1
|
Oh J, Kang JH, Chae HD, Yoo HJ, Hong SH, Lee DY, Choi JY. Diagnosis of osteochondral lesions of the talus on Dual-layer spectral detector CT arthrography: clinical feasibility of virtual noncontrast images. Clin Radiol 2024:S0009-9260(24)00144-2. [PMID: 38649313 DOI: 10.1016/j.crad.2024.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 03/05/2024] [Accepted: 03/12/2024] [Indexed: 04/25/2024]
Abstract
AIM To compare the image quality of virtual noncontrast (VNC) and true noncontrast (TNC) CT images and to evaluate the clinical feasibility of VNC CT images for assessing osteochondral lesions of the talus (OLTs). MATERIALS AND METHODS Forty-five OLT patients who underwent ankle CT arthrography (CTA) using dual-layer spectral detector CT were enrolled. Reconstruction of VNC and three-dimensional volume rendering images was performed. Afterward, image noise, the signal-to-noise ratio (SNR), and the contrast-to-noise ratio (CNR) were measured. For the subjective evaluation, two board-certified musculoskeletal radiologists [R2-1] assessed spatial resolution, overall image quality, and lesion conspicuity. The accuracy rate for OLT grading was determined in 23 patients who underwent arthroscopic surgery. RESULTS While VNC images showed significantly less noise than TNC images, TNC images showed better SNRs and CNRs (p<.01). In the subjective analysis, TNC images showed better overall image quality (p<.001). For the 3D volume rendering images, VNC images scored significantly higher for lesion conspicuity (p<.001). The accuracy rates of CTA and CTA with VNC images for OLT grading were 79.2% and 83.3%, respectively. Regarding confidence level, when CTA and VNC images were evaluated together, the confidence level was significantly higher than that when only CTA images were evaluated (p<.001). CONCLUSION VNC imaging can provide better confidence level of OLT grading and evaluation of the integrity of the subchondral bone plate when combined with conventional CTA without additional radiation dose to the patient. In addition, VNC images-based 3D volume rendering reconstruction would be helpful for preoperative planning in OLT patients.
Collapse
Affiliation(s)
- J Oh
- Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea
| | - J H Kang
- Department of Radiology, Konkuk University Medical Center, Seoul, Republic of Korea
| | - H-D Chae
- Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea; Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - H J Yoo
- Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea; Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - S H Hong
- Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea; Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - D Y Lee
- Department of Orthopedic Surgery, Seoul National University Hospital, Seoul, Republic of Korea
| | - J-Y Choi
- Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea; Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea.
| |
Collapse
|
2
|
Chung WK, Huh KY, Park J, Oh J, Yu KS. Establishment of Advanced Regulatory Innovation for Clinical Trials Transformation (ARICTT): a multi-stakeholder public-private partnership-based organization to accelerate the transformation of clinical trials. Transl Clin Pharmacol 2024; 32:30-40. [PMID: 38586121 PMCID: PMC10990728 DOI: 10.12793/tcp.2024.32.e1] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 01/09/2024] [Accepted: 01/12/2024] [Indexed: 04/09/2024] Open
Abstract
Clinical trials have evolved with digital technologies and tend towards patient-centricity. A multi-stakeholder approach is needed to address the emerging complexities in clinical trials. In particular, the introduction of digital technologies and an emphasis on patient-centricity are the major trends in clinical trials. In response, we established a public-private partnership-based organization named Advanced Regulatory Innovation for Clinical Trials Transformation (ARICTT). Eleven organizations in total, from academia, industry, and regulatory agencies, participate in ARICTT. Based on multi-stakeholder collaboration from academia, industry, and government/regulatory bodies, we collected and prioritized current topics in clinical trials based on an internal survey. We established a three-year roadmap with axes that were termed trend, goal, structure, theme, topic, and method. In addition, we planned the development of recommendations based on real-world cases with feasibility studies. We developed appropriate organizational structure to fulfill the roadmap of ARICTT. The selected topics were decentralized clinical trials during the first year, followed by the three topics that were awarded the highest priority according to the internal survey: advances in the informed consent process, supporting sites using digital technology, and an effective recruitment strategy. We developed a case-based recommendation paper presenting an overview of the regulatory landscape and practical considerations with explanatory cases. We also designed and conducted fully decentralized trials to evaluate considerations in real-world settings for the selected topics. Overall engagement and communication were supported by the online platform and annual symposiums. In conclusion, we established a multi-stakeholder, public-private partnership-based organization to accelerate the transformation of clinical trials.
Collapse
Affiliation(s)
- Woo Kyung Chung
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Korea
| | - Ki Young Huh
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Korea
| | - Jiyeon Park
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Korea
| | - Jaeseong Oh
- Department of Pharmacology, Jeju National University College of Medicine, Jeju, Korea
| | - Kyung-Sang Yu
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Korea
| |
Collapse
|
3
|
Yoon JG, Jang DG, Cho SG, Lee C, Noh SH, Seo SK, Yu JW, Chung HW, Han K, Kwon SS, Han DH, Oh J, Jang IJ, Kim SH, Jee YK, Lee H, Park DW, Sohn JW, Yoon HJ, Kim CH, Lee JM, Kim SH, Lee MG. Synergistic toxicity with copper contributes to NAT2-associated isoniazid toxicity. Exp Mol Med 2024; 56:570-582. [PMID: 38424191 PMCID: PMC10984958 DOI: 10.1038/s12276-024-01172-8] [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: 06/21/2023] [Revised: 12/12/2023] [Accepted: 12/15/2023] [Indexed: 03/02/2024] Open
Abstract
Anti-tuberculosis (AT) medications, including isoniazid (INH), can cause drug-induced liver injury (DILI), but the underlying mechanism remains unclear. In this study, we aimed to identify genetic factors that may increase the susceptibility of individuals to AT-DILI and to examine genetic interactions that may lead to isoniazid (INH)-induced hepatotoxicity. We performed a targeted sequencing analysis of 380 pharmacogenes in a discovery cohort of 112 patients (35 AT-DILI patients and 77 controls) receiving AT treatment for active tuberculosis. Pharmacogenome-wide association analysis was also conducted using 1048 population controls (Korea1K). NAT2 and ATP7B genotypes were analyzed in a replication cohort of 165 patients (37 AT-DILI patients and 128 controls) to validate the effects of both risk genotypes. NAT2 ultraslow acetylators (UAs) were found to have a greater risk of AT-DILI than other genotypes (odds ratio [OR] 5.6 [95% confidence interval; 2.5-13.2], P = 7.2 × 10-6). The presence of ATP7B gene 832R/R homozygosity (rs1061472) was found to co-occur with NAT2 UA in AT-DILI patients (P = 0.017) and to amplify the risk in NAT2 UA (OR 32.5 [4.5-1423], P = 7.5 × 10-6). In vitro experiments using human liver-derived cell lines (HepG2 and SNU387 cells) revealed toxic synergism between INH and Cu, which were strongly augmented in cells with defective NAT2 and ATP7B activity, leading to increased mitochondrial reactive oxygen species generation, mitochondrial dysfunction, DNA damage, and apoptosis. These findings link the co-occurrence of ATP7B and NAT2 genotypes to the risk of INH-induced hepatotoxicity, providing novel mechanistic insight into individual AT-DILI susceptibility. Yoon et al. showed that individuals who carry NAT2 UAs and ATP7B 832R/R genotypes are at increased risk of developing isoniazid hepatotoxicity, primarily due to the increased synergistic toxicity between isoniazid and copper, which exacerbates mitochondrial dysfunction-related apoptosis.
