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Yang M, Su S, Cheng S, Wang Z, Du M. Absorption and transport properties of a codfish-derived peptide and its protective effect on bone loss in ovariectomized mice. Food Funct 2024; 15:3496-3506. [PMID: 38463011 DOI: 10.1039/d3fo04819e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
A potential osteogenic tetradecapeptide with the amino acid sequence GETNPADSKPGSIR (P-GM-2) was identified from Gadus morhua. The present study aimed to elucidate its absorption and transport properties using Caco-2/HT29-MTX co-culture monolayers and to evaluate its osteogenic activity using an ovariectomized mouse model. The results showed that P-GM-2 could cross Caco-2/HT29-MTX co-culture barriers intactly with an apparent permeability coefficient of 4.02 × 10-6 cm s-1via the TJ-mediated passive paracellular pathway. Pharmacokinetic results revealed that P-GM-2 was detectable in the blood of mice within 5 min of oral administration and reached its maximum concentration at 30 min. Furthermore, the oral administration of P-GM-2 for a duration of three months has been found to effectively regulate the secretion of key markers of bone turnover, thereby protecting against bone microstructure degeneration and bone loss in ovariectomized mice. Importantly, no toxicity related to the treatment was observed. Taken together, these findings offer valuable insights into the absorption and transport mechanisms of P-GM-2, highlighting its potential as a safe and effective active ingredient for preventing osteoporosis.
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Affiliation(s)
- Meilian Yang
- School of Food Science and Technology, National Engineering Research Center of Seafood, Collaborative Innovation Center of Seafood Deep Processing, SKL of Marine Food Processing & Safety Control, Dalian Polytechnic University, Dalian 116034, China.
| | - Shengpeng Su
- Inner Mongolia Enterprise Key Laboratory of Dairy Nutrition, Health & Safety, Inner Mongolia Mengniu Dairy (Group) Co., Ltd, Huhhot 011500, P.R. China
| | - Shuzhen Cheng
- School of Food Science and Technology, National Engineering Research Center of Seafood, Collaborative Innovation Center of Seafood Deep Processing, SKL of Marine Food Processing & Safety Control, Dalian Polytechnic University, Dalian 116034, China.
| | - Zhenyu Wang
- School of Food Science and Technology, National Engineering Research Center of Seafood, Collaborative Innovation Center of Seafood Deep Processing, SKL of Marine Food Processing & Safety Control, Dalian Polytechnic University, Dalian 116034, China.
| | - Ming Du
- School of Food Science and Technology, National Engineering Research Center of Seafood, Collaborative Innovation Center of Seafood Deep Processing, SKL of Marine Food Processing & Safety Control, Dalian Polytechnic University, Dalian 116034, China.
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Liu Y, Arora T, Zhang J, Sodhi SK, Xie F, Curtis JR. The interruption of romosozumab treatment during COVID lockdown among US post-menopausal women enrolled in Medicare. Bone 2024; 178:116954. [PMID: 37935313 DOI: 10.1016/j.bone.2023.116954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 10/25/2023] [Accepted: 11/03/2023] [Indexed: 11/09/2023]
Abstract
PURPOSE To evaluate the impact of the COVID lock-down on treatment interruptions of romosozumab, a first in class biologic therapy, administered by healthcare providers once monthly. METHODS We used Medicare data from 1/1/2017 to 9/30/2021 to identify women age ≥65 initiating romosozumab between 4/1/2019 and 6/30/2021. Patient demographics, provider specialty, and baseline comorbidities were identified. Romosozumab dispensations were grouped into five 6-month periods based on the dispensing date from FDA licensure to the end of the data (Period 1 to 5). "Treatment interruption" was defined as any interval gap between 2 dispensations >60 days. The numbers of treatment interruption event were aggregated per period per patient. Mixed effect Poisson regression with patient-level random effects was performed, including an interaction term between Period and number of prior doses. RESULTS There were 12,216 romosozumab new users identified. A total of 2724 treatment interruption events were identified among 2229 romosozumab users. After adjustment, comparing with the period immediately before the lockdown (Period 2: 2019-10-1-2020-3-30), the IRRs (95 % CI) for treatment interruption were 0.49 (0.29, 0.81), 1.65 (1.48, 1.85), 1.79 (1.60, 2.01), and 1.67 (1.49, 1.87) for periods 1, 3, 4, and 5, respectively, per 1 prior dose change (p < 0.01 for all IRRs), where Periods 3, 4, and 5 were post-lockdown. CONCLUSION Compared to the pre-COVID period, the lockdown negatively impacted the continuity of romosozumab treatment among Medicare beneficiaries. Prioritizing in-time assistance for patients receiving a provider-administered parenteral therapy is critical when patients' in-person access to their provider is compromised.
