 Lisburn Road, Belfast BT9 7AE, United Kingdom
| | - Christopher J. Scott
- The
Patrick G Johnston Centre for Cancer Research, School of Medicine,
Dentistry and Biomedical Sciences, Queen’s
University Belfast, 97 Lisburn Road, Belfast BT9 7AE, United Kingdom
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22
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Wada N, Mizunaga M, Abe N, Miyauchi K, Kobayashi S, Ohtani M, Tsunekawa R, Nagabuchi M, Morishita S, Ohyama T, Yamaguchi S, Iuchi H, Noda T, Saga Y, Motoya T, Kawakami N, Nishihara M, Numata A, Kakizaki H. Comparison of mirabegron and vibegron for clinical efficacy and safety in female patients with overactive bladder: a multicenter prospective randomized crossover trial. World J Urol 2024; 42:113. [PMID: 38431689 DOI: 10.1007/s00345-024-04799-4] [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: 07/12/2023] [Accepted: 01/16/2024] [Indexed: 03/05/2024] Open
Abstract
PURPOSE To compare the efficacy and safety of mirabegron and vibegron in female OAB patients. METHODS We conducted a multicenter, prospective, randomized crossover study of female patients with OAB. The patients were assigned to Group MV (mirabegron for 8 weeks, followed by vibegron for 8 weeks) or group VM (vibegron for 8 weeks, followed by mirabegron for 8 weeks). The primary endpoint was the change in OABSS from baseline, and the secondary endpoint was the change in FVC parameters. After completion of the study, each patient was asked which drug was preferable. RESULTS A total of 83 patients were enrolled (40 and 43 in groups MV and VM, respectively). At 8th and 16th week, 33 and 29 in Group MV and 34 and 27 in Group VM continued to receive the treatment. The change in PVR was not significantly different between treatment with mirabegron and vibegron. The changes in OABSS, nighttime frequency, mean, and maximum voided volume were similar between mirabegron and vibegron. The mean change in the daytime frequency was greater in the vibegron than in the mirabegron. Of the 56 patients, 15 (27%) and 30 (53%) preferred mirabegron and vibegron, respectively. The remaining 11 patients (20%) showed no preference. The change in the urgency incontinence score during vibegron was better in patients who preferred vibegron to mirabegron. CONCLUSION The efficacies of mirabegron and vibegron in female patients was similar. The patients' preference for vibegron could depend on the efficacy of vibegron for urgency incontinence.
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Affiliation(s)
- Naoki Wada
- Department of Renal and Urologic Surgery, Asahikawa Medical University, 2-1-1-1 Midorigaoka Higashi, Asahikawa, 078-8510, Japan.
| | | | - Noriyuki Abe
- Department of Renal and Urologic Surgery, Asahikawa Medical University, 2-1-1-1 Midorigaoka Higashi, Asahikawa, 078-8510, Japan
| | - Kotona Miyauchi
- Department of Renal and Urologic Surgery, Asahikawa Medical University, 2-1-1-1 Midorigaoka Higashi, Asahikawa, 078-8510, Japan
| | - Shin Kobayashi
- Department of Renal and Urologic Surgery, Asahikawa Medical University, 2-1-1-1 Midorigaoka Higashi, Asahikawa, 078-8510, Japan
| | - Miyu Ohtani
- Department of Renal and Urologic Surgery, Asahikawa Medical University, 2-1-1-1 Midorigaoka Higashi, Asahikawa, 078-8510, Japan
| | - Ryoken Tsunekawa
- Department of Renal and Urologic Surgery, Asahikawa Medical University, 2-1-1-1 Midorigaoka Higashi, Asahikawa, 078-8510, Japan
| | - Masaya Nagabuchi
- Department of Renal and Urologic Surgery, Asahikawa Medical University, 2-1-1-1 Midorigaoka Higashi, Asahikawa, 078-8510, Japan
| | - Shun Morishita
- Department of Renal and Urologic Surgery, Asahikawa Medical University, 2-1-1-1 Midorigaoka Higashi, Asahikawa, 078-8510, Japan
| | - Teppei Ohyama
- Department of Urology, Kitasaito Hospital, Asahikawa, Japan
| | | | - Hiromichi Iuchi
- Department of Urology, Hokushinkai Megumino Hospital, Eniwa, Japan
| | - Tsuyoshi Noda
- Department of Urology, Fukagawa City Hospital, Fukagawa, Japan
| | - Yuji Saga
- Department of Urology, Fukagawa City Hospital, Fukagawa, Japan
| | - Tadasu Motoya
- Department of Urology, Asahikawa Rehabilitation Hospital, Asahikawa, Japan
| | - Norihiro Kawakami
- Department of Urology, Asahikawa Rehabilitation Hospital, Asahikawa, Japan
| | | | - Atsushi Numata
- Department of Urology, Furano Kyokai Hospital, Furano, Japan
| | - Hidehiro Kakizaki
- Department of Renal and Urologic Surgery, Asahikawa Medical University, 2-1-1-1 Midorigaoka Higashi, Asahikawa, 078-8510, Japan
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23
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Sudhadevi T, Ackerman SJ, Jafri A, Basa P, Ha AW, Natarajan V, Harijith A. Sphingosine kinase 1-specific inhibitor PF543 reduces goblet cell metaplasia of bronchial epithelium in an acute asthma model. Am J Physiol Lung Cell Mol Physiol 2024; 326:L377-L392. [PMID: 38290992 DOI: 10.1152/ajplung.00269.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 01/16/2024] [Accepted: 01/21/2024] [Indexed: 02/01/2024] Open
Abstract
Sphingosine kinase 1 (SPHK1) has been shown to play a key role in the pathogenesis of asthma where SPHK1-generated sphingosine-1-phosphate (S1P) is known to mediate innate and adaptive immunity while promoting mast cell degranulation. Goblet cell metaplasia (GCM) contributes to airway obstruction in asthma and has been demonstrated in animal models. We investigated the role of PF543, a SPHK1-specific inhibitor, in preventing the pathogenesis of GCM using a murine (C57BL/6) model of allergen-induced acute asthma. Treatment with PF543 before triple allergen exposure (DRA: House dust mite, Ragweed pollen, and Aspergillus) reduced inflammation, eosinophilic response, and GCM followed by reduced airway hyperreactivity to intravenous methacholine. Furthermore, DRA exposure was associated with increased expression of SPHK1 in the airway epithelium which was reduced by PF543. DRA-induced reduction of acetylated α-tubulin in airway epithelium was associated with an increased expression of NOTCH2 and SPDEF which was prevented by PF543. In vitro studies using human primary airway epithelial cells showed that inhibition of SPHK1 using PF543 prevented an allergen-induced increase of both NOTCH2 and SPDEF. siRNA silencing of SPHK1 prevented the allergen-induced increase of both NOTCH2 and SPDEF. NOTCH2 silencing was associated with a reduction of SPDEF but not that of SPHK1 upon allergen exposure. Our studies demonstrate that inhibition of SPHK1 protected allergen-challenged airways by preventing GCM and airway hyperreactivity, associated with downregulation of the NOTCH2-SPDEF signaling pathway. This suggests a potential novel link between SPHK1, GCM, and airway remodeling in asthma.NEW & NOTEWORTHY The role of SPHK1-specific inhibitor, PF543, in preventing goblet cell metaplasia (GCM) and airway hyperreactivity (AHR) is established in an allergen-induced mouse model. This protection was associated with the downregulation of NOTCH2-SPDEF signaling pathway, suggesting a novel link between SPHK1, GCM, and AHR.
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Affiliation(s)
- Tara Sudhadevi
- Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio, United States
| | - Steven J Ackerman
- Department of Biochemistry and Molecular Genetics, University of Illinois at Chicago, Chicago, Illinois, United States
| | - Anjum Jafri
- Department of Genetics and Genome Sciences, School of Medicine, Case Western Reserve University, Cleveland, Ohio, United States
| | - Prathima Basa
- Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio, United States
| | - Alison W Ha
- Department of Biochemistry and Molecular Genetics, University of Illinois at Chicago, Chicago, Illinois, United States
| | - Viswanathan Natarajan
- Department of Pharmacology and Regenerative Medicine, University of Illinois at Chicago, Chicago, Illinois, United States
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, United States
| | - Anantha Harijith
- Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio, United States
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24
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Pham H, Vandeleur M, Ranganathan S. Neuropsychiatric symptoms with elexacaftor/tezacaftor/ivacaftor: What does this mean for children? Pediatr Pulmonol 2024; 59:537-539. [PMID: 37991124 DOI: 10.1002/ppul.26762] [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] [Received: 07/24/2023] [Revised: 10/22/2023] [Accepted: 11/06/2023] [Indexed: 11/23/2023]
Affiliation(s)
- Hiep Pham
- Respiratory and Sleep Medicine, The Royal Children's Hospital, Parkville, Victoria, Australia
- Respiratory Diseases, Murdoch Research Children's Institute, Royal Children's Hospital, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Moya Vandeleur
- Respiratory and Sleep Medicine, The Royal Children's Hospital, Parkville, Victoria, Australia
| | - Sarath Ranganathan
- Respiratory and Sleep Medicine, The Royal Children's Hospital, Parkville, Victoria, Australia
- Respiratory Diseases, Murdoch Research Children's Institute, Royal Children's Hospital, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
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25
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Hara S, Sakai D, Ikemura K, Shintani T, Yamamoto T, Satoh T, Okuda M. Comparative Efficacy and Safety of Standard and Biweekly Trifluridine/Tipiracil Regimen in Patients With Colorectal Cancer. Anticancer Res 2024; 44:1219-1226. [PMID: 38423630 DOI: 10.21873/anticanres.16917] [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: 10/24/2023] [Revised: 12/04/2023] [Accepted: 12/08/2023] [Indexed: 03/02/2024]
Abstract
BACKGROUND/AIM Trifluridine/tipiracil (FTD/TPI) is used to treat metastatic colorectal cancer (mCRC). Since the standard regimen of FTD/TPI features a complex dosing schedule and frequently results in severe hematological toxicities, a simplified regimen has emerged, in which FTD/TPI is orally administered biweekly. However, the survival benefits and potential adverse events associated with the biweekly FTD/TPI regimen have not been fully evaluated in previous reports. Therefore, in this study, the differences in efficacy and safety between the standard and biweekly FTD/TPI regimens were retrospectively investigated in patients with mCRC. PATIENTS AND METHODS Data from 90 patients who received FTD/TPI for mCRC were extracted from the electronic medical records at the Osaka University Hospital. According to the inclusion and exclusion criteria, 85 of the 90 patients were enrolled in the study. We compared patient characteristics, overall survival (OS), progression-free survival (PFS), and adverse events between the standard (n=56) and biweekly groups (n=29). RESULTS The biweekly group exhibited prolonged OS and PFS compared to patients in the standard group. Multivariate analysis for OS and PFS demonstrated that the biweekly regimen was the only significant factor that affected OS, and not PFS (HR=0.561, p=0.049). Kaplan-Meier analysis indicated that neutropenia (grade ≥3) in the biweekly group was significantly prolonged compared to the standard group (p=0.012). However, there were no significant differences in adverse events between the two groups (p>0.999). CONCLUSION The biweekly FTD/TPI regimen, compared to the standard regimen, should enhance both OS and PFS in patients with mCRC without escalating any adverse event.