Collapse
Affiliation(s)
- Jihoon G Yoon
- Department of Pharmacology, BK21 Project of Yonsei Advanced Medical Science, Woo Choo Lee Institute for Precision Drug Development, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Genomic Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Dong Geon Jang
- Department of Pharmacology, BK21 Project of Yonsei Advanced Medical Science, Woo Choo Lee Institute for Precision Drug Development, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sung-Gyu Cho
- Department of Microbiology and Immunology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Chaeyoung Lee
- Department of Pharmacology, BK21 Project of Yonsei Advanced Medical Science, Woo Choo Lee Institute for Precision Drug Development, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Shin Hye Noh
- Department of Pharmacology, BK21 Project of Yonsei Advanced Medical Science, Woo Choo Lee Institute for Precision Drug Development, Yonsei University College of Medicine, Seoul, Republic of Korea
- Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Soo Kyung Seo
- Department of Pharmacology, BK21 Project of Yonsei Advanced Medical Science, Woo Choo Lee Institute for Precision Drug Development, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jung Woo Yu
- Department of Pharmacology, BK21 Project of Yonsei Advanced Medical Science, Woo Choo Lee Institute for Precision Drug Development, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hyeon Woo Chung
- Department of Microbiology and Immunology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - KyeoRe Han
- Department of Microbiology and Immunology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Soon Sung Kwon
- Department of Pharmacology, BK21 Project of Yonsei Advanced Medical Science, Woo Choo Lee Institute for Precision Drug Development, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Dai Hoon Han
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Jaeseong Oh
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Republic of Korea
| | - In-Jin Jang
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Republic of Korea
| | - Sang-Hoon Kim
- Department of Internal Medicine, Eulji University School of Medicine, Seoul, Republic of Korea
| | - Young-Koo Jee
- Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea
| | - Hyun Lee
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Dong Won Park
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Jang Won Sohn
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Ho Joo Yoon
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Chul Hoon Kim
- Department of Pharmacology, BK21 Project of Yonsei Advanced Medical Science, Woo Choo Lee Institute for Precision Drug Development, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jae Myun Lee
- Department of Microbiology and Immunology, Yonsei University College of Medicine, Seoul, Republic of Korea.
| | - Sang-Heon Kim
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea.
| | - Min Goo Lee
- Department of Pharmacology, BK21 Project of Yonsei Advanced Medical Science, Woo Choo Lee Institute for Precision Drug Development, Yonsei University College of Medicine, Seoul, Republic of Korea.
- Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
| |
Collapse
|
4
|
Won H, Yoon DY, Lee S, Cho J, Oh J, Jang I, Yoo S, Yu K. Effects of meal type on the bioavailability of vutiglabridin, a novel anti-obesity agent, in healthy subjects. Clin Transl Sci 2024; 17:e13744. [PMID: 38436494 PMCID: PMC10910614 DOI: 10.1111/cts.13744] [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: 09/09/2023] [Revised: 01/29/2024] [Accepted: 02/01/2024] [Indexed: 03/05/2024] Open
Abstract
Vutiglabridin, which affects the pharmacokinetics (PKs) of food, is currently under clinical development for the treatment of obesity. This study aimed to evaluate the effects of low- and high-fat meals on PKs of vutiglabridin in healthy male subjects. A randomized, open-label, single-dose, three-period, six-sequence crossover study was conducted. The subjects received a single oral dose of vutiglabridin 480 mg in a fasted state, 30 min after the intake of a low-fat meal (total 500-600 kcal, fat content 100-125 kcal) and high-fat meal (total 800-1000 kcal, fat content 500-600 kcal), with a 21-day washout period. Geometric mean ratios (GMRs) and 90% confidence intervals (CIs) for maximum plasma concentration (Cmax ) and area under the plasma concentration-time curve to the last measurable timepoint (AUClast ) were calculated. After intake of low- and high-fat meals, systemic exposure to vutiglabridin was increased, and the time to reach Cmax (Tmax ) was delayed compared to that in the fasted state. The GMRs (90% CIs) of low-fat meal to fasted state for Cmax and AUClast were 2.14 (1.76-2.60) and 2.15 (1.92-2.42), respectively, and those of high-fat meal to fasted state were 3.07 (2.53-3.72) and 3.00 (2.67-3.37), respectively. The median Tmax was delayed by 1.5 h in both fed states compared with that in the fasted state. The study drug was well-tolerated after administration in both the fed and fasted states. Food ingestion substantially increased the extent of oral vutiglabridin absorption in healthy subjects, and this enhancement increased with the fat content of the meal.
Collapse
Affiliation(s)
- Heejae Won
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of Medicine and HospitalSeoulKorea
- Department of Biomedical SciencesSeoul National University College of MedicineSeoulKorea
| | - Deok Yong Yoon
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of Medicine and HospitalSeoulKorea
| | - Sangmi Lee
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of Medicine and HospitalSeoulKorea
- Integrated Major in Innovative Medical ScienceSeoul National University Graduate SchoolSeoulKorea
| | - Joo‐Youn Cho
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of Medicine and HospitalSeoulKorea
- Department of Biomedical SciencesSeoul National University College of MedicineSeoulKorea
| | - Jaeseong Oh
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of Medicine and HospitalSeoulKorea
- Department of PharmacologyJeju National University College of MedicineJejuRepublic of Korea
| | - In‐Jin Jang
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of Medicine and HospitalSeoulKorea
| | | | - Kyung‐Sang Yu
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of Medicine and HospitalSeoulKorea
- Department of Biomedical SciencesSeoul National University College of MedicineSeoulKorea
| |
Collapse
|
5
|
Khwarg J, Lee S, Jang IJ, Kang WH, Lee HJ, Kim KY, Jeong KS, Won C, Choi YW, Ha DC, Jung R, Han MG, Jung WT, Nam KY, Kim Y, Yu KS, Oh J. Pharmacokinetic Comparison Between a Fixed-Dose Combination of Atorvastatin/Omega-3-Acid Ethyl Esters and the Corresponding Loose Combination in Healthy Korean Male Subjects. Drug Des Devel Ther 2024; 18:395-406. [PMID: 38352172 PMCID: PMC10861834 DOI: 10.2147/dddt.s435885] [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: 09/18/2023] [Accepted: 01/03/2024] [Indexed: 02/16/2024] Open
Abstract
Purpose Statins are widely used in combination with omega-3 fatty acids for the treatment of patients with dyslipidemia. The aim of this study was to compare the pharmacokinetic (PK) profiles of atorvastatin and omega-3-acid ethyl esters between fixed-dose combination (FDC) and loose combination in healthy subjects. Methods A randomized, open-label, single-dose, 2-sequence, 2-treatment, 4-period replicated crossover study was performed. Subjects were randomly assigned to one of the 2 sequences and alternately received four FDC soft capsules of atorvastatin/omega-3-acid ethyl esters (10/1000 mg) or a loose combination of atorvastatin tablets (10 mg × 4) and omega-3-acid ethyl ester soft capsules (1000 mg× 4) for four periods, each period accompanied by a high-fat meal. Serial blood samples were collected for PK analysis of atorvastatin, eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA). PK parameters were calculated by a non-compartmental analysis. The geometric mean ratio (GMR) and its 90% confidence interval (CI) of the FDC to the loose combination were calculated to compare PK parameters. Results A total of 43 subjects completed the study as planned. The GMR (90% CI) of FDC to loose combination for maximum concentration (Cmax) and area under the time-concentration curve from zero to the last measurable point (AUClast) were 1.0931 (1.0054-1.1883) and 0.9885 (0.9588-1.0192) for atorvastatin, 0.9607 (0.9068-1.0178) and 0.9770 (0.9239-1.0331) for EPA, and 0.9961 (0.9127-1.0871) and 0.9634 (0.8830-1.0512) for DHA, respectively. The intra-subject variability for Cmax and AUClast of DHA was 30.8% and 37.5%, respectively, showing high variability. Both the FDC and the loose combination were safe and well tolerated. Conclusion The FDC of atorvastatin and omega-3-acid ethyl esters showed comparable PK characteristics to the corresponding loose combination, offering a convenient therapeutic option for the treatment of dyslipidemia.