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Affiliation(s)
- Ye Liu
- University of Alabama at Birmingham, Birmingham, AL, USA.
| | - Tarun Arora
- Foundation for Advancing Science, Technology, Education and Research, Birmingham, AL, USA
| | - Jingyi Zhang
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - Sandeep K Sodhi
- Foundation for Advancing Science, Technology, Education and Research, Birmingham, AL, USA
| | - Fenglong Xie
- Foundation for Advancing Science, Technology, Education and Research, Birmingham, AL, USA
| | - Jeffrey R Curtis
- University of Alabama at Birmingham, Birmingham, AL, USA; Foundation for Advancing Science, Technology, Education and Research, Birmingham, AL, USA
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Yang L, Tang S, He M, Guo J, Gabriel N, Swabe G, Gellad WF, Essien UR, Saba S, Benjamin EJ, Magnani JW, Hernandez I. COVID-19 pandemic and initiation of treatment for atrial fibrillation: a nationwide analysis of claims data. BMC Cardiovasc Disord 2023; 23:604. [PMID: 38066445 PMCID: PMC10704685 DOI: 10.1186/s12872-023-03614-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 11/14/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic profoundly disrupted the delivery of medical care. It remains unclear whether individuals diagnosed with new onset disease during the pandemic were less likely to initiate treatments after diagnosis. We sought to evaluate changes in the treatment initiation of patients newly diagnosed with atrial fibrillation (AF) after the onset of the COVID-19 pandemic. METHODS In this retrospective cohort study, we identified individuals with incident AF from 01/01/2016-09/30/2021 using Optum's de-identified Clinformatics® Data Mart Database. The primary outcome was initiation of oral anticoagulation (OAC) within 30 days of AF diagnosis. Secondary outcomes included initiation of OAC within 180 days of diagnosis, initiation of warfarin, direct oral anticoagulants (DOACs), rhythm control medications and electrical cardioversion within 30 days of diagnosis. We constructed interrupted time series analyses to examine changes in the outcomes following the onset of the pandemic. RESULTS A total of 573,524 patients (age 73.0 ± 10.9 years) were included in the study. There were no significant changes in the initiation of OAC, DOAC, and rhythm control medications associated with the onset of the pandemic. There was a significant decrease in initiation of electrical cardioversion associated with the onset of the pandemic. The rate of electronic cardioversion within 30 days of diagnosis decreased by 4.9% per 1,000 patients after the onset of the pandemic and decreased by about 35% in April 2020, compared to April 2019, from 5.53% to 3.58%. CONCLUSION The COVID-19 pandemic did not affect the OAC initiation within 30 days of AF diagnosis but was associated with a decline in the provision of procedures for patients newly diagnosed with AF.
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Affiliation(s)
- Lanting Yang
- Department of Pharmacy and Therapeutics, University of Pittsburgh School of Pharmacy, Pittsburgh, PA, USA
| | - Shangbin Tang
- Division of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, La Jolla, CA, USA
| | - Meiqi He
- Division of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, La Jolla, CA, USA
| | - Jingchuan Guo
- Department of Pharmaceutical Outcomes and Policy, University of Florida College of Pharmacy, Gainesville, FL, USA
| | - Nico Gabriel
- Division of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, La Jolla, CA, USA
| | - Gretchen Swabe
- Division of Cardiology, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Walid F Gellad
- Division of General Internal Medicine, Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Utibe R Essien
- Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, Center for the Study of Healthcare Innovation, Implementation & Policy, University of California, Greater Los Angeles VA Healthcare System, Los Angeles, Los Angeles, CA, USA
| | - Samir Saba
- Division of Cardiology, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Emelia J Benjamin
- Department of Epidemiology, Boston University School of Public Health, Department of Medicine, Boston Medical Center and Boston University Chobanian and Avedisian School of Medicine, Boston University, Boston, MA, USA
| | - Jared W Magnani
- Division of Cardiology, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Inmaculada Hernandez
- Division of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, La Jolla, CA, USA.