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Affiliation(s)
- Shinsuke Hara
- Department of Pharmacy, Osaka University Hospital, Suita, Japan
| | - Daisuke Sakai
- Department of Frontier Science for Cancer and Chemotherapy, Osaka University Graduate School of Medicine, Suita, Japan
| | - Kenji Ikemura
- Department of Pharmacy, Osaka University Hospital, Suita, Japan;
| | - Takuya Shintani
- Department of Pharmacy, Osaka University Hospital, Suita, Japan
| | - Tomoya Yamamoto
- Department of Pharmacy, Osaka University Hospital, Suita, Japan
| | - Taroh Satoh
- Department of Frontier Science for Cancer and Chemotherapy, Osaka University Graduate School of Medicine, Suita, Japan
| | - Masahiro Okuda
- Department of Pharmacy, Osaka University Hospital, Suita, Japan
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26
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Lonabaugh K, Li G, List R, Huang R, James A, Barros A, Somerville L, Albon D. Real world study on elexacaftor-tezacaftor-ivacaftor impact on cholesterol levels in adults with cystic fibrosis. Pharmacotherapy 2024; 44:231-240. [PMID: 38143243 DOI: 10.1002/phar.2903] [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: 06/20/2023] [Revised: 11/20/2023] [Accepted: 11/21/2023] [Indexed: 12/26/2023]
Abstract
INTRODUCTION The introduction of the highly effective modulator therapy elexacaftor-tezacaftor-ivacaftor (ETI) has revolutionized the care of persons with cystic fibrosis (PwCF) with major improvements seen in lung function and body mass index. The effects of ETI therapy in real-world cohorts on other parameters such as cholesterol levels are largely unknown. METHODS A single-center, retrospective chart review study was conducted to assess the change in lipid panels before and after ETI initiation. The study investigated total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglyceride levels using both a univariate and multivariate mixed-effects model to evaluate the change after initiation of ETI in a cohort of PwCF. RESULTS There were 128 adult PwCF included in the analysis. Statistically significant changes were seen in both univariate and multivariate analyses for TC, LDL-C, and HDL-C. On multivariate analysis, TC increased by an average of 15.0 mg/dL after ETI initiation (p < 0.0001), LDL-C increased by an average of 9.3 mg/dL (p < 0.001), and HDL-C increased by an average of 3.8 mg/dL (p < 0.001) after ETI initiation. CONCLUSION In this real-world cohort of PwCF, cholesterol parameters increased after initiation with ETI therapy. Further consideration may need to be given for PwCF in regards to screening for cardiometabolic risk factors as PwCF age as well as the potential need for cholesterol-lowering therapies.
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Affiliation(s)
- Kevin Lonabaugh
- University of Virginia Health, Charlottesville, Virginia, USA
| | - Galvin Li
- University of Virginia Health, Charlottesville, Virginia, USA
| | - Rhonda List
- University of Virginia Health, Charlottesville, Virginia, USA
| | - Reyna Huang
- University of Virginia Health, Charlottesville, Virginia, USA
| | - Amber James
- University of Virginia Health, Charlottesville, Virginia, USA
| | - Andrew Barros
- University of Virginia Health, Charlottesville, Virginia, USA
| | | | - Dana Albon
- University of Virginia Health, Charlottesville, Virginia, USA
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27
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Tabernero J, Taieb J, Fakih M, Prager GW, Van Cutsem E, Ciardiello F, Mayer RJ, Amellal N, Skanji D, Calleja E, Yoshino T. Impact of KRAS G12 mutations on survival with trifluridine/tipiracil plus bevacizumab in patients with refractory metastatic colorectal cancer: post hoc analysis of the phase III SUNLIGHT trial. ESMO Open 2024; 9:102945. [PMID: 38471240 PMCID: PMC10944099 DOI: 10.1016/j.esmoop.2024.102945] [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: 11/17/2023] [Revised: 02/15/2024] [Accepted: 02/19/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND In metastatic colorectal cancer (mCRC), KRAS mutations are often associated with poorer survival; however, the prognostic impact of specific point mutations is unclear. In the phase III SUNLIGHT trial, trifluridine/tipiracil (FTD/TPI) plus bevacizumab significantly improved overall survival (OS) versus FTD/TPI alone. We assessed the impact of KRASG12 mutational status on OS in SUNLIGHT. PATIENTS AND METHODS In the global, open-label, randomized, phase III SUNLIGHT trial, adults with mCRC who had received no more than two prior chemotherapy regimens were randomized 1 : 1 to receive FTD/TPI alone or FTD/TPI plus bevacizumab. In this post hoc analysis, OS was assessed according to the presence or absence of a KRASG12 mutation in the overall population and in patients with RAS-mutated tumors. RESULTS Overall, 450 patients were analyzed, including 302 patients in the RAS mutation subgroup (214 with a KRASG12 mutation and 88 with a non-KRASG12RAS mutation). In the overall population, similar OS outcomes were observed in patients with and without a KRASG12 mutation [median 8.3 and 9.2 months, respectively; hazard ratio (HR) 1.09, 95% confidence interval (CI) 0.87-1.4]. Similar OS outcomes were also observed in the subgroup analysis of patients with a KRASG12 mutation versus those with a non-KRASG12RAS mutation (HR 1.03, 95% CI 0.76-1.4). FTD/TPI plus bevacizumab improved OS compared with FTD/TPI alone irrespective of KRASG12 mutational status. Among patients with a KRASG12 mutation, the median OS was 9.4 months with FTD/TPI plus bevacizumab versus 7.2 months with FTD/TPI alone (HR 0.67, 95% CI 0.48-0.93), and in patients without a KRASG12 mutation, the median OS was 11.3 versus 7.1 months, respectively (HR 0.59, 95% CI 0.43-0.81). CONCLUSIONS The presence of a KRASG12 mutation had no detrimental effect on OS among patients treated in SUNLIGHT. The benefit of FTD/TPI plus bevacizumab over FTD/TPI alone was confirmed independently of KRASG12 status.
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Affiliation(s)
- J Tabernero
- Vall d'Hebron Hospital Campus, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain.
| | - J Taieb
- Georges Pompidou European Hospital, AP-HP, Paris-Cité University, SIRIC CARPEM Comprehensive Cancer Center, Paris, France
| | - M Fakih
- City of Hope Comprehensive Cancer Center, Duarte, USA
| | - G W Prager
- Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - E Van Cutsem
- University Hospitals Gasthuisberg and KU Leuven, Leuven, Belgium
| | - F Ciardiello
- University of Campania Luigi Vanvitelli, Naples, Italy
| | - R J Mayer
- Dana-Farber Cancer Institute, Boston, USA
| | - N Amellal
- Servier International Research Institute, Suresnes, France
| | - D Skanji
- Servier International Research Institute, Suresnes, France
| | - E Calleja
- Taiho Oncology, Inc., Princeton, USA
| | - T Yoshino
- National Cancer Center Hospital East, Kashiwa, Japan
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28
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James A, Li G, List R, Lonabaugh K, Smith AD, Barros A, Somerville L, Albon D. Analysis of iron status after initiation of elexacaftor/tezacaftor/ivacaftor in people with cystic fibrosis. Pediatr Pulmonol 2024; 59:669-678. [PMID: 38088203 DOI: 10.1002/ppul.26805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 11/08/2023] [Accepted: 11/27/2023] [Indexed: 02/16/2024]
Abstract
BACKGROUND Iron deficiency is highly prevalent in people with cystic fibrosis (PwCF). While elexacaftor/tezacaftor/ivacaftor (ETI) has shown remarkable improvements in respiratory symptoms in PwCF, the effect of ETI on iron status remains unknown. This study aims to identify the effect of ETI on iron status in PwCF. METHODS A single-center retrospective cohort study of 127 adult PwCF was conducted to assess the impact of ETI on iron, ferritin, transferrin levels, and percent saturation of transferrin (PSAT). Data were collected from the electronic medical record from January 2017 to September 2022, encompassing 2 years before and after ETI initiation. The primary outcome was serum iron parameters: iron, ferritin, transferrin, and PSAT levels following ETI treatment. Secondary outcomes analyzed iron supplementation. Univariate and multivariate mixed-effects models were used for the analysis of ETI. RESULTS After adjusting for covariates, following ETI initiation, the mean iron level increased by 20.24 μg/dL (p < .001), ferritin levels were 31.4% (p < .001) higher, PSAT showed a 5.09 percentage point increase (p < .001), and transferrin levels increased by 2.71 mg/dL (p = .439). Patients with and without iron supplementation experienced a significant increase in iron after ETI (p < .001). CONCLUSIONS ETI is associated with a significant increase in iron, ferritin, and PSAT levels. Patients with and without iron supplementation demonstrated a significant increase in iron. This study shows the benefits of ETI on iron status in PwCF. However, further translational studies are required to understand the impact of ETI on iron absorption and metabolism in PwCF.