Collapse
Affiliation(s)
- Juyoung Khwarg
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Republic of Korea
| | - Soyoung Lee
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Republic of Korea
- Integrated Major in Innovative Medical Science, Seoul National University Graduate School, Seoul, Republic of Korea
| | - In-Jin Jang
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Republic of Korea
| | - Won-Ho Kang
- R&D Center, Korea United Pharm. Inc., Seoul, Republic of Korea
| | | | | | | | - Chongho Won
- Caleb Multilab, Inc., Seoul, Republic of Korea
| | - Youn Woong Choi
- R&D Center, Korea United Pharm.Inc., Sejong, Republic of Korea
| | - Dae Chul Ha
- R&D Center, Korea United Pharm.Inc., Sejong, Republic of Korea
| | - RaeHoon Jung
- R&D Center, Korea United Pharm.Inc., Sejong, Republic of Korea
| | - Min-Gu Han
- R&D Center, Korea United Pharm.Inc., Sejong, Republic of Korea
| | - Won Tae Jung
- Global R&D, Korea United Pharm. Inc., Seoul, Republic of Korea
| | - Kyu-Yeol Nam
- Global R&D, Korea United Pharm. Inc., Seoul, Republic of Korea
| | - YeSeul Kim
- Global R&D, Korea United Pharm. Inc., Seoul, Republic of Korea
| | - Kyung-Sang Yu
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Republic of Korea
| | - Jaeseong Oh
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Republic of Korea
- Department of Pharmacology, Jeju National University College of Medicine, Jeju, Republic of Korea
| |
Collapse
|
6
|
Kim B, Cho JY, Song I, Oh J. Pharmacogenetic Analysis of an 8-Year Old Girl with Reye Syndrome Associated with Use of Naproxen. Am J Case Rep 2024; 25:e942242. [PMID: 38311849 PMCID: PMC10862079 DOI: 10.12659/ajcr.942242] [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: 08/21/2023] [Revised: 12/28/2023] [Accepted: 12/21/2023] [Indexed: 02/06/2024]
Abstract
BACKGROUND Reye syndrome is a rare, yet potentially life-threatening disease characterized by acute encephalopathy and hepatic failure. This report presents the case of an 8-year-old girl with Reye syndrome and seizures after the use of naproxen. CASE REPORT An 8-year-old girl experienced a 3-day episode of fever and abdominal pain. After receiving naproxen (375 mg twice daily) starting from day -3, she exhibited hypotension, tonic seizure, and loss of consciousness (day 1). Physical examination and laboratory test results revealed acute kidney injury, metabolic acidosis, and elevated levels of lactate dehydrogenase (LDH), liver enzymes, and ferritin. On day 2, the maximum values of aspartate aminotransferase, alanine aminotransferase, LDH, creatinine, and ferritin were 955 U/L, 132 U/L, 8040 U/L, 2 mg/dL, and >40000 ug/L, respectively. She was given supportive care and recovered after 11 days (day 12), with normalization of kidney function and metabolic abnormalities. To identify possible genetic polymorphisms associated with the patient's symptoms, genotypes were tested using a drug metabolizing enzymes and transporters (DMET) gene chip. Among genes involved in the metabolism of naproxen, UGT1A6 (*1/*2) and UGT2B7 (*1/*2) resulted in possibly decreased function. Other results which may have had clinical significance included homozygote results for NAT2*6/*6 (rs1799930). CONCLUSIONS A rare case of Reye syndrome after administration of naproxen was presented in this case. A DMET gene chip was used to screen for possible genetic polymorphisms associated with Reye syndrome, but the result was inconclusive.
Collapse
Affiliation(s)
- Byungwook Kim
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, South Korea
| | - Joo-Youn Cho
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, South Korea
| | - Ildae Song
- Department of Pharmaceutical Science and Technology, Kyungsung University, Busan, South Korea
| | - Jaeseong Oh
- Department of Pharmacology, Jeju National University College of Medicine, Jeju, South Korea
| |
Collapse
|
7
|
Lee S, Kim HC, Jang Y, Lee HS, Ahn S, Lee S, Jung K, Park K, Jung K, Oh J, Lee S, Yu K, Jang I, Lee S, Chu K, Lee SK. Topiramate dosage optimization for effective antiseizure management via population pharmacokinetic modeling. Ann Clin Transl Neurol 2024; 11:424-435. [PMID: 38062636 PMCID: PMC10863906 DOI: 10.1002/acn3.51962] [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] [Received: 09/23/2023] [Revised: 11/07/2023] [Accepted: 11/18/2023] [Indexed: 02/15/2024] Open
Abstract
OBJECTIVE Despite the suggested topiramate serum level of 5-20 mg/L, numerous institutions have observed substantial drug response at lower levels. We aim to investigate the correlation between topiramate serum levels, drug responsiveness, and adverse events to establish a more accurate and tailored therapeutic range. METHODS We retrospectively analyzed clinical data collected between January 2017 and January 2022 at Seoul National University Hospital. Drug responses to topiramate were categorized as "insufficient" or "sufficient" by reduction in seizure frequency ≥ 50%. A population pharmacokinetic model estimated serum levels from spot measurements. ROC curve analysis determined the optimal cutoff values. RESULTS A total of 389 epilepsy patients were reviewed having a mean dose of 178.4 ± 117.9 mg/day and the serum level, 3.9 ± 2.8 mg/L. Only 5.6% samples exhibited insufficient response, with a mean serum level of 3.6 ± 2.5 mg/L while 94.4% demonstrated sufficient response, with a mean 4.0 ± 2.8 mg/L, having no statistical significance. Among the 69 reported adverse events, logistic regression analysis identified a significant association between ataxia and serum concentration (p = 0.04), with an optimal cutoff value of 6.5 mg/L. INTERPRETATION This study proposed an optimal therapeutic concentration for topiramate based on patients' responsiveness to the drug and the incidence of adverse effects. We recommended serum levels below 6.5 mg/L to mitigate the risk of ataxia-related side effects while dose elevation was found unnecessary for suboptimal responders, as the drug's effectiveness plateaus at minimal doses.