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Varenna M, Orsini F, Di Taranto R, Zucchi F, Manara M, Caporali R, Crotti C. How the COVID-19 pandemic affected bone health: a retrospective, longitudinal study on denosumab persistence from the epicentre of European spreading. Arch Osteoporos 2023; 18:95. [PMID: 37438617 DOI: 10.1007/s11657-023-01307-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 07/03/2023] [Indexed: 07/14/2023]
Abstract
In this study, we investigated how the COVID-19 pandemic involved osteoporosis care in patients treated with denosumab. Almost a third of patients missed the prescription renewal, mandatory to obtain the subsidized drug. Among patients who suspended denosumab, more than half reported fragility fractures. PURPOSE This study aimed to evaluate persistence on denosumab (Dmab) treatment during the COVID-19 pandemic and the clinical effects of possible discontinuation. METHODS We retrospectively assessed patients affected by osteoporosis and treated with Dmab, scheduled to have the yearly renewal of prescription between March 9, 2020, and May 9, 2021, 2 months after the second pandemic wave. In June 2022, a telephone survey started, by calling all patients who missed the yearly renewal of Dmab. Predictors of missed renewal and fragility fracture occurrence were assessed by logistic analyses. RESULTS Patients scheduled to have a renewal of Dmab prescription during the observational period were 538 (age 75.5 ± 9.3 years, female 511). A total of 152 (28.2%) patients did not have the renewal. Patients not renewing Dmab prescription were significantly older (p = 0.01) and more frequently affected by pulmonary (p = 0.04) and cardiovascular comorbidity (p = 0.01). Telephone survey on non-persistent patients showed that 44 had died, 28 patients were missing, 23 shifted to bisphosphonate treatment, and 22 patients suspended Dmab. Following discontinuation, 12/22 patients (54.5%) reported fragility fractures; 5/22 had multiple fractures, for a total number of 18 fractures, mainly vertebral. Logistic analyses showed that the odds of Dmab withdrawal increased in older patients with pulmonary comorbidity and treated for a shorter time. Dmab discontinuation was the only variable that increased the risk of fracture. CONCLUSION This study provided real-world data about an impaired persistence of Dmab treatment resulting in an increased number of fragility fractures in a geographic area heavily affected by the outbreak of COVID-19.
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Affiliation(s)
- Massimo Varenna
- Bone Diseases Unit, Department of Rheumatology and Medical Sciences, ASST G.Pini-CTO, Via Pini, 9, 20122, Milan, Italy.
| | - F Orsini
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Clinical Rheumatology Unit, Department of Rheumatology and Medical Sciences, ASST G.Pini-CTO, Milan, Italy
| | - R Di Taranto
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Clinical Rheumatology Unit, Department of Rheumatology and Medical Sciences, ASST G.Pini-CTO, Milan, Italy
| | - F Zucchi
- Bone Diseases Unit, Department of Rheumatology and Medical Sciences, ASST G.Pini-CTO, Via Pini, 9, 20122, Milan, Italy
| | - M Manara
- Clinical Rheumatology Unit, Department of Rheumatology and Medical Sciences, ASST G.Pini-CTO, Milan, Italy
| | - R Caporali
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Clinical Rheumatology Unit, Department of Rheumatology and Medical Sciences, ASST G.Pini-CTO, Milan, Italy
| | - C Crotti
- Bone Diseases Unit, Department of Rheumatology and Medical Sciences, ASST G.Pini-CTO, Via Pini, 9, 20122, Milan, Italy
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