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Affiliation(s)
- Amber James
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Galvin Li
- Department of Statistics, University of Virginia, Charlottesville, Virginia, USA
| | - Rhonda List
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Kevin Lonabaugh
- Department of Medicine, Division of Pulmonology and Critical Care Medicine, University of Virginia, Charlottesville, Virginia, USA
| | - Aaron D Smith
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Andrew Barros
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, Virginia, USA
- Department of Medicine, Division of Pulmonology and Critical Care Medicine, University of Virginia, Charlottesville, Virginia, USA
| | - Lindsay Somerville
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, Virginia, USA
- Department of Medicine, Division of Pulmonology and Critical Care Medicine, University of Virginia, Charlottesville, Virginia, USA
| | - Dana Albon
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, Virginia, USA
- Department of Medicine, Division of Pulmonology and Critical Care Medicine, University of Virginia, Charlottesville, Virginia, USA
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29
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Patel T, McBennett K, Sankararaman S, Schindler T, Sundaram K, Minich NM, Malay S, Kutney K. Impact of elexacaftor/tezacaftor/ivacaftor on lipid and fat-soluble vitamin levels and association with body mass index. Pediatr Pulmonol 2024; 59:734-742. [PMID: 38179878 DOI: 10.1002/ppul.26823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 11/04/2023] [Accepted: 12/04/2023] [Indexed: 01/06/2024]
Abstract
INTRODUCTION Cystic fibrosis transmembrane conductance regulator (CFTR) modulators improve gastrointestinal absorption of nutrients and may result in changes in body mass index (BMI), serum lipids, and fat-soluble vitamin levels. We hypothesized that serum lipids and vitamin levels would increase with CFTR modulator therapy and that greater increase in lipids and vitamin levels would be related to greater increase in BMI. METHODS A retrospective study was performed to evaluate the impact of elexacaftor/tezacaftor/ivacaftor (ETI) on nutritional parameters, serum lipids, and fat-soluble vitamin levels. Pre-ETI values (<2 years prior) and post-ETI values (>1 month after) were compared. Linear regression was used to evaluate whether change in BMI is associated with the change in lipid and/or vitamin levels and whether modulator duration is associated with the degree of rise in lipid and/or vitamin levels. RESULTS Adults and adolescents with CF (n = 137) were evaluated before and 31-300 days after starting ETI. Median BMI (adults 21.9 vs. 23.5 kg/m2 ; adolescents 48 vs. 63 percentile) increased after initiation of ETI. Total cholesterol (126 vs. 154 mg/dL), low-density lipoprotein cholesterol (63 vs. 78 mg/dL), non-high-density lipoprotein cholesterol (84 vs. 102 mg/dL), and high density lipoprotein cholesterol (43 vs. 49 mg/dL) increased after ETI, while triglycerides and very low density lipoprotein did not change. Median values for vitamin D (34.5 vs. 38.0 ng/mL) and vitamin A (40.1 vs. 47.9 µg/dL) increased, while vitamin E did not change significantly. There was no significant correlation between BMI change or duration of modulator therapy with vitamin levels or lipid changes. CONCLUSION After initiation of ETI therapy, serum lipids increased in our population, but most values remained within the normal range. Vitamins A and D levels increased post-ETI and no changes were noted in vitamin E. No significant correlation between the degree of BMI change and the magnitude of increase in lipids or vitamin levels was found.
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Affiliation(s)
- Tanvi Patel
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
- Loyola University School of Medicine, Maywood, Illinois, USA
| | - Kimberly McBennett
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
- University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Senthilkumar Sankararaman
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
- University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Teresa Schindler
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
- University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Krithika Sundaram
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Nori Mercuri Minich
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
- University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Sindhoosha Malay
- University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Katherine Kutney
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
- University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
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30
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Dayyani F, Balangue J, Valerin J, Keating MJ, Zell JA, Taylor TH, Cho MT. A Phase 1 Study of Cabozantinib and Trifluridine/Tipiracil in Metastatic Colorectal Adenocarcinoma. Clin Colorectal Cancer 2024; 23:67-72. [PMID: 38103947 DOI: 10.1016/j.clcc.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 11/10/2023] [Accepted: 11/19/2023] [Indexed: 12/19/2023]
Abstract
INTRODUCTION This study determined the safety and recommended phase 2 dose (RP2D) of the multikinase inhibitor cabozantinib in combination with trifluridine/tipiracil (FTD/TPI) in refractory metastatic colorectal carcinoma (mCRC). PATIENTS AND METHODS Single institution investigator-initiated phase 1 study using 3+3 design. Eligible mCRC patients had received prior standard regimens. Cabozantinib was given orally (p.o.) at 20 mg (dose level [DL] 0) or 40 mg (DL 1) daily on days 1-28, and FTD/TPI p.o. at 35 mg/m2 on days 1-5 and 8-12 every 28 days. Prophylactic growth-factor support was allowed. RESULTS Fifteen patients were enrolled. Median age 56 years (31-80), male (12/15), ECOG 0/1 = 9/6. Three patients were treated at DL 0 and another nine were treated at DL 1, none exhibiting a DLT. Most common any grade (G) treatment related adverse events (TRAE) were diarrhea (50%), nausea (42%), neutropenia (42%), fatigue (33%), and rash (25%). G3-4 TRAE were neutropenia (25%) and thrombocytopenia, hypokalemia, and weight loss (each 8%). No serious TRAE or G5 were reported. The RP2D was determined to be DL 1. Median PFS was 3.8 months (95% CI 1.9-6.8) and disease control rate was 86.7%. CONCLUSION The combination of cabozantinib and FTD/TPI is feasible and tolerable at standard doses with the use of growth factors and showed encouraging clinical activity in refractory mCRC. CLINICALTRIALS GOV: NCT04868773.
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Affiliation(s)
- Farshid Dayyani
- Division of Hematology/Oncology, Department of Medicine and Chao Family Comprehensive Cancer Center, University of California Irvine, Orange, CA.
| | - Jasmine Balangue
- Division of Hematology/Oncology, Department of Medicine and Chao Family Comprehensive Cancer Center, University of California Irvine, Orange, CA
| | - Jennifer Valerin
- Division of Hematology/Oncology, Department of Medicine and Chao Family Comprehensive Cancer Center, University of California Irvine, Orange, CA
| | - Matthew J Keating
- Division of Hematology/Oncology, Department of Medicine and Chao Family Comprehensive Cancer Center, University of California Irvine, Orange, CA
| | - Jason A Zell
- Division of Hematology/Oncology, Department of Medicine and Chao Family Comprehensive Cancer Center, University of California Irvine, Orange, CA
| | | | - May T Cho
- Division of Hematology/Oncology, Department of Medicine and Chao Family Comprehensive Cancer Center, University of California Irvine, Orange, CA
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Kong Y, Cao L, Xie F, Wang X, Zuo C, Shi K, Rominger A, Huang Q, Xiao J, Jiang D, Guan Y, Ni R. Reduced SV2A and GABA A receptor levels in the brains of type 2 diabetic rats revealed by [ 18F]SDM-8 and [ 18F]flumazenil PET. Biomed Pharmacother 2024; 172:116252. [PMID: 38325265 DOI: 10.1016/j.biopha.2024.116252] [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: 09/11/2023] [Revised: 12/19/2023] [Accepted: 02/02/2024] [Indexed: 02/09/2024] Open
Abstract
PURPOSE Type 2 diabetes mellitus (T2DM) is associated with a greater risk of Alzheimer's disease. Synaptic impairment and protein aggregates have been reported in the brains of T2DM models. Here, we assessed whether neurodegenerative changes in synaptic vesicle 2 A (SV2A), γ-aminobutyric acid type A (GABAA) receptor, amyloid-β, tau and receptor for advanced glycosylation end product (RAGE) can be detected in vivo in T2DM rats. METHODS Positron emission tomography (PET) using [18F]SDM-8 (SV2A), [18F]flumazenil (GABAA receptor), [18F]florbetapir (amyloid-β), [18F]PM-PBB3 (tau), and [18F]FPS-ZM1 (RAGE) was carried out in 12-month-old diabetic Zucker diabetic fatty (ZDF) and SpragueDawley (SD) rats. Immunofluorescence staining, Thioflavin S staining, proteomic profiling and pathway analysis were performed on the brain tissues of ZDF and SD rats. RESULTS Reduced cortical [18F]SDM-8 uptake and cortical and hippocampal [18F]flumazenil uptake were observed in 12-month-old ZDF rats compared to SD rats. The regional uptake of [18F]florbetapir and [18F]PM-PBB3 was comparable in the brains of 12-month-old ZDF and SD rats. Immunofluorescence staining revealed Thioflavin S-negative, phospho-tau-positive inclusions in the cortex and hypothalamus in the brains of ZDF rats and the absence of amyloid-beta deposits. The level of GABAA receptors was lower in the cortex of ZDF rats than SD rats. Proteomic analysis further demonstrated that, compared with SD rats, synaptic-related proteins and pathways were downregulated in the hippocampus of ZDF rats. CONCLUSION These findings provide in vivo evidence for regional reductions in SV2A and GABAA receptor levels in the brains of aged T2DM ZDF rats.
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Affiliation(s)
- Yanyan Kong
- PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Lei Cao
- PET Center, Huashan Hospital, Fudan University, Shanghai, China; Inst. Regenerative Medicine, University of Zurich, Zurich, Switzerland
| | - Fang Xie
- PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Xiuzhe Wang
- Dept. Neurology, Shanghai Sixth People's Hospital affiliated with Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chuantao Zuo
- PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Kuangyu Shi
- Dept. Nuclear Medicine, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Axel Rominger
- Dept. Nuclear Medicine, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Qi Huang
- PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Jianfei Xiao
- PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Donglang Jiang
- PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Yihui Guan
- PET Center, Huashan Hospital, Fudan University, Shanghai, China.
| | - Ruiqing Ni
- Inst. Regenerative Medicine, University of Zurich, Zurich, Switzerland; Dept. Nuclear Medicine, Inselspital, Bern University Hospital, Bern, Switzerland; Inst. Biomedical Engineering, University of Zurich & ETH Zurich, Zurich, Switzerland.