Collapse
Affiliation(s)
- Seolah Lee
- Laboratory for Neurotherapeutics, Department of Neurology, Comprehensive Epilepsy Center, Center for Medical InnovationBiomedical Research Institute, Seoul National University College of Medicine and HospitalSeoulSouth Korea
| | - Hyun Chul Kim
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of Medicine and HospitalSeoulSouth Korea
- Integrated Major in Innovative Medical ScienceSeoul National University Graduate SchoolSeoulSouth Korea
| | - Yoonhyuk Jang
- Laboratory for Neurotherapeutics, Department of Neurology, Comprehensive Epilepsy Center, Center for Medical InnovationBiomedical Research Institute, Seoul National University College of Medicine and HospitalSeoulSouth Korea
| | - Han Sang Lee
- Laboratory for Neurotherapeutics, Department of Neurology, Comprehensive Epilepsy Center, Center for Medical InnovationBiomedical Research Institute, Seoul National University College of Medicine and HospitalSeoulSouth Korea
- Center for Hospital MedicineSeoul National University HospitalSeoulSouth Korea
| | - Seon‐Jae Ahn
- Laboratory for Neurotherapeutics, Department of Neurology, Comprehensive Epilepsy Center, Center for Medical InnovationBiomedical Research Institute, Seoul National University College of Medicine and HospitalSeoulSouth Korea
- Center for Hospital MedicineSeoul National University HospitalSeoulSouth Korea
| | - Soon‐Tae Lee
- Laboratory for Neurotherapeutics, Department of Neurology, Comprehensive Epilepsy Center, Center for Medical InnovationBiomedical Research Institute, Seoul National University College of Medicine and HospitalSeoulSouth Korea
| | - Keun‐Hwa Jung
- Laboratory for Neurotherapeutics, Department of Neurology, Comprehensive Epilepsy Center, Center for Medical InnovationBiomedical Research Institute, Seoul National University College of Medicine and HospitalSeoulSouth Korea
| | - Kyung‐Il Park
- Laboratory for Neurotherapeutics, Department of Neurology, Comprehensive Epilepsy Center, Center for Medical InnovationBiomedical Research Institute, Seoul National University College of Medicine and HospitalSeoulSouth Korea
- Division of NeurologySeoul National University Hospital Healthcare System Gangnam CenterSeoulSouth Korea
| | - Ki‐Young Jung
- Laboratory for Neurotherapeutics, Department of Neurology, Comprehensive Epilepsy Center, Center for Medical InnovationBiomedical Research Institute, Seoul National University College of Medicine and HospitalSeoulSouth Korea
| | - Jaeseong Oh
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of Medicine and HospitalSeoulSouth Korea
- Department of PharmacologyJeju National University College of MedicineJeju Special Self‐Governing ProvinceRepublic of Korea
| | - SeungHwan Lee
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of Medicine and HospitalSeoulSouth Korea
| | - Kyung‐Sang Yu
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of Medicine and HospitalSeoulSouth Korea
| | - In‐Jin Jang
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of Medicine and HospitalSeoulSouth Korea
| | - Soyoung Lee
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of Medicine and HospitalSeoulSouth Korea
- Integrated Major in Innovative Medical ScienceSeoul National University Graduate SchoolSeoulSouth Korea
| | - Kon Chu
- Laboratory for Neurotherapeutics, Department of Neurology, Comprehensive Epilepsy Center, Center for Medical InnovationBiomedical Research Institute, Seoul National University College of Medicine and HospitalSeoulSouth Korea
| | - Sang Kun Lee
- Laboratory for Neurotherapeutics, Department of Neurology, Comprehensive Epilepsy Center, Center for Medical InnovationBiomedical Research Institute, Seoul National University College of Medicine and HospitalSeoulSouth Korea
| |
Collapse
|
8
|
Kim HC, Yang E, Lee S, Oh J, Lee M, Lee C, Ha KS, Lee WS, Jang IJ, Yu KS. Effects of food and ethnicity on the pharmacokinetics of venadaparib, a next-generation PARP inhibitor, in healthy Korean, Caucasian, and Chinese male subjects. Invest New Drugs 2024; 42:80-88. [PMID: 38099989 PMCID: PMC10891214 DOI: 10.1007/s10637-023-01405-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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 10/26/2023] [Indexed: 02/24/2024]
Abstract
AIM Venadaparib is a next-generation poly(ADP-ribose) polymerase inhibitor under development for treating gastric cancer. This study aimed to evaluate the effects of food and ethnicity on the pharmacokinetics (PKs) and safety of venadaparib after a single oral administration in healthy Korean, Caucasian, and Chinese male subjects. METHODS In this randomized, open-label, single-dose, two-sequence, two-period, and crossover study, Korean and Caucasian subjects received venadaparib 80 mg in each period (fasted or fed state) with a seven-day washout. In an open-label, single-dose study, Chinese subjects received venadaparib 80 mg only in the fasted state. Serial blood samples were collected up to 72 h post-dosing. RESULTS Twelve subjects from each ethnic group completed the study. The geometric mean ratios (90% confidence intervals) of the maximum plasma concentration (Cmax) and area under the plasma concentration-time curve from time zero to the last measurable time point (AUClast) of venadaparib for the fed to fasted state were 0.82 (0.7457-0.9094) and 1.02 (0.9088-1.1339) in Koreans, and 0.77 (0.6871-0.8609) and 0.96 (0.9017-1.0186) in Caucasians, respectively. No statistically significant differences were observed in Cmax (P-value = 0.45) or AUClast (P-value = 0.30) among the three ethnic groups. A single venadaparib dose was well-tolerated. CONCLUSION The overall systemic exposure of venadaparib was not affected by the high-fat meal, despite delayed absorption with a decreased Cmax in the fed state. The PK profiles were comparable among the Korean, Caucasian, and Chinese subjects. A single venadaparib 80 mg dose was safe and well-tolerated in both fasted and fed states.
Collapse
Affiliation(s)
- Hyun Chul Kim
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
- Integrated Major in Innovative Medical Science, Seoul National University Graduate School, Seoul, Republic of Korea
| | - Eunsol Yang
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, San Francisco, CA, United States of America
| | - Soyoung Lee
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
- Kidney Research Institute, Seoul National University Medical Research Center, Seoul, Republic of Korea
| | - Jaeseong Oh
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
- Department of Pharmacology, Jeju National University College of Medicine, Jeju, Republic of Korea
| | | | | | | | | | - In-Jin Jang
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Kyung-Sang Yu
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
| |
Collapse
|
9
|
Lee H, Hwang S, Jang IJ, Chung JY, Oh J. Adaptive design clinical trials: current status by disease and trial phase in various perspectives. Transl Clin Pharmacol 2023; 31:202-216. [PMID: 38197001 PMCID: PMC10772057 DOI: 10.12793/tcp.2023.31.e21] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 10/18/2023] [Accepted: 11/15/2023] [Indexed: 01/11/2024] Open
Abstract
An adaptive design is a clinical trial design that allows for modification of a structured plan in a clinical trial based on data accumulated during pre-planned interim analyses. This flexible approach to clinical trial design improves the success rate of clinical trials while reducing time, cost, and sample size compared to conventional methods. The purpose of this study is to identify the current status of adaptive design and present key considerations for planning an appropriate adaptive design based on specific circumstances. We searched for clinical trials conducted between January 2006 to July 2021 in the Clinical Trials Registry (ClinicalTrials.gov) using keywords specified in the Food and Drug Administration Adaptive Design Clinical Trial Guidelines. In order to analyze the adaptive designs used in selected cases, we classified the results according to the phase of the clinical trial, type of indication, and the specific adaptation method employed. A total of 267 clinical trials were identified on ClinicalTrials.gov. Among them, 236 clinical trials actually applied adaptive designs and were classified according to phase, indication types, and adaptation methods. Adaptive designs were most frequently used in phase 2 clinical trials and oncology research. The most commonly used adaptation method was the adaptive treatment selection design. In the case of coronavirus disease 2019, the most frequently used designs were adaptive platform design and seamless design. Through this study, we expect to provide valuable insights and considerations for the implementation of adaptive design clinical trials in different diseases and stages.
Collapse
Affiliation(s)
- Hyunjoon Lee
- Department of Clinical Pharmacology and Therapeutics, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 03080, Korea
- Department of Translational Medicine, Seoul National University College of Medicine, Seoul 03080, Korea
| | - Sejung Hwang
- Department of Clinical Pharmacology and Therapeutics, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 03080, Korea
- Kidney Research Institute, Seoul National University Medical Research Center, Seoul 03080, Korea
| | - In-Jin Jang
- Department of Clinical Pharmacology and Therapeutics, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 03080, Korea
| | - Jae-Yong Chung
- Department of Translational Medicine, Seoul National University College of Medicine, Seoul 03080, Korea
- Department of Clinical Pharmacology and Therapeutics, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam 13620, Korea
| | - Jaeseong Oh
- Department of Clinical Pharmacology and Therapeutics, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 03080, Korea
- Department of Pharmacology, Jeju National University College of Medicine, Jeju 63241, Korea
| |
Collapse
|
10
|
Huh KY, Chung WK, Park J, Lee S, Kim M, Oh J, Yu K. Feasibility study for a fully decentralized clinical trial in participants with functional constipation symptoms. Clin Transl Sci 2023; 16:2177-2188. [PMID: 37632169 PMCID: PMC10651644 DOI: 10.1111/cts.13617] [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: 05/12/2023] [Revised: 07/17/2023] [Accepted: 08/11/2023] [Indexed: 08/27/2023] Open
Abstract
Decentralized clinical trials (DCTs) leverage digital technologies to reduce dependency on study sites and intermediaries. DCT should be balanced with accessibility and data reliability while meeting regulatory requirements. Here, we conducted a pilot study for functional constipation symptoms to investigate the feasibility of DCT. The study was an open, fully remote, randomized clinical trial in participants who had functional constipation symptoms. Electronic consent was obtained remotely, and study volunteers were screened through web-based questionnaires. Subjects were randomized to either receive Lactobacillus and vitamin C supplements or vitamin C alone in a 1:1 ratio, which were delivered directly to subjects. Subjects kept track of bowel diaries daily during the 1-week baseline and 2-week treatment period using mobile applications. Bowel symptoms and the validity of the records were descriptively evaluated. A total of 30 subjects were randomized and completed the study. A total of 26.7% of subjects resided outside of the metropolitan area. Two-week Lactobacillus treatments increased the number of defecations (+0.80 vs. +0.46 times per week) and decreased the defecation time (-3.94 h vs. -1.62 h) compared to the comparator group. Overall, 67.1% of bowel diary records were completed in accordance with the schedule whereas 32.9% were not. Implementation of DCTs can facilitate geographic accessibility but should be guaranteed for data reliability. Prompt detection of errors and response using objective metrics would be required.
