Pharmacokinetics, Safety, and Tolerability of Cedirogant in Healthy Japanese and Chinese Adults

Cedirogant is an inverse agonist of retinoic acid-related orphan receptor gamma, thymus (RORγt) developed for treatment of psoriasis. This study aimed to characterize pharmacokinetics, pharmacodynamics, safety, and tolerability of cedirogant following a single oral dose in Japanese participants and multiple oral doses in Japanese and Chinese participants. The single doses evaluated in healthy Japanese participants were 75, 225, and 395 mg. The multiple doses evaluated in both healthy Japanese and Chinese participants was 375 mg once daily for 14 days. Cedirogant plasma exposure increased dose proportionally with administration of single doses. Maximum cedirogant plasma concentration was reached within a median time of 4-5 hours after dosing. The harmonic mean elimination half-life ranged from 19 to 25 hours. Cedirogant pharmacokinetics were similar between Japanese and Chinese participants. Compared with healthy Western participants in a cross-study analysis, steady-state cedirogant plasma exposure was 38%-73% higher in Japanese or Chinese participants. Ex vivo interleukin-17 inhibition increased in a dose-dependent manner and was maximized by 375 mg once-daily doses. The cedirogant regimens tested were generally well tolerated, and no new safety issues were identified. The results supported enrollment of Japanese and Chinese subjects in subsequent clinical trials for cedirogant.

Pharmacokinetics, safety, and efficacy of cedirogant from phase I studies in healthy participants and patients with chronic plaque psoriasis

Cedirogant is an inverse agonist of retinoic acid-related orphan receptor gamma thymus (RORγt) developed for the treatment of moderate to severe chronic plaque psoriasis. Here, we report the results from two phase I studies in which the pharmacokinetics (PK), safety, and efficacy of cedirogant in healthy participants and patients with moderate to severe chronic plaque psoriasis were evaluated. The studies consisted of single (20-750 mg) and multiple (75-375 mg once-daily [q.d.]) ascending dose designs, with effect of food and itraconazole on cedirogant exposure also evaluated. Safety and PK were evaluated for both healthy participants and psoriasis patients, and efficacy was assessed in psoriasis patients. Following single and multiple doses, cedirogant mean terminal half-life ranged from 16 to 28 h and median time to reach maximum plasma concentration ranged from 2 to 5 h across both populations. Cedirogant plasma exposures were dose-proportional after single doses and less than dose-proportional from 75 to 375 mg q.d. doses. Steady-state concentrations were achieved within 12 days. Accumulation ratios ranged from approximately 1.2 to 1.8 across tested doses. Food had minimal effect and itraconazole had limited impact on cedirogant exposure. No discontinuations or serious adverse events due to cedirogant were recorded. Psoriasis Area and Severity Index (PASI) and Self-Assessment of Psoriasis Symptoms (SAPS) assessments demonstrated numerical improvement with treatment of cedirogant 375 mg q.d. compared with placebo. The PK, safety, and efficacy profiles of cedirogant supported advancing it to phase II clinical trial in psoriasis patients.

A survey of preschool oral health education programs

The purpose of this survey was to determine how frequently various components of oral health education were included in 27 preschool oral health education programs and to compare the frequencies and the various combinations of components. The results of this survey indicate that the most significant problems relate to inadequate program design and evaluation. Goals, behavioral objectives, program content, media, evaluation measures, and parent and teacher involvement need to be more specifically and thoroughly designed and evaluated. The primary problem with program content was the lack of emphasis on education about the benefits of fluoride. Because of inconsistent and incomplete reporting of programs, judgments of the quality and effectiveness of the components in the 27 programs were not made.

The status of fluoride in oral health education in Head Start programs

Due to the potential impact fluoride has on the prevention of dental caries and the lack of research on health education programs in Head Start, a status study was conducted to identify what is being taught to pre-school children and their parents about fluoride. The content of the oral health education program was adequate in terms of toothbrushing, nutrition, and functions of and visits to the dentist. The most significant problem was the lack of education about the significance of fluoride. Parents' and teachers' knowledge of oral health was quite high. The parents' lowest level of knowledge was in the area of fluoride. Inconsistencies between oral health knowledge and behavior were noted for parents and teachers. Health professionals should be aware of the lack of emphasis on fluoride education and direct their efforts toward educating children and their parents through clinical and preschool educational situations.

Effect of acute beta-adrenergic blockade on lactate-induced panic

Many clinical and theoretic attempts have been made to link anxiety disorders and the beta-adrenergic nervous system. Six patients with panic disorder, who had panic attacks produced by sodium lactate infusions, were given repeated lactate infusions that were immediately preceded by intravenous administration of propranolol hydrochloride. In all cases, propranolol pretreatment infusion failed to prevent panic attacks, anxiety, tachycardia, and increased systolic BP during the lactate infusion.