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Nathan N, Thouvenin G, Dubern B, Corvol H. Elexacaftor/tezacaftor/ivacaftor can rescue pancreatic function in F508del homozygous children. Pediatr Pulmonol 2024; 59:788-790. [PMID: 38088210 DOI: 10.1002/ppul.26794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 11/09/2023] [Accepted: 11/27/2023] [Indexed: 02/16/2024]
Affiliation(s)
- Nadia Nathan
- Pediatric Pulmonology Department, Reference Center for Rare Lung Diseases RespiRare, Armand Trousseau Hospital, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
- Inserm UMR_S933, Laboratory of Childhood Genetic Diseases, Paris, France
| | - Guillaume Thouvenin
- Pediatric Pulmonology Department, Reference Center for Rare Lung Diseases RespiRare, Armand Trousseau Hospital, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
- Centre de recherche Saint Antoine (CRSA), Paris, France
| | - Béatrice Dubern
- Assistance Publique-Hôpitaux de Paris, French Reference Center for Prader-Willi Syndrome and Other Rare Obesities (PRADORT), Paris, France
- Nutrition and Obesities: Systemic Approaches Research Unit (Nutriomics), Sorbonne Université, INSERM, Paris, France
| | - Harriet Corvol
- Pediatric Pulmonology Department, Reference Center for Rare Lung Diseases RespiRare, Armand Trousseau Hospital, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
- Centre de recherche Saint Antoine (CRSA), Paris, France
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Giuliani J, Mantoan B, Mangiola D, Muraro M, Napoli G, Tommasi M, Fiorica F, Mandarà M. Cost-Effectiveness of the New Combination Trifluridine/Tipiracil Plus Bevacizumab for the Third-Line Treatment for Metastatic Colorectal Cancer in Italy. Clin Colorectal Cancer 2024; 23:1-3. [PMID: 37932152 DOI: 10.1016/j.clcc.2023.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 10/06/2023] [Accepted: 10/12/2023] [Indexed: 11/08/2023]
Affiliation(s)
- Jacopo Giuliani
- Department of Oncology, Azienda ULSS 9 Scaligera, Legnago (VR), Italy.
| | - Beatrice Mantoan
- Department of Diagnostic Imaging, Azienda ULSS 9 Scaligera, Legnago (VR), Italy
| | - Daniela Mangiola
- Department of Oncology, Azienda ULSS 9 Scaligera, Legnago (VR), Italy
| | - Marco Muraro
- Department of Oncology, Azienda ULSS 9 Scaligera, Legnago (VR), Italy
| | - Giuseppe Napoli
- Department of Oncology, Azienda ULSS 9 Scaligera, Legnago (VR), Italy
| | - Marina Tommasi
- Pharmaceuthical Department, Azienda ULSS 9 Scaligera, Legnago (VR), Italy
| | - Francesco Fiorica
- Department of Oncology, Azienda ULSS 9 Scaligera, Legnago (VR), Italy
| | - Marta Mandarà
- Department of Oncology, Azienda ULSS 9 Scaligera, Legnago (VR), Italy
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Wielpütz MO, Mall MA. Therapeutic improvement of CFTR function and reversibility of bronchiectasis in cystic fibrosis. Eur Respir J 2024; 63:2400234. [PMID: 38548272 DOI: 10.1183/13993003.00234-2024] [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] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 02/14/2024] [Indexed: 04/02/2024]
Affiliation(s)
- Mark O Wielpütz
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University Hospital Heidelberg, Heidelberg, Germany
| | - Marcus A Mall
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
- German Center for Lung Research (DZL), associated partner site, Berlin, Germany
- Berlin Institute of Health (BIH) at Charité-Universitätsmedizin Berlin, Berlin, Germany
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Indolfi G, Easterbrook P, Giometto S, Malik F, Chou R, Lucenteforte E. Efficacy and safety of DAA in children and adolescents with chronic HCV infection: A systematic review and meta-analysis. Liver Int 2024; 44:663-681. [PMID: 38293756 DOI: 10.1111/liv.15827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 10/13/2023] [Accepted: 12/18/2023] [Indexed: 02/01/2024]
Abstract
BACKGROUND AND AIMS We evaluated the effectiveness and safety of pan-genotypic regimens, glecaprevir/pibrentasvir (GLE/PIB), sofosbuvir/velpatasvir (SOF/VEL), and sofosbuvir/daclatasvir (SOF/DCV) and other direct-acting antivirals (DAA) regimens for the treatment of hepatitis C virus (HCV)-infected adolescents (12-18 years), older children (6-11 years), and young children (3-5 years). The purpose of this systematic review and meta-analysis was to inform the World Health Organization (WHO) guidelines. METHODS We included clinical trials and observational studies published up to August 11, 2021, that evaluated DAA regimens in HCV-infected adolescents, older children, and young children. We searched MEDLINE, EMBASE, and CENTRAL databases and key conference abstracts. Sustained virological response 12 weeks after the end of treatment (SVR12), adverse events (AEs), and treatment discontinuation were the outcomes evaluated. Risk of bias was assessed using a modified version of the ROBINS-I tool. Data were pooled using random-effects models, and certainty of the evidence was assessed using the GRADE approach. RESULTS A total of 49 studies including 1882 adolescents, 436 older children, and 166 young children were considered. The SVR12 was 100% (95% Confidence Interval: 96-100), 96% (90-100), and 96% (83-100) for GLE/PIB in adolescents, older, and young children, respectively; 95% (90-99), 93% (86-98), and 83% (70-93), for SOF/VEL, respectively; and 100% (97-100) and 100% (94-100) for SOF/DCV in adolescent and older children, respectively. There was a clear trend towards a higher rate of any reported AE from adolescents (50%), older children (53%), to young children (72%). Serious AEs and treatment discontinuations were uncommon in adolescents and older children (<1%) but slightly higher in young children (3%). CONCLUSIONS All three pan-genotypic DAA regimens were highly effective and well-tolerated and are now recommended by the WHO for use in adults, adolescents, and children down to 3 years, which will simplify procurement and supply chain management. The evidence was based largely on single-arm non-randomized controlled studies. Moreover, there were also missing data regarding key variables such as route of HCV acquisition, presence or absence of cirrhosis, or HIV co-infection that precluded evaluation of the impact of these factors on outcomes. PROSPERO RECORD CRD42020146752.
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Affiliation(s)
- Giuseppe Indolfi
- Department Neurofarba, University of Florence, Florence, Italy
- Paediatric and Liver Unit, Meyer Children's Hospital IRCCS, Firenze, Italy
| | - Philippa Easterbrook
- Global HIV, Hepatitis and STI Programmes, World Health Organization Headquarters, Geneva, Switzerland
| | - Sabrina Giometto
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Farihah Malik
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Roger Chou
- Departments of Medicine, and Medical Informatics & Clinical Epidemiology, Oregon Health Sciences University, Portland, Oregon, USA
| | - Ersilia Lucenteforte
- Department of Statistics, Computer Science and Applications «G. Parenti», University of Florence, Florence, Italy
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Zenklusen I, Dingemanse J, Reh C, Gehin M, Kaufmann P. Effect of Daridorexant on the Pharmacokinetics of Midazolam, and on the Pharmacokinetics and Pharmacodynamics of Warfarin in Healthy Male Subjects. Drugs R D 2024; 24:97-108. [PMID: 38472696 PMCID: PMC11035509 DOI: 10.1007/s40268-024-00456-8] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Daridorexant, a dual orexin receptor antagonist was recently approved for the treatment of insomnia at doses up to 50 mg once per night. This study investigated the effect of single-dose and multiple-dose daridorexant 50 mg at steady state on the pharmacokinetics (PK) of the cytochrome P450 (CYP) 3A4-sensitive substrate midazolam, and the effect of single-dose daridorexant 50 mg on the PK and pharmacodynamics (PD) of the CYP2C9-sensitive substrate warfarin. METHODS In this prospective, single-center, open-label, fixed-sequence, phase I, drug-drug interaction study, 18 healthy male subjects sequentially received Treatment A, B, and C in three periods. Treatment A consisted of a single oral concomitant administration of midazolam 2 mg and warfarin 25 mg on day 1 of the first period. Treatment B consisted of one oral administration of daridorexant 50 mg followed 1 h later by a single oral dose of midazolam 2 mg concomitantly with a single oral dose of warfarin 25 mg on day 1 and a once-daily oral administration of daridorexant 50 mg for 6 days of the second period. Treatment C consisted of a single oral administration of daridorexant 50 mg at steady state followed 1 h later by a single oral administration of midazolam 2 mg on day 1 of the third period. Blood samples were assessed for midazolam and S-warfarin PK, and PD (international normalized ratio and factor VII). Noncompartmental PK parameters and PD variables were evaluated with geometric mean ratios and 90% confidence intervals of Treatment B/A versus C/A for midazolam, and treatment B/A for warfarin. Safety and tolerability of each treatment were also assessed. RESULTS Midazolam maximum plasma concentration (Cmax) and area under the plasma concentration-time curve from 0 to 24 h (AUC0-24) were 1.13- and 1.42-fold higher, respectively, after single-dose administration of daridorexant 50 mg compared to administration of midazolam alone, while Cmax and AUC0-24 were 1.12- and 1.35-fold higher, respectively, after administration of daridorexant 50 mg once daily at steady state. Terminal half-life and time to maximum plasma concentration were comparable between treatments. Daridorexant had no influence on the PK and PD of warfarin. All treatments were safe and well tolerated. CONCLUSIONS Daridorexant at 50 mg is classified as a weak CYP3A4 inhibitor after single- and multiple-dose administration once daily at steady state. Daridorexant 50 mg did not induce CYP3A4 activity or inhibit CYP2C9 activity. CLINICAL TRIAL REGISTRATION This trial (NCT05480488) was registered on 29 July, 2022.