Collapse
Affiliation(s)
- Ki Young Huh
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of Medicine and HospitalSeoulKorea
| | - Woo Kyung Chung
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of Medicine and HospitalSeoulKorea
| | - Jiyeon Park
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of Medicine and HospitalSeoulKorea
| | - SeungHwan Lee
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of Medicine and HospitalSeoulKorea
| | - Min‐Gul Kim
- Nanum Space Co., LtdJeonjuKorea
- Department of Pharmacology, Medical SchoolJeonbuk National UniversityJeonjuKorea
| | - Jaeseong Oh
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of Medicine and HospitalSeoulKorea
- Present address:
Department of PharmacologyJeju National University School of MedicineJejuRepublic of Korea
| | - Kyung‐Sang Yu
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of Medicine and HospitalSeoulKorea
| |
Collapse
|
11
|
Witek TJ, Abolhassani F, Schwartz R, Oh J. A "Tail" of three cities. Public health and acute atrophy of vigilance. Public Health 2023; 223:e12-e13. [PMID: 36907746 PMCID: PMC10002669 DOI: 10.1016/j.puhe.2023.01.032] [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: 01/10/2023] [Revised: 01/20/2023] [Accepted: 01/27/2023] [Indexed: 03/12/2023]
Affiliation(s)
- T J Witek
- Institute of Health Policy Management & Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario Canada.
| | | | - R Schwartz
- Institute of Health Policy Management & Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario Canada
| | - J Oh
- Seoul National University College of Medicine, Seoul, Republic of Korea
| |
Collapse
|
12
|
Martin SJ, Brand-Arzamendi K, Saab G, Muccilli A, Oh J, Schneider R. GM-CSF is a marker of compartmentalised intrathecal inflammation in multiple sclerosis. Mult Scler 2023; 29:1373-1382. [PMID: 37700482 DOI: 10.1177/13524585231195861] [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: 09/14/2023]
Abstract
BACKGROUND Granulocyte-macrophage colony stimulating factor (GM-CSF) is a pro-inflammatory cytokine secreted by various immune cells. Several studies have demonstrated an expansion of GM-CSF producing T cells in the blood or CSF of people with MS (pwMS). However, whether this equates to greater concentrations of circulating cytokine remains unknown as quantification is difficult with traditional assays. OBJECTIVE To determine whether GM-CSF can be quantified and whether GM-CSF levels are elevated in pwMS. METHODS We employed Single Molecule Array (Simoa) to measure GM-CSF in both CSF and blood. We then investigated relationships between GM-CSF levels and measures of blood-CSF-barrier integrity. RESULTS GM-CSF was quantifiable in all samples and was significantly higher in the CSF of pwMS compared with controls. No association was found between CSF GM-CSF levels and Q-Albumin - a measure of blood-CSF-barrier integrity. CSF GM-CSF correlated with measures of intrathecal inflammation, and these relationships were greater in primary progressive MS compared with relapsing-remitting MS. CONCLUSION GM-CSF levels are elevated specifically in the CSF of pwMS. Our results suggest that elevated cytokine levels may reflect (at least partial) intrathecal production, as opposed to simple diffusion across a dysfunctional blood-CSF-barrier.
Collapse
Affiliation(s)
- S-J Martin
- St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
- Keenan Research Centre for Biomedical Science, Unity Health Toronto, Toronto, ON, Canada
| | - K Brand-Arzamendi
- St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
- Keenan Research Centre for Biomedical Science, Unity Health Toronto, Toronto, ON, Canada
| | - G Saab
- St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - A Muccilli
- St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - J Oh
- St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
- Keenan Research Centre for Biomedical Science, Unity Health Toronto, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - R Schneider
- St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
- Keenan Research Centre for Biomedical Science, Unity Health Toronto, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
13
|
Yang H, Kim MS, Rhee SY, Lee J, Cho W, Min C, Lee SW, Shin JI, Oh J, Choi Y, Lee JH, Kim H, Rahmati M, Yeo SG, Yon DK. National prevalence and socioeconomic factors associated with the acceptance of COVID-19 vaccines in South Korea: a large-scale representative study in 2021. Eur Rev Med Pharmacol Sci 2023; 27:8943-8951. [PMID: 37782203 DOI: 10.26355/eurrev_202309_33815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
OBJECTIVE Among the global efforts toward preventing the COVID-19 pandemic, vaccines are a pivotal factor in ending the pandemic. Thus, through a large-scale population-based study, we investigated the individual-, social-, and family-associated factors affecting the acceptance of COVID-19 vaccines in South Korea. PATIENTS AND METHODS Data were obtained from a nationwide representative study (Korea Community Health) conducted in 2021. To determine the individual-, social-, and family-associated variables for COVID-19 vaccination acceptance, we investigated data from 225,319 individuals. RESULTS In the total sample (n=225,319), 184,529 COVID-19-vaccinated people and 40,790 non-vaccinated people were evaluated. The factors related to the acceptance of COVID-19 vaccination were significantly associated with the demographic factors, namely, older age group, female sex, and a history of influenza vaccination, as well as medical conditions such as diabetes, hypertension, and depression. Socioeconomic conditions influencing the acceptance of COVID-19 vaccination were significantly associated with low-income families and blue-collar workers. Health-related risk factors were high in the obese group. However, a noteworthy negative association was found between the acceptance of vaccination and smoking habits and alcohol consumption. Conversely, a positive association was observed between academic level and vaccination acceptance. CONCLUSIONS Our findings suggest that old age, female sex, a history of influenza vaccination, medical conditions, such as diabetes, hypertension, and depression, low-income families, blue-collar workers, and health-related risk factors, such as obesity, were associated with the acceptance of COVID-19 vaccination. Additionally, a high academic level, absence of smoking habits, and non-current alcohol use were positively associated with vaccine acceptance.