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Affiliation(s)
- Isabelle Zenklusen
- Department of Clinical Pharmacology, Idorsia Pharmaceuticals Ltd, Allschwil, Switzerland
| | - Jasper Dingemanse
- Department of Clinical Pharmacology, Idorsia Pharmaceuticals Ltd, Allschwil, Switzerland
| | | | - Martine Gehin
- Department of Clinical Pharmacology, Idorsia Pharmaceuticals Ltd, Allschwil, Switzerland.
| | - Priska Kaufmann
- Department of Clinical Pharmacology, Idorsia Pharmaceuticals Ltd, Allschwil, Switzerland
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Bazarbashi S, Alkhatib R, Aseafan M, Tuleimat Y, Abdel-Aziz N, Mahrous M, Elsamany S, Elhassan T, Alghamdi M. Efficacy of Chemotherapy Rechallenge Versus Regorafenib or Trifluridine/Tipiracil in Third-Line Setting of Metastatic Colorectal Cancer: A Multicenter Retrospective Comparative Study. JCO Glob Oncol 2024; 10:e2300461. [PMID: 38484194 PMCID: PMC10954077 DOI: 10.1200/go.23.00461] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 01/13/2024] [Accepted: 01/30/2024] [Indexed: 03/19/2024] Open
Abstract
PURPOSE Metastatic colorectal cancer (mCRC) is a significant global health burden. This retrospective study compared the effectiveness of trifluridine/tipiracil (FTD/TPI), regorafenib, and chemotherapy rechallenge for third-line mCRC treatment. MATERIALS AND METHODS We reviewed the medical records of 132 patients with mCRC treated with regorafenib, FTD/TPI, or a rechallenge with the initial chemotherapy regimen in a third-line setting from four different institutions. The primary end point was progression-free survival (PFS). Secondary end points were objective response rate and overall survival (OS) across the three treatment approaches. RESULTS Twenty-nine patients received chemotherapy rechallenge, and 103 received FTD/TPI or regorafenib. Patients' characteristics were comparable, except for a lower number of left-sided primaries and KRAS wild-type tumors in the FTD/TPI-regorafenib group. The median PFS for the entire group was 3.0 months, and the median OS was 13.7 months. Chemotherapy rechallenge has resulted in a median PFS of 3.1 months and a median OS of 21.2 months, compared with 2.9 months (PFS) and 12.6 months (OS) for the FTD/TPI-regorafenib group. Multivariate analyses identified male sex and an Eastern Cooperative Oncology Group performance status (ECOG PS) of 0-1 as independent prognostic factors for better PFS, whereas chemotherapy rechallenge, localized stage at diagnosis, and an ECOG PS of 0-1 were significant prognostic factors for better OS. CONCLUSION This study suggests that chemotherapy rechallenge may provide a survival benefit in the third-line treatment of mCRC. However, patient characteristics, such as sex and ECOG PS, should also be considered in treatment decisions. Further prospective studies are required to confirm our findings.
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Affiliation(s)
- Shouki Bazarbashi
- Department of Medical Oncology, Cancer Centre of Excellence, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Radwan Alkhatib
- Faculty of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Mohamed Aseafan
- Department of Internal Medicine, Section of Medical Oncology, Security Forces Hospital, Riyadh, Saudi Arabia
| | - Yasmin Tuleimat
- Faculty of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Nashwa Abdel-Aziz
- Department of Medical Oncology, King Saud University Medical City, King Saud University, National Blood and Cancer Centre, Riyadh, Saudi Arabia
| | - Mervat Mahrous
- Oncology Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
- Faculty of Medicine, Minia University, Minia, Egypt
| | - Sherif Elsamany
- Oncology Centre, King Abdullah Medical City, Makkah, Saudi Arabia
- Oncology Centre, Mansoura University, Mansoura, Egypt
| | - Tusneem Elhassan
- Research Unit, Cancer Centre of Excellence, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Mohammed Alghamdi
- Department of Medical Oncology, King Saud University Medical City, King Saud University, National Blood and Cancer Centre, Riyadh, Saudi Arabia
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Matsumoto T, Yamamoto Y, Kotaka M, Masuishi T, Tsuji Y, Shoji H, Hirata K, Tsuduki T, Makiyama A, Izawa N, Takahashi N, Tsuda M, Yasui H, Ohta T, Kito Y, Otsu S, Hironaka S, Yamazaki K, Boku N, Hyodo I, Yoshimura K, Muro K. A Phase II Study of FOLFIRI Plus Ziv-Aflibercept After Trifluridine/Tipiracil Plus Bevacizumab in Patients with Metastatic Colorectal Cancer: WJOG 11018G. Target Oncol 2024; 19:181-190. [PMID: 38427280 DOI: 10.1007/s11523-024-01043-2] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND Non-inferiority of trifluridine/tipiracil (FTD/TPI) plus bevacizumab (BEV) to irinotecan/fluoropyrimidine plus BEV in metastatic colorectal cancer was investigated in the phase III TRUSTY study, and we conducted a phase II study of FOLFIRI (5-FU+leucovorin+irinotecan) plus zib-aflibercept (AFL) after FTD/TPI plus BEV. However, the TRUSTY study failed during the recruitment of our patients. OBJECTIVE We present the findings of a phase II study on the efficacy of FOLFIRI plus zib-aflibercept (AFL) after FTD/TPI plus BEV, including clinical results with plasma biomarker analyses. METHODS This was a multicenter, single-arm, phase II study in patients with metastatic colorectal cancer refractory or intolerant to oxaliplatin, fluoropyrimidine, BEV, and FTD/TPI. The primary endpoint was progression-free survival. Fifteen plasma angiogenesis-associated biomarkers were analyzed using a Luminex® multiplex assay U-kit. RESULTS Between January 2020 and May 2022, 26 patients (median age, 68 years) from 15 sites were enrolled. The median progression-free survival was 4.9 months (85% confidence interval, 3.4 month-not estimated). The overall response and disease control rates were 8% and 62%, respectively. The median levels of vascular endothelial growth factor-A and placental growth factor, both targets of AFL, were below the measurable limit of 30 pg/mL and 16 pg/mL, respectively. Patients were divided into two groups at the median levels of baseline biomarkers. The progression-free survival did not differ between high and low expressers of placental growth factor (p = 0.7), while it tended to be shorter in those with high levels of osteopontin (p = 0.05), angiopoietin-2 (p = 0.07), and tissue inhibitor of matrix metalloproteinases-1 (p = 0.1). CONCLUSIONS This study did not meet the primary endpoint. Hence, FOLFIRI plus AFL should not be used after FTD/TPI plus BEV for metastatic colorectal cancer. Further studies are needed to determine factors not targeted by AFL that may affect the efficacy of the treatment. CLINICAL TRIAL REGISTRATION jRCTs041190100.
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Affiliation(s)
- Toshihiko Matsumoto
- Cancer Treatment Center, Kansai Medical University Hospital, 2-3-1, Shinmachi, Hirakata-shi, Osaka, 5731191, Japan.
| | - Yoshiyuki Yamamoto
- Department of Gastroenterology, Faculty of Medicine, University of Tsukuba, Tsukuba-shi, Ibaragi, Japan
| | - Masahito Kotaka
- Gastrointestinal Cancer Center, Sano Hospital, Kobe-shi, Hyogo, Japan
| | - Toshiki Masuishi
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya-shi, Aichi, Japan
| | - Yasushi Tsuji
- Department of Clinical Oncology, Tonan Hospital, Sapporo-shi, Hokkaido, Japan
| | - Hirokazu Shoji
- Department of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Kenro Hirata
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University, Tokyo, Japan
| | - Takao Tsuduki
- Department of Internal Medicine, Himeji Red Cross Hospital, Himeji-shi, Hyogo, Japan
| | | | - Naoki Izawa
- Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki-shi, Kanagawa, Japan
| | - Naoki Takahashi
- Department of Gastroenterology, Saitama Cancer Center Hospital, Kita-adachi-gun, Saitama, Japan
| | - Masahiro Tsuda
- Department of Gastroenterological Oncology, Hyogo Cancer Center, Akashi-shi, Hyogo, Japan
| | - Hisateru Yasui
- Department of Medical Oncology, Kobe City Medical Center General Hospital, Kobe-shi, Hyogo, Japan
| | - Takashi Ohta
- Department of Clinical Oncology, Kansai Rosai Hospital, Amagasaki-shi, Hyogo, Japan
| | - Yosuke Kito
- Department of Medical Oncology, Ishikawa Prefectural Central Hospital, Kanazawa-shi, Ishikawa, Japan
| | - Satoshi Otsu
- Department of Medical Oncology and Hematology, Faculty of Medicine, Oita University, Yufu-shi, Oita, Japan
| | - Shuichi Hironaka
- Department of Medical Oncology and Hematology, Faculty of Medicine, Oita University, Yufu-shi, Oita, Japan
- Department of Medical Oncology, Faculty of Medicine, Kyorin University, Mitaka-shi, Tokyo, Japan
| | - Kentaro Yamazaki
- Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Sunto-gun, Shizuoka, Japan
| | - Narikazu Boku
- Department of Oncology and General Medicine, Institute of Medical Science Hospital, University of Tokyo, Tokyo, Japan
| | - Ichinosuke Hyodo
- Department of Gastrointestinal Medical Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Kenichi Yoshimura
- Medical Center for Translational and Clinical Research, Hiroshima University, Hiroshima-shi, Hiroshima, Japan
| | - Kei Muro
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya-shi, Aichi, Japan
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Heerspink HJL, Greasley PJ, Ahlström C, Althage M, Dwyer JP, Law G, Wijkmark E, Lin M, Mercier AK, Sunnåker M, Turton M, Wheeler DC, Ambery P. Efficacy and safety of zibotentan and dapagliflozin in patients with chronic kidney disease: study design and baseline characteristics of the ZENITH-CKD trial. Nephrol Dial Transplant 2024; 39:414-425. [PMID: 37632201 PMCID: PMC10899767 DOI: 10.1093/ndt/gfad183] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 07/07/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Sodium-glucose co-transporter 2 inhibitors (SGLT2is) are part of the standard of care for patients with chronic kidney disease (CKD), both with and without type 2 diabetes. Endothelin A (ETA) receptor antagonists have also been shown to slow progression of CKD. Differing mechanisms of action of SGLT2 and ETA receptor antagonists may enhance efficacy. We outline a study to evaluate the effect of combination zibotentan/dapagliflozin versus dapagliflozin alone on albuminuria and estimated glomerular filtration rate (eGFR). METHODS We are conducting a double-blind, active-controlled, Phase 2b study to evaluate the efficacy and safety of ETA receptor antagonist zibotentan and SGLT2i dapagliflozin in a planned 415 adults with CKD (Zibotentan and Dapagliflozin for the Treatment of CKD; ZENITH-CKD). Participants are being randomized (1:2:2) to zibotentan 0.25 mg/dapagliflozin 10 mg once daily (QD), zibotentan 1.5 mg/dapagliflozin 10 mg QD and dapagliflozin 10 mg QD alone, for 12 weeks followed by a 2-week off-treatment wash-out period. The primary endpoint is the change in log-transformed urinary albumin-to-creatinine ratio (UACR) from baseline to Week 12. Other outcomes include change in blood pressure from baseline to Week 12 and change in eGFR the study. The incidence of adverse events will be monitored. Study protocol-defined events of special interest include changes in fluid-related measures (weight gain or B-type natriuretic peptide). RESULTS A total of 447 patients were randomized and received treatment in placebo/dapagliflozin (n = 177), zibotentan 0.25 mg/dapagliflozin (n = 91) and zibotentan 1.5 mg/dapagliflozin (n = 179). The mean age was 62.8 years, 30.9% were female and 68.2% were white. At baseline, the mean eGFR of the enrolled population was 46.7 mL/min/1.73 m2 and the geometric mean UACR was 538.3 mg/g. CONCLUSION This study evaluates the UACR-lowering efficacy and safety of zibotentan with dapagliflozin as a potential new treatment for CKD. The study will provide information about an effective and safe zibotentan dose to be further investigated in a Phase 3 clinical outcome trial. CLINICAL TRIAL REGISTRATION NUMBER NCT04724837.
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Affiliation(s)
- Hiddo J L Heerspink
- Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- The George Institute for Global Health, Sydney, New South Wales, Australia
| | - Peter J Greasley
- Research and Early Development, Cardiovascular, Renal and Metabolism, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Christine Ahlström
- DMPK, Research and Early Development Cardiovascular, Renal and Metabolism, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Magnus Althage
- Translational Science & Experimental Medicine, Research and Early Development Cardiovascular, Renal, and Metabolism, Biopharmaceutical R&D, AstraZeneca, Gaithersburg, MD, USA
| | - Jamie P Dwyer
- Division of Nephrology/Hypertension, University of Utah Health, Salt Lake City, UT, USA
| | - Gordon Law
- Early Biometrics & Statistical Innovation, Data Science and Artificial Intelligence, R&D, AstraZeneca, Gaithersburg, MD, USA
| | - Emma Wijkmark
- Biometrics Late Development, Cardiovascular, Renal and Metabolism, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Min Lin
- Biometrics Late Development, Cardiovascular, Renal and Metabolism, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD, USA
| | - Anne-Kristina Mercier
- Clinical Pharmacology and Quantitative Pharmacology, Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, Gothenburg, Sweden
| | - Mikael Sunnåker
- Clinical Pharmacology and Quantitative Pharmacology, Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, Gothenburg, Sweden
| | - Michelle Turton
- Biopharma Clinical Operations, Early CVRM, AstraZeneca, Cambridge, UK
| | - David C Wheeler
- Department of Renal Medicine, University College London, London, UK
| | - Philip Ambery
- Clinical Late Development, Cardiovascular, Renal and Metabolism, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
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Phillips TJ, Avigdor A, Gurion R, Patti C, Corradini P, Tani M, Mehta A, Lossos IS, Zinzani PL, Thieblemont C, Jurczak W, Zheng F, Rappold E, Zhao W, Jiang P, Johnson P. A phase 2 study of the PI3Kδ inhibitor parsaclisib in relapsed and refractory marginal zone lymphoma (CITADEL-204). Blood Adv 2024; 8:867-877. [PMID: 38113459 PMCID: PMC10875254 DOI: 10.1182/bloodadvances.2023010648] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 11/02/2023] [Accepted: 11/07/2023] [Indexed: 12/21/2023] Open
Abstract
ABSTRACT Parsaclisib, a potent and highly selective PI3Kδ inhibitor, has shown clinical benefit in patients with relapsed or refractory (R/R) B-cell lymphomas. The phase 2 CITADEL-204 study (NCT03144674, EudraCT 2017-000970-12) assessed efficacy and safety of parsaclisib in Bruton tyrosine kinase (BTK) inhibitor-experienced (cohort 1) or BTK inhibitor-naive (cohort 2) patients with R/R marginal zone lymphoma (MZL). Patients aged ≥18 years with histologically confirmed R/R MZL, treated with ≥1 prior systemic therapy (including ≥1 anti-CD20 antibody) received parsaclisib 20 mg once daily for 8 weeks then 20 mg once weekly (weekly dosing group [WG]) or parsaclisib 20 mg once daily for 8 weeks then 2.5 mg once daily (daily dosing group [DG]); DG was selected for further assessment. Primary end point of the study was objective response rate (ORR). Owing to slower than expected recruitment, cohort 1 was closed with 10 patients (WG, n = 4; DG, n = 6) enrolled. Based on a planned interim analysis in cohort 2, the futility boundary was not crossed, and enrollment continued to study completion. At data cutoff (15 January 2021), 100 patients were enrolled and treated in cohort 2 (WG, n = 28; DG, n = 72). In the DG, the ORR was 58.3% (95% confidence interval [CI], 46.1-69.8), with a complete response rate of 4.2% (95% CI, 0.9-11.7); the lower bound of the ORR 95% CI exceeded the protocol-defined threshold of 40%. The median duration of response was 12.2 months (95% CI, 8.1-17.5) and progression-free survival was 16.5 months (95% CI, 11.5-20.6); median overall survival was not reached. The most common treatment-emergent adverse events (TEAEs) among all patients were diarrhea (47.0%), cough (23.0%), and rash (18.0%); the most common grade ≥3 TEAEs included diarrhea (12.0%), neutropenia, and pneumonia (9.0% each). TEAEs led to dose interruptions, reductions, and discontinuations in 56.0%, 16.0%, and 29.0% of all patients, respectively. Durable responses and an overall manageable safety profile were demonstrated in patients with R/R MZL treated with parsaclisib monotherapy.
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Affiliation(s)
| | - Abraham Avigdor
- Institute of Hematology, Sheba Medical Center, Ramat Gan, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ronit Gurion
- Institute of Hematology, Rabin Medical Center & Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Caterina Patti
- Department of Hematology I, Azienda Ospedali Riuniti Villa Sofia-Cervello, Palermo, Italy
| | - Paolo Corradini
- University of Milano Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Monica Tani
- Ospedale di Ravenna, Azienda Unità Sanitaria Locale della Romagna, Ravenna, Italy
| | | | - Izidore S. Lossos
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL
| | - Pier Luigi Zinzani
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli,” Bologna, Italy
- Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
| | - Catherine Thieblemont
- Université de Paris; APHP, Hôpital Saint-Louis, Hémato-oncologie, Paris Diderot, Paris, France
| | - Wojciech Jurczak
- Maria Sklodowska-Curie National Research Institute of Oncology, Kraków, Poland
| | | | | | | | | | - Peter Johnson
- School of Cancer Sciences, University of Southampton, Southampton, United Kingdom
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He X, Narushima K, Kojima M, Nagai C, Li K. Pharmacokinetics, Pharmacodynamics, and Safety of Evocalcet (KHK7580), a Novel Calcimimetic Agent: An Open-Label, Single- and Multiple-Dose, Phase I Trial in Healthy Chinese Subjects. Drug Des Devel Ther 2024; 18:567-581. [PMID: 38436038 PMCID: PMC10906727 DOI: 10.2147/dddt.s437903] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 02/04/2024] [Indexed: 03/05/2024] Open
Abstract
Purpose This study explored the pharmacokinetics (PK), pharmacodynamics (PD), and safety of evocalcet (KHK7580), a new calcimimetic agent, in healthy Chinese subjects following single and multiple doses. Methods This was a single-center, open-label phase I trial conducted in China. The study started from the single-dose cohorts (1, 3, 6, 12 mg evocalcet, step-by-step administration) and proceeded to the multiple-dose cohort (6 mg evocalcet once daily for eight days). Blood and urine samples were collected at the designated time points for pharmacokinetic and pharmacodynamic analysis. Safety was evaluated by treatment-emergent adverse events (TEAEs), clinical laboratory tests, vital signs, electrocardiograms (ECGs), and ophthalmological examination. Results Among 42 enrolled subjects, eight in each single-dose cohort and 10 in multiple-dose cohort, 40 subjects completed the study. In single-dose cohorts, tmax was 1.00-2.00 h and declined biphasically. The mean t1/2 was 15.99-20.84 h. Evocalcet exposure in AUC0-inf, AUC0-t, and Cmax showed a dose-proportional increase. In the multiple-dose cohort, tmax was 2.00 h and declined biphasically after multiple administrations. The accumulation was negligible. Ctrough levels were similar across days and steady from 24 hours after the first administration. The mean t1/2 was 15.59 h. PD analysis showed that evocalcet decreased intact parathyroid hormone and corrected calcium levels in a dose-dependent manner. Seventeen (40.5%) subjects reported TEAEs. No serious or severe TEAE occurred. Conclusion In healthy Chinese subjects, evocalcet demonstrated dose-dependent PK and PD properties and was well-tolerated.
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Affiliation(s)
- Xuemei He
- Clinical Trial Center, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Key Laboratory of Assessment of Clinical Drugs Risk and Individual Application, Beijing, People’s Republic of China
| | - Kazuya Narushima
- Research & Development Division, Kyowa Kirin Co., Ltd, Tokyo, Japan
| | - Masahiro Kojima
- Research & Development Division, Kyowa Kirin Co., Ltd, Tokyo, Japan
| | - Chisato Nagai
- Research & Development Division, Kyowa Kirin Co., Ltd, Tokyo, Japan
| | - Kexin Li
- Clinical Trial Center, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Key Laboratory of Assessment of Clinical Drugs Risk and Individual Application, Beijing, People’s Republic of China
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Reasoner SA, Bernard R, Waalkes A, Penewit K, Lewis J, Sokolow AG, Brown RF, Edwards KM, Salipante SJ, Hadjifrangiskou M, Nicholson MR. Longitudinal profiling of the intestinal microbiome in children with cystic fibrosis treated with elexacaftor-tezacaftor-ivacaftor. mBio 2024; 15:e0193523. [PMID: 38275294 PMCID: PMC10865789 DOI: 10.1128/mbio.01935-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 12/18/2023] [Indexed: 01/27/2024] Open
Abstract
The intestinal microbiome influences growth and disease progression in children with cystic fibrosis (CF). Elexacaftor-tezacaftor-ivacaftor (ELX/TEZ/IVA), the newest pharmaceutical modulator for CF, restores the function of the pathogenic mutated CF transmembrane conductance regulator (CFTR) channel. We performed a single-center longitudinal analysis of the effect of ELX/TEZ/IVA on the intestinal microbiome, intestinal inflammation, and clinical parameters in children with CF. Following ELX/TEZ/IVA, children with CF had significant improvements in body mass index and percent predicted forced expiratory volume in one second, and required fewer antibiotics for respiratory infections. Intestinal microbiome diversity increased following ELX/TEZ/IVA coupled with a decrease in the intestinal carriage of Staphylococcus aureus, the predominant respiratory pathogen in children with CF. There was a reduced abundance of microbiome-encoded antibiotic resistance genes. Microbial pathways for aerobic respiration were reduced after ELX/TEZ/IVA. The abundance of microbial acid tolerance genes was reduced, indicating microbial adaptation to increased CFTR function. In all, this study represents the first comprehensive analysis of the intestinal microbiome in children with CF receiving ELX/TEZ/IVA.IMPORTANCECystic fibrosis (CF) is an autosomal recessive disease with significant gastrointestinal symptoms in addition to pulmonary complications. Recently approved treatments for CF, CF transmembrane conductance regulator (CFTR) modulators, are anticipated to substantially improve the care of people with CF and extend their lifespans. Prior work has shown that the intestinal microbiome correlates with health outcomes in CF, particularly in children. Here, we study the intestinal microbiome of children with CF before and after the CFTR modulator, ELX/TEZ/IVA. We identify promising improvements in microbiome diversity, reduced measures of intestinal inflammation, and reduced antibiotic resistance genes. We present specific bacterial taxa and protein groups which change following ELX/TEZ/IVA. These results will inform future mechanistic studies to understand the microbial improvements associated with CFTR modulator treatment. This study demonstrates how the microbiome can change in response to a targeted medication that corrects a genetic disease.