Collapse
Affiliation(s)
- H Yang
- Department of Regulatory Science, Kyung Hee University, Seoul, South Korea.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
14
|
Lee S, Hong KT, Jang I, Yu K, Kang HJ, Oh J. Semimechanistic pharmacokinetic-pharmacodynamic model of tripegfilgrastim for pediatric patients after chemotherapy. CPT Pharmacometrics Syst Pharmacol 2023; 12:1319-1334. [PMID: 37559343 PMCID: PMC10508573 DOI: 10.1002/psp4.13012] [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: 01/26/2023] [Revised: 07/03/2023] [Accepted: 07/06/2023] [Indexed: 08/11/2023] Open
Abstract
Tripegfilgrastim is a long-acting granulocyte colony-stimulating factor (G-CSF) that has been used to prevent chemotherapy-induced neutropenia in adults. This study aimed to establish a pharmacokinetic (PK)-pharmacodynamic (PD) model to explore the impact of chemotherapy and tripegfilgrastim on absolute neutrophil counts (ANCs) and to further propose a fixed-dose regimen in pediatric patients. Because neutrophils affect the clearance of tripegfilgrastim, the semimechanistic PK-PD model was developed simultaneously by using data from 40 healthy adults and 27 pediatric patients with solid tumors. Tripegfilgrastim PK and ANC dynamics were described with a pharmacodynamics-mediated drug disposition model assuming quasi-equilibrium with five transit compartments mimicking neutrophil granulopoiesis. The effect of chemotherapy on neutrophils was included by stimulating the elimination of the G-CSF receptor at the mitotic cells. Healthy adult and pediatric patients showed significantly different value for dissociation constant of the tripegfilgrastim-G-CSF receptor complex (Kd ) and apparent volume of distribution (Vd /F). Patients treated with chemotherapy had a higher Vd /F and 62% lower Kd than healthy adults. As the age increased, the absorption rate of tripegfilgrastim was decreased. Body weight affected the G-CSF receptor-mediated internalization of tripegfilgrastim, and the baseline ANC value impacted the production rate of G-CSF receptors. Simulations from the developed model suggested that 1.5, 2.5, 4, and 6 mg single subcutaneous tripegfilgrastim doses for the respective weight groups of 10-20, 21-30, 31-44, and more than 45 kg significantly reduced the duration of Grade 4 neutropenia similar to tripegfilgrastim weight-based treatment with 100 μg/kg.
Collapse
Affiliation(s)
- Soyoung Lee
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of Medicine and HospitalSeoulKorea
- Kidney Research InstituteSeoul National University Medical Research CenterSeoulKorea
| | - Kyung Taek Hong
- Department of PediatricsSeoul National University College of Medicine, Seoul National University Children's HospitalSeoulKorea
- Seoul National University Cancer Research InstituteSeoulKorea
| | - In‐Jin Jang
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of Medicine and HospitalSeoulKorea
| | - Kyung‐Sang Yu
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of Medicine and HospitalSeoulKorea
| | - Hyoung Jin Kang
- Department of PediatricsSeoul National University College of Medicine, Seoul National University Children's HospitalSeoulKorea
- Seoul National University Cancer Research InstituteSeoulKorea
| | - Jaeseong Oh
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of Medicine and HospitalSeoulKorea
| |
Collapse
|
15
|
Jiang X, Bae S, Yoon DY, Park SJ, Oh J, Cho JY, Yu KS. Comparison of the Pharmacokinetics, Safety, and Tolerability of Two Empagliflozin Formulations in Healthy Korean Subjects. Drug Des Devel Ther 2023; 17:2137-2145. [PMID: 37521035 PMCID: PMC10377562 DOI: 10.2147/dddt.s409368] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 06/28/2023] [Indexed: 08/01/2023] Open
Abstract
Purpose Empagliflozin is a sodium-glucose cotransporter 2 inhibitor that is commonly used for the treatment of type 2 diabetes mellitus. As cocrystal formulation can improve the chemical properties of drugs, CKD-370 was newly developed as a cocrystal formulation of empagliflozin with solvate L-proline. This study aimed to compare the pharmacokinetics, safety, and tolerability of these two empagliflozin formulations in healthy Korean subjects. Methods A randomized, open-label, two-sequence, two-period crossover study was conducted on healthy Korean participants. The subjects received a single oral 25 mg dose of either test (CKD-370) or reference treatment (Jardiance®) tablet at each period. Plasma empagliflozin concentrations were determined using liquid chromatography with tandem mass spectrometry. Pharmacokinetic (PK) parameters were analyzed using non-compartmental methods. The primary PK parameters included the maximum concentration (Cmax) and the area under the concentration-time curve from 0 to last (AUClast). The safety of both formulations was monitored and evaluated. Results A total of 28 healthy Korean adult subjects were randomized, and 27 subjects were included in the PK analysis. The mean ± standard deviation values of the primary PK parameters, Cmax and AUClast after administration of the test treatment, were 442.02 ± 103.37 μg/L and 3131.08 ± 529.30 μg·h/L, respectively, and those after administration of the reference treatment were 436.29 ± 118.74 μg/L and 3006.88 ± 514.21 μg·h/L, respectively. The geometric mean ratio and its 90% confidence interval of test to reference treatment for Cmax and AUClast were 1.0221 (0.9527-1.0967) and 1.0411 (1.0153-1.0677), respectively, which were within the commonly accepted bioequivalence criteria of 0.80 to 1.25. Both treatments were well-tolerated. Conclusion The two formulations of empagliflozin showed similar PK characteristics and were generally well tolerated in healthy subjects.
Collapse
Affiliation(s)
- Xu Jiang
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Republic of Korea
| | - Sungyeun Bae
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Republic of Korea
| | - Deok Yong Yoon
- Department of Pharmaceutics, Center for Pharmacometrics and Systems Pharmacology, College of Pharmacy, University of Florida, Orlando, FL, USA
| | - Shin Jung Park
- Department of Pharmaceutical Research Laboratory, Chong Kun Dang Research Institute, Chong Kun Dang Pharmaceutical Corporation, Yongin, Republic of Korea
| | - Jaeseong Oh
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Republic of Korea
| | - Joo-Youn Cho
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Republic of Korea
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Kyung-Sang Yu
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Republic of Korea
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea
| |
Collapse
|
16
|
Park MY, Bae S, Heo JA, Park M, Kim Y, Han J, Jang I, Yu K, Oh J. Safety, tolerability, pharmacokinetic/pharmacodynamic characteristics of bersiporocin, a novel prolyl-tRNA synthetase inhibitor, in healthy subjects. Clin Transl Sci 2023; 16:1163-1176. [PMID: 37095713 PMCID: PMC10339703 DOI: 10.1111/cts.13518] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 08/31/2022] [Revised: 03/07/2023] [Accepted: 03/11/2023] [Indexed: 04/26/2023] Open
Abstract
Bersiporocin, a novel first-in-class prolyl-tRNA synthetase (PRS) inhibitor currently under clinical development, was shown to exert an antifibrotic effect through the downregulation of collagen synthesis in various pulmonary fibrosis models. The aim of this first-in-human, randomized, double-blind, placebo-controlled, single- and multiple-dose, dose-escalation study was to evaluate the safety, tolerability, pharmacokinetic (PK) and pharmacodynamic (PD) characteristics of bersiporocin in healthy adults. A total of 40 and 32 subjects were included in a single- (SAD) and multiple-ascending dose (MAD) study, respectively. No severe or serious adverse events were observed after a single oral dose up to 600 mg and multiple oral doses up to 200 mg twice daily for 14 days. The most common treatment-emergent adverse events were gastrointestinal adverse events. To improve the tolerability, initial bersiporocin solution was changed to the enteric-coated formulation. Afterward, the enteric-coated tablet was used in the last cohort of SAD and in the MAD study. Bersiporocin showed dose-proportional PK characteristics after a single dose up to 600 mg and multiple doses up to 200 mg. Upon reviewing the safety and PK data, the final SAD cohort (800 mg enteric-coated tablet) was canceled by the Safety Review Committee. The levels of pro-peptide of type 3 procollagen were lower after treatment with bersiporocin than after the placebo in the MAD study, whereas no significant change was observed in other idiopathic pulmonary fibrosis (IPF) biomarkers. In conclusion, the safety, PK, and PD profile of bersiporocin supported its further investigation in patients with IPF.
Collapse
Affiliation(s)
| | - Sungyeun Bae
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of Medicine and HospitalSeoulKorea
| | - Jung A Heo
- Daewoong Pharmaceutical Co., LtdSeoulKorea
| | - Mihee Park
- Daewoong Pharmaceutical Co., LtdSeoulKorea
| | | | - Jumi Han
- Daewoong Pharmaceutical Co., LtdSeoulKorea
| | - In‐Jin Jang
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of Medicine and HospitalSeoulKorea
| | - Kyung‐Sang Yu
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of Medicine and HospitalSeoulKorea
| | - Jaeseong Oh
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of Medicine and HospitalSeoulKorea
| |
Collapse
|
17
|
Abdulameer NJ, Acharya U, Adare A, Aidala C, Ajitanand NN, Akiba Y, Akimoto R, Alfred M, Apadula N, Aramaki Y, Asano H, Atomssa ET, Awes TC, Azmoun B, Babintsev V, Bai M, Bandara NS, Bannier B, Barish KN, Bathe S, Bazilevsky A, Beaumier M, Beckman S, Belmont R, Berdnikov A, Berdnikov Y, Bichon L, Black D, Blankenship B, Bok JS, Borisov V, Boyle K, Brooks ML, Bryslawskyj J, Buesching H, Bumazhnov V, Campbell S, Canoa Roman V, Chen CH, Chiu M, Chi CY, Choi IJ, Choi JB, Chujo T, Citron Z, Connors M, Corliss R, Corrales Morales Y, Csanád M, Csörgő T, Datta A, Daugherity MS, David G, Dean CT, DeBlasio K, Dehmelt K, Denisov A, Deshpande A, Desmond EJ, Ding L, Dion A, Doomra V, Do JH, Drees A, Drees KA, Durham JM, Durum A, En'yo H, Enokizono A, Esha R, Fadem B, Fan W, Feege N, Fields DE, Finger M, Finger M, Firak D, Fitzgerald D, Fokin SL, Frantz JE, Franz A, Frawley AD, Gallus P, Gal C, Garg P, Ge H, Giles M, Giordano F, Glenn A, Goto Y, Grau N, Greene SV, Grosse Perdekamp M, Gunji T, Guragain H, Gu Y, Hachiya T, Haggerty JS, Hahn KI, Hamagaki H, Hanks J, Han SY, Harvey M, Hasegawa S, Hemmick TK, He X, Hill JC, Hodges A, Hollis RS, Homma K, Hong B, Hoshino T, Huang J, Ikeda Y, Imai K, Imazu Y, Inaba M, Iordanova A, Isenhower D, Ivanishchev D, Jacak BV, Jeon SJ, Jezghani M, Jiang X, Ji Z, Johnson BM, Joo E, Joo KS, Jouan D, Jumper DS, Kang JH, Kang JS, Kawall D, Kazantsev AV, Key JA, Khachatryan V, Khanzadeev A, Khatiwada A, Kihara K, Kim C, Kim DH, Kim DJ, Kim EJ, Kim HJ, Kim M, Kim T, Kim YK, Kincses D, Kingan A, Kistenev E, Klatsky J, Kleinjan D, Kline P, Koblesky T, Kofarago M, Koster J, Kotov D, Kovacs L, Kurgyis B, Kurita K, Kurosawa M, Kwon Y, Lajoie JG, Larionova D, Lebedev A, Lee KB, Lee SH, Leitch MJ, Leitgab M, Lewis NA, Lim SH, Liu MX, Li X, Loomis DA, Lynch D, Lökös S, Majoros T, Makdisi YI, Makek M, Manion A, Manko VI, Mannel E, McCumber M, McGaughey PL, McGlinchey D, McKinney C, Meles A, Mendoza M, Meredith B, Miake Y, Mignerey AC, Miller AJ, Milov A, Mishra DK, Mitchell JT, Mitrankova M, Mitrankov I, Miyasaka S, Mizuno S, Mondal MM, Montuenga P, Moon T, Morrison DP, Moukhanova TV, Muhammad A, Mulilo B, Murakami T, Murata J, Mwai A, Nagamiya S, Nagle JL, Nagy MI, Nakagawa I, Nakagomi H, Nakano K, Nattrass C, Nelson S, Netrakanti PK, Nihashi M, Niida T, Nouicer R, Novitzky N, Nukazuka G, Nyanin AS, O'Brien E, Ogilvie CA, Oh J, Orjuela Koop JD, Orosz M, Osborn JD, Oskarsson A, Ozawa K, Pak R, Pantuev V, Papavassiliou V, Park JS, Park S, Patel L, Patel M, Pate SF, Peng JC, Peng W, Perepelitsa DV, Perera GDN, Peressounko DY, PerezLara CE, Perry J, Petti R, Pinkenburg C, Pinson R, Pisani RP, Potekhin M, Pun A, Purschke ML, Radzevich PV, Rak J, Ramasubramanian N, Ravinovich I, Read KF, Reynolds D, Riabov V, Riabov Y, Richford D, Riveli N, Roach D, Rolnick SD, Rosati M, Rowan Z, Rubin JG, Runchey J, Saito N, Sakaguchi T, Sako H, Samsonov V, Sarsour M, Sato S, Sawada S, Schaefer B, Schmoll BK, Sedgwick K, Seele J, Seidl R, Sen A, Seto R, Sett P, Sexton A, Sharma D, Shein I, Shibata M, Shibata TA, Shigaki K, Shimomura M, Shi Z, Shukla P, Sickles A, Silva CL, Silvermyr D, Singh BK, Singh CP, Singh V, Slunečka M, Smith KL, Soltz RA, Sondheim WE, Sorensen SP, Sourikova IV, Stankus PW, Stepanov M, Stoll SP, Sugitate T, Sukhanov A, Sumita T, Sun J, Sun Z, Sziklai J, Takahama R, Takahara A, Taketani A, Tanida K, Tannenbaum MJ, Tarafdar S, Taranenko A, Timilsina A, Todoroki T, Tomášek M, Torii H, Towell M, Towell R, Towell RS, Tserruya I, Ueda Y, Ujvari B, van Hecke HW, Vargyas M, Velkovska J, Virius M, Vrba V, Vznuzdaev E, Wang XR, Wang Z, Watanabe D, Watanabe Y, Watanabe YS, Wei F, Whitaker S, Wolin S, Wong CP, Woody CL, Wysocki M, Xia B, Xue L, Yalcin S, Yamaguchi YL, Yanovich A, Yoon I, Younus I, Yushmanov IE, Zajc WA, Zelenski A, Zou L. Measurement of Direct-Photon Cross Section and Double-Helicity Asymmetry at sqrt[s]=510 GeV in p[over →]+p[over →] Collisions. Phys Rev Lett 2023; 130:251901. [PMID: 37418716 DOI: 10.1103/physrevlett.130.251901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 11/04/2022] [Accepted: 04/28/2023] [Indexed: 07/09/2023]
Abstract
We present measurements of the cross section and double-helicity asymmetry A_{LL} of direct-photon production in p[over →]+p[over →] collisions at sqrt[s]=510 GeV. The measurements have been performed at midrapidity (|η|<0.25) with the PHENIX detector at the Relativistic Heavy Ion Collider. At relativistic energies, direct photons are dominantly produced from the initial quark-gluon hard scattering and do not interact via the strong force at leading order. Therefore, at sqrt[s]=510 GeV, where leading-order-effects dominate, these measurements provide clean and direct access to the gluon helicity in the polarized proton in the gluon-momentum-fraction range 0.02<x<0.08, with direct sensitivity to the sign of the gluon contribution.