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Affiliation(s)
- Seth A. Reasoner
- Department of Pathology, Microbiology, and Immunology, Division of Molecular Pathogenesis, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Rachel Bernard
- Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, Monroe Carrell Junior Children’s Hospital at Vanderbilt, Nashville, Tennessee, USA
| | - Adam Waalkes
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA
| | - Kelsi Penewit
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA
| | - Janessa Lewis
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA
| | - Andrew G. Sokolow
- Department of Pediatrics, Division of Allergy, Immunology, and Pulmonary Medicine, Monroe Carrell Junior Children’s Hospital at Vanderbilt, Nashville, Tennessee, USA
| | - Rebekah F. Brown
- Department of Pediatrics, Division of Allergy, Immunology, and Pulmonary Medicine, Monroe Carrell Junior Children’s Hospital at Vanderbilt, Nashville, Tennessee, USA
| | - Kathryn M. Edwards
- Department of Pediatrics, Division of Infectious Diseases, Monroe Carrell Junior Children’s Hospital at Vanderbilt, Nashville, Tennessee, USA
| | - Stephen J. Salipante
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA
| | - Maria Hadjifrangiskou
- Department of Pathology, Microbiology, and Immunology, Division of Molecular Pathogenesis, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Center for Personalized Microbiology (CPMi), Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Vanderbilt Institute for Infection, Immunology and Inflammation, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Maribeth R. Nicholson
- Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, Monroe Carrell Junior Children’s Hospital at Vanderbilt, Nashville, Tennessee, USA
- Vanderbilt Institute for Infection, Immunology and Inflammation, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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Vanderlinden G, Carron C, Vandenberghe R, Vandenbulcke M, Van Laere K. In vivo PET of synaptic density as potential diagnostic marker for cognitive disorders: prospective comparison with current imaging markers for neuronal dysfunction and relation to symptomatology - study protocol. BMC Med Imaging 2024; 24:41. [PMID: 38347458 PMCID: PMC10860316 DOI: 10.1186/s12880-024-01224-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 02/05/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND 18F-FDG brain PET is clinically used for differential diagnosis in cognitive dysfunction of unclear etiology and for exclusion of a neurodegenerative cause in patients with cognitive impairment in late-life psychiatric disorders. 18F-FDG PET measures regional glucose metabolism, which represents a combination of neuronal/synaptic activity but also astrocytic activity and neuroinflammation. Recently, imaging of synaptic vesicle protein 2 A (SV2A) has become available and was shown to be a proxy of synaptic density. This prospective study will investigate the use of 18F-SynVesT-1 for imaging SV2A and its discriminative power for differential diagnosis in cognitive disorders in a head-to-head comparison to 18F-FDG PET. In addition, simultaneous PET/MR allows an evaluation of contributing factors and the additional value of advanced MRI imaging to FDG/SV2A PET imaging will be investigated. In this work, the study design and protocol are depicted. METHODS In this prospective, multimodal imaging study, 110 patients with uncertain diagnosis of cognitive impairment who are referred for 18F-FDG PET brain imaging in their diagnostic work-up in a tertiary memory clinic will be recruited. In addition, 40 healthy volunteers (HV) between 18 and 85 years (M/F) will be included. All study participants will undergo simultaneous 18F-SynVesT-1 PET/MR and an extensive neuropsychological evaluation. Amyloid status will be measured by PET using 18FNAV4694, in HV above 50 years of age. Structural T1-weighted and T2-weighted fluid-attenuated inversion recovery MR images, triple-tagging arterial spin labeling (ASL) and resting-state functional MRI (rs-fMRI) will be obtained. The study has been registered on ClinicalTrials.gov (NCT05384353) and is approved by the local Research Ethics Committee. DISCUSSION The main endpoint of the study will be the comparison of the diagnostic accuracy between 18F-SynVesT-1 and 18F-FDG PET in cognitive disorders with uncertain etiology and in exclusion of a neurodegenerative cause in patients with cognitive impairment in late-life psychiatric disorders. The strength of the relationship between cognition and imaging data will be assessed, as well as the potential incremental diagnostic value of including MR volumetry, ASL perfusion and rs-fMRI.
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Affiliation(s)
- Greet Vanderlinden
- Nuclear Medicine and Molecular Imaging, Imaging and Pathology, KU Leuven, Leuven, Belgium.
| | - Charles Carron
- Nuclear Medicine and Molecular Imaging, Imaging and Pathology, KU Leuven, Leuven, Belgium
- Division of Nuclear Medicine, University Hospitals UZ Leuven, Leuven, Belgium
| | - Rik Vandenberghe
- Department of Neurology, University Hospitals UZ Leuven, Leuven, Belgium
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Mathieu Vandenbulcke
- Research Group Psychiatry, KU Leuven, Leuven, Belgium
- Department of Old-Age Psychiatry, University Hospitals UZ Leuven, Leuven, Belgium
- Leuven Brain Institute, Leuven, Belgium
| | - Koen Van Laere
- Nuclear Medicine and Molecular Imaging, Imaging and Pathology, KU Leuven, Leuven, Belgium
- Division of Nuclear Medicine, University Hospitals UZ Leuven, Leuven, Belgium
- Leuven Brain Institute, Leuven, Belgium
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Ahmed AA, Chen S, Roman-Escorza M, Angell R, Oxenford S, McConville M, Barton N, Sunose M, Neidle D, Haider S, Arshad T, Neidle S. Structure-activity relationships for the G-quadruplex-targeting experimental drug QN-302 and two analogues probed with comparative transcriptome profiling and molecular modeling. Sci Rep 2024; 14:3447. [PMID: 38342953 PMCID: PMC10859377 DOI: 10.1038/s41598-024-54080-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 02/08/2024] [Indexed: 02/13/2024] Open
Abstract
The tetrasubstituted naphthalene diimide compound QN-302 binds to G-quadruplex (G4) DNA structures. It shows high potency in pancreatic ductal adenocarcinoma (PDAC) cells and inhibits the transcription of cancer-related genes in these cells and in PDAC animal models. It is currently in Phase 1a clinical evaluation as an anticancer drug. A study of structure-activity relationships of QN-302 and two related analogues (CM03 and SOP1247) is reported here. These have been probed using comparisons of transcriptional profiles from whole-genome RNA-seq analyses, together with molecular modelling and molecular dynamics simulations. Compounds CM03 and SOP1247 differ by the presence of a methoxy substituent in the latter: these two compounds have closely similar transcriptional profiles. Whereas QN-302 (with an additional benzyl-pyrrolidine group), although also showing down-regulatory effects in the same cancer-related pathways, has effects on distinct genes, for example in the hedgehog pathway. This distinctive pattern of genes affected by QN-302 is hypothesized to contribute to its superior potency compared to CM03 and SOP1247. Its enhanced ability to stabilize G4 structures has been attributed to its benzyl-pyrrolidine substituent fitting into and filling most of the space in a G4 groove compared to the hydrogen atom in CM03 or the methoxy group substituent in SOP1247.
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Affiliation(s)
- Ahmed Abdullah Ahmed
- The School of Pharmacy, University College London, London, WC1N 1AX, UK
- Now at Guy's Cancer Centre, Guy's Hospital, London, SE1 9RT, UK
| | - Shuang Chen
- The School of Pharmacy, University College London, London, WC1N 1AX, UK
| | | | - Richard Angell
- The School of Pharmacy, University College London, London, WC1N 1AX, UK
- Now at Medicines Discovery Institute, Cardiff University, Cardiff, CF10 3AT, UK
| | - Sally Oxenford
- The School of Pharmacy, University College London, London, WC1N 1AX, UK
- Now at Artios Ltd, Cambridge, CB22 3FH, UK
| | | | | | - Mihiro Sunose
- Sygnature Discovery Ltd, BioCity, Nottingham, NG1 1GR, UK
| | - Dan Neidle
- Tax Policy Associates, London, EC1R 0ET, UK
| | - Shozeb Haider
- The School of Pharmacy, University College London, London, WC1N 1AX, UK
| | - Tariq Arshad
- Qualigen Therapeutics Inc, Carlsbad, CA, 92011, USA
| | - Stephen Neidle
- The School of Pharmacy, University College London, London, WC1N 1AX, UK.
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Ferreira FC, Buarque CD, Lopes-Pacheco M. Organic Synthesis and Current Understanding of the Mechanisms of CFTR Modulator Drugs Ivacaftor, Tezacaftor, and Elexacaftor. Molecules 2024; 29:821. [PMID: 38398574 PMCID: PMC10891718 DOI: 10.3390/molecules29040821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 02/02/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024] Open
Abstract
The monogenic rare disease Cystic Fibrosis (CF) is caused by mutations in the gene encoding the CF transmembrane conductance (CFTR) protein, an anion channel expressed at the apical plasma membrane of epithelial cells. The discovery and subsequent development of CFTR modulators-small molecules acting on the basic molecular defect in CF-have revolutionized the standard of care for people with CF (PwCF), thus drastically improving their clinical features, prognosis, and quality of life. Currently, four of these drugs are approved for clinical use: potentiator ivacaftor (VX-770) alone or in combination with correctors lumacaftor, (VX-809), tezacaftor (VX-661), and elexacaftor (VX-445). Noteworthily, the triple combinatorial therapy composed of ivacaftor, tezacaftor, and elexacaftor constitutes the most effective modulator therapy nowadays for the majority of PwCF. In this review, we exploit the organic synthesis of ivacaftor, tezacaftor, and elexacaftor by providing a retrosynthetic drug analysis for these CFTR modulators. Furthermore, we describe the current understanding of the mechanisms of action (MoA's) of these compounds by discussing several studies that report the key findings on the molecular mechanisms underlying their action on the CFTR protein.
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Affiliation(s)
- Filipa C. Ferreira
- Biosystems & Integrative Sciences Institute (BioISI), Faculty of Sciences, University of Lisbon, 1749-016 Lisbon, Portugal
| | - Camilla D. Buarque
- Department of Chemistry, Pontifical Catholic University of Rio de Janeiro (PUC-Rio), Rio de Janeiro 22435-900, RJ, Brazil
| | - Miquéias Lopes-Pacheco
- Biosystems & Integrative Sciences Institute (BioISI), Faculty of Sciences, University of Lisbon, 1749-016 Lisbon, Portugal
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Merrill TB, Tyes J, Woodard TD. Is Elexacaftor/Tezacaftor/Ivacaftor Effective in Treating Sinonasal Disease in Patients with Cystic Fibrosis? Laryngoscope 2024; 134:501-503. [PMID: 37548273 DOI: 10.1002/lary.30937] [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] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 07/15/2023] [Indexed: 08/08/2023]
Affiliation(s)
- Tyler B Merrill
- Section of Rhinology, Sinus, and Skull Base Surgery, Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio, U.S.A
| | - Jonathan Tyes
- University of Louisville School of Medicine, Louisville, Kentucky, U.S.A
| | - Troy D Woodard
- Section of Rhinology, Sinus, and Skull Base Surgery, Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio, U.S.A
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Huang F, Yang H, Bao W, Bin Y, Zhou S, Wang M, Lv X. Efficacy and safety of trifluridine/tipiracil (TAS-102) in patients with metastatic colorectal cancer: a systematic review and meta-analysis. Clin Transl Oncol 2024; 26:468-476. [PMID: 37414979 DOI: 10.1007/s12094-023-03268-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 06/25/2023] [Indexed: 07/08/2023]
Abstract
OBJECTIVES The purpose of this meta-analysis is to evaluate the efficacy and safety of TAS-102 in treating metastatic colorectal cancer (mCRC) using the most recent data available. METHODS The literature on the efficacy and safety of TAS-102 versus placebo and/or best supportive care (BSC) in mCRC was obtained through a systematic search of PubMed, Embase, and Web of Science databases through January 2023. Identify the included literature and extract pertinent data, such as the overall survival (OS), progression-free survival (PFS), time to treatment failure (TTF), disease control rate (DCR), incidence of adverse events (AEs) and serious adverse events (SAEs). RESULTS There were eight eligible articles that included 2903 patients (1964 TAS-102 versus 939 Placebo and/or BSC). In this meta-analysis, TAS-102 treatment resulted in longer OS, PFS, TTF, and higher DCR in patients with mCRC versus placebo and/or BSC. TAS-102 improved OS and PFS in subgroup analyses of mCRC patients with KRAS wild-type and KRAS mutant-type. In addition, TAS-102 did not increase the incidence of serious adverse events. CONCLUSION TAS-102 can enhance the prognosis of mCRC patients whose standard therapy has failed, regardless of KRAS mutation status, and its safety is acceptable.
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Affiliation(s)
- Fengxiang Huang
- Department of Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Haiyan Yang
- Department of Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Wenguang Bao
- Department of Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Yehong Bin
- Department of Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Shengsheng Zhou
- Department of Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Man Wang
- Department of Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xiaoping Lv
- Department of Gastroenterology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
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Nakanishi K, Tanaka C, Kanda M, Miyata K, Machida N, Sakai M, Kobayashi D, Teramoto H, Ishiyama A, Sato B, Oshima T, Kajikawa M, Matsushita H, Ishigure K, Yamashita K, Fujitake S, Sueoka S, Asada T, Shimizu D, Sugita S, Kuwatsuka Y, Maeda O, Furune S, Murotani K, Ando Y, Ebata T, Kodera Y. Protocol of a phase II study investigating the efficacy and safety of trifluridine/tipiracil plus ramucirumab as a third-line or later treatment for advanced gastric cancer. Nagoya J Med Sci 2024; 86:43-51. [PMID: 38505718 PMCID: PMC10945229 DOI: 10.18999/nagjms.86.1.43] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 03/17/2023] [Indexed: 03/21/2024]
Abstract
In Japan, systemic chemotherapy is the standard treatment for unresectable, advanced, or recurrent gastric cancer. However, numerous patients with gastric cancer do not receive late-line treatment because of the rapid progression of gastric cancer. Additionally, late-line treatments, such as nivolumab, trifluridine tipiracil (FTD/TPI), or irinotecan, have limited effects on improving clinical symptoms and delaying the onset of symptoms associated with cancer progression. Recently, a combination of FTD/TPI and ramucirumab was reported to have a high response rate in late-line treatment; however, owing to patient selection bias and a high rate of hematologic toxicity in that previous study, this regimen may not be feasible in real-world clinical applications. Our objective is to conduct a single-arm phase II study to assess the safety and efficacy of FTD/TPI plus ramucirumab combination therapy for gastric cancer after third-line treatment under real-world clinical conditions. This study will recruit 32 patients according to eligibility criteria and administer FTD/TPI (35 mg/m2) and intravenous ramucirumab (8 mg/kg). The primary endpoint will be the time to treatment failure. The secondary endpoints will include the overall survival time, progression-free survival time, overall response rate, disease control rate, relative dose intensity, and incidence of adverse events. The results will add new insights for improving the late-line treatment of advanced gastric cancer.
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Affiliation(s)
- Koki Nakanishi
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Chie Tanaka
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Mitsuro Kanda
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kazushi Miyata
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nozomu Machida
- Department of Gastroenterology, Kanagawa Cancer Center, Yokohama, Japan
| | - Mitsuru Sakai
- Department of Surgery, Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | | | - Hitoshi Teramoto
- Department of Surgery, Yokkaichi Municipal Hospital, Yokkaichi, Japan
| | | | - Bin Sato
- Department of Surgery, Kainan Hospital, Yatomi, Japan
| | - Takashi Oshima
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan
| | - Masaki Kajikawa
- Department of Surgery, Gifu Prefectural Tajimi Hospital, Tajimi, Japan
| | | | | | | | | | - Satoshi Sueoka
- Department of Surgery, Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - Takahiro Asada
- Department of Surgery, Gifu Prefectural Tajimi Hospital, Tajimi, Japan
| | - Dai Shimizu
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shizuki Sugita
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yachiyo Kuwatsuka
- Department of Advanced Medicine, Nagoya University Hospital, Nagoya, Japan
| | - Osamu Maeda
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan
| | - Satoshi Furune
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan
| | - Kenta Murotani
- The Biostatistics Center, Graduate School of Medicine, Kurume University, Kurume, Japan
| | - Yuichi Ando
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan
| | - Tomoki Ebata
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yasuhiro Kodera
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Dittrich AM, Sieber S, Naehrlich L, Burkhart M, Hafkemeyer S, Tümmler B. Use of elexacaftor/tezacaftor/ivacaftor leads to changes in detection frequencies of Staphylococcus aureus and Pseudomonas aeruginosa dependent on age and lung function in people with cystic fibrosis. Int J Infect Dis 2024; 139:124-131. [PMID: 38036261 DOI: 10.1016/j.ijid.2023.11.013] [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: 07/20/2023] [Revised: 11/08/2023] [Accepted: 11/09/2023] [Indexed: 12/02/2023] Open
Abstract
OBJECTIVES The impressive improvements of cystic fibrosis (CF) transmembrane conductance regulator (CFTR) function by elexacaftor/tezacaftor/ivacaftor (ETI) result in changes in the detection frequencies of Staphylococcus aureus (SA) and Pseudomonas aeruginosa (PA). We assessed determinants of the response to ETI with regards to SA and PA detection frequencies as documented in the German CF registry for people with CF (pwCF) ≥12 years. METHODS We evaluated changes in the detection frequencies of SA and PA for 21 months before and after initiation of ETI and used different statistical tests to identify determinants of detection changes. RESULTS We included data from 1092 pwCF with results from culture-dependent diagnostics for SA and PA detection from 7944 microbiological samples before and 6.845 microbiological samples after initiation of ETI. Detections of SA decreased from 54.3% to 44.3% and 40.2% and those of PA from 39.9% to 31.9% and 22.6% 3 and 21 months after initiation of therapy, respectively (all P <0.001). Reduction of SA and PA were observed in throat swabs and sputa, associated significantly with age, previous lung function, and were dependent on pre-ETI colonization status. CONCLUSIONS The different patterns of reductions of SA and PA suggest that pathogen-specific biological processes govern the responsiveness of microbiological colonization towards ETI in pwCF.
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Affiliation(s)
- Anna-Maria Dittrich
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany; Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover Medical School, Hannover, Germany.
| | - Sarah Sieber
- STAT-UP Statistical Consulting & Data Science GmbH, Munich, Germany
| | - Lutz Naehrlich
- Department of Pediatrics, Justus-Liebig-University Giessen, Giessen, Germany; Universities of Giessen and Marburg Lung Center (UGMLC), German Center for Lung Research (DZL), Giessen, Germany
| | | | | | - Burkhard Tümmler
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany; Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover Medical School, Hannover, Germany
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50
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Lee TWR, Duff AJA. Questions and Answers? Depression Symptoms Associated with Elexacaftor/Tezacaftor/Ivacaftor Treatment for Cystic Fibrosis. Am J Respir Crit Care Med 2024; 209:239-241. [PMID: 38113403 PMCID: PMC10840773 DOI: 10.1164/rccm.202311-2159ed] [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] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 12/19/2023] [Indexed: 12/21/2023] Open
Affiliation(s)
- Tim W R Lee
- Leeds Centre for Children's Respiratory Medicine Leeds Teaching Hospitals NHS Trust Leeds, United Kingdom
| | - Alistair J A Duff
- Leeds Centre for Children's Respiratory Medicine
- Department of Paediatric Psychology Leeds Teaching Hospitals NHS Trust Leeds, United Kingdom
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