Collapse
Affiliation(s)
- N J Abdulameer
- Debrecen University, H-4010 Debrecen, Egyetem tér 1, Hungary
| | - U Acharya
- Georgia State University, Atlanta, Georgia 30303, USA
| | - A Adare
- University of Colorado, Boulder, Colorado 80309, USA
| | - C Aidala
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109-1040, USA
| | - N N Ajitanand
- Chemistry Department, Stony Brook University, SUNY, Stony Brook, New York 11794-3400, USA
| | - Y Akiba
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - R Akimoto
- Center for Nuclear Study, Graduate School of Science, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - M Alfred
- Department of Physics and Astronomy, Howard University, Washington, D.C. 20059, USA
| | - N Apadula
- Iowa State University, Ames, Iowa 50011, USA
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - Y Aramaki
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - H Asano
- Kyoto University, Kyoto 606-8502, Japan
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - E T Atomssa
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - T C Awes
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - B Azmoun
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - V Babintsev
- IHEP Protvino, State Research Center of Russian Federation, Institute for High Energy Physics, Protvino 142281, Russia
| | - M Bai
- Collider-Accelerator Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - N S Bandara
- Department of Physics, University of Massachusetts, Amherst, Massachusetts 01003-9337, USA
| | - B Bannier
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - K N Barish
- University of California-Riverside, Riverside, California 92521, USA
| | - S Bathe
- Baruch College, City University of New York, New York, New York 10010, USA
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - A Bazilevsky
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - M Beaumier
- University of California-Riverside, Riverside, California 92521, USA
| | - S Beckman
- University of Colorado, Boulder, Colorado 80309, USA
| | - R Belmont
- University of Colorado, Boulder, Colorado 80309, USA
- Physics and Astronomy Department, University of North Carolina at Greensboro, Greensboro, North Carolina 27412, USA
| | - A Berdnikov
- Saint Petersburg State Polytechnic University, St. Petersburg 195251 Russia
| | - Y Berdnikov
- Saint Petersburg State Polytechnic University, St. Petersburg 195251 Russia
| | - L Bichon
- Vanderbilt University, Nashville, Tennessee 37235, USA
| | - D Black
- University of California-Riverside, Riverside, California 92521, USA
| | - B Blankenship
- Vanderbilt University, Nashville, Tennessee 37235, USA
| | - J S Bok
- New Mexico State University, Las Cruces, New Mexico 88003, USA
| | - V Borisov
- Saint Petersburg State Polytechnic University, St. Petersburg 195251 Russia
| | - K Boyle
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - M L Brooks
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - J Bryslawskyj
- Baruch College, City University of New York, New York, New York 10010, USA
- University of California-Riverside, Riverside, California 92521, USA
| | - H Buesching
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - V Bumazhnov
- IHEP Protvino, State Research Center of Russian Federation, Institute for High Energy Physics, Protvino 142281, Russia
| | - S Campbell
- Columbia University, New York, New York 10027 and Nevis Laboratories, Irvington, New York 10533, USA
- Iowa State University, Ames, Iowa 50011, USA
| | - V Canoa Roman
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - C-H Chen
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - M Chiu
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - C Y Chi
- Columbia University, New York, New York 10027 and Nevis Laboratories, Irvington, New York 10533, USA
| | - I J Choi
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - J B Choi
- Jeonbuk National University, Jeonju, 54896, Korea
| | - T Chujo
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - Z Citron
- Weizmann Institute, Rehovot 76100, Israel
| | - M Connors
- Georgia State University, Atlanta, Georgia 30303, USA
| | - R Corliss
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | | | - M Csanád
- ELTE, Eötvös Loránd University, H-1117 Budapest, Pázmány P. s. 1/A, Hungary
| | - T Csörgő
- MATE, Laboratory of Femtoscopy, Károly Róbert Campus, H-3200 Gyöngyös, Mátraiút 36, Hungary
- Institute for Particle and Nuclear Physics, Wigner Research Centre for Physics, Hungarian Academy of Sciences (Wigner RCP, RMKI) H-1525 Budapest 114, P.O. Box 49, Budapest, Hungary
| | - A Datta
- University of New Mexico, Albuquerque, New Mexico 87131, USA
| | | | - G David
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - C T Dean
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - K DeBlasio
- University of New Mexico, Albuquerque, New Mexico 87131, USA
| | - K Dehmelt
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - A Denisov
- IHEP Protvino, State Research Center of Russian Federation, Institute for High Energy Physics, Protvino 142281, Russia
| | - A Deshpande
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - E J Desmond
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - L Ding
- Iowa State University, Ames, Iowa 50011, USA
| | - A Dion
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - V Doomra
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - J H Do
- Yonsei University, IPAP, Seoul 120-749, Korea
| | - A Drees
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - K A Drees
- Collider-Accelerator Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - J M Durham
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - A Durum
- IHEP Protvino, State Research Center of Russian Federation, Institute for High Energy Physics, Protvino 142281, Russia
| | - H En'yo
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - A Enokizono
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Physics Department, Rikkyo University, 3-34-1 Nishi-Ikebukuro, Toshima, Tokyo 171-8501, Japan
| | - R Esha
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - B Fadem
- Muhlenberg College, Allentown, Pennsylvania 18104-5586, USA
| | - W Fan
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - N Feege
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - D E Fields
- University of New Mexico, Albuquerque, New Mexico 87131, USA
| | - M Finger
- Charles University, Faculty of Mathematics and Physics, 180 00 Troja, Prague, Czech Republic
| | - M Finger
- Charles University, Faculty of Mathematics and Physics, 180 00 Troja, Prague, Czech Republic
| | - D Firak
- Debrecen University, H-4010 Debrecen, Egyetem tér 1, Hungary
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - D Fitzgerald
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109-1040, USA
| | - S L Fokin
- National Research Center "Kurchatov Institute," Moscow 123098, Russia
| | - J E Frantz
- Department of Physics and Astronomy, Ohio University, Athens, Ohio 45701, USA
| | - A Franz
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - A D Frawley
- Florida State University, Tallahassee, Florida 32306, USA
| | - P Gallus
- Czech Technical University, Zikova 4, 166 36 Prague 6, Czech Republic
| | - C Gal
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - P Garg
- Department of Physics, Banaras Hindu University, Varanasi 221005, India
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - H Ge
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - M Giles
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - F Giordano
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - A Glenn
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - Y Goto
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - N Grau
- Department of Physics, Augustana University, Sioux Falls, South Dakota 57197, USA
| | - S V Greene
- Vanderbilt University, Nashville, Tennessee 37235, USA
| | | | - T Gunji
- Center for Nuclear Study, Graduate School of Science, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - H Guragain
- Georgia State University, Atlanta, Georgia 30303, USA
| | - Y Gu
- Chemistry Department, Stony Brook University, SUNY, Stony Brook, New York 11794-3400, USA
| | - T Hachiya
- Nara Women's University, Kita-uoya Nishi-machi Nara 630-8506, Japan
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - J S Haggerty
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - K I Hahn
- Ewha Womans University, Seoul 120-750, Korea
| | - H Hamagaki
- Center for Nuclear Study, Graduate School of Science, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - J Hanks
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - S Y Han
- Ewha Womans University, Seoul 120-750, Korea
- Korea University, Seoul 02841, Korea
| | - M Harvey
- Texas Southern University, Houston, Texas 77004, USA
| | - S Hasegawa
- Advanced Science Research Center, Japan Atomic Energy Agency, 2-4 Shirakata Shirane, Tokai-mura, Naka-gun, Ibaraki-ken 319-1195, Japan
| | - T K Hemmick
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - X He
- Georgia State University, Atlanta, Georgia 30303, USA
| | - J C Hill
- Iowa State University, Ames, Iowa 50011, USA
| | - A Hodges
- Georgia State University, Atlanta, Georgia 30303, USA
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - R S Hollis
- University of California-Riverside, Riverside, California 92521, USA
| | - K Homma
- Hiroshima University, Kagamiyama, Higashi-Hiroshima 739-8526, Japan
| | - B Hong
- Korea University, Seoul 02841, Korea
| | - T Hoshino
- Hiroshima University, Kagamiyama, Higashi-Hiroshima 739-8526, Japan
| | - J Huang
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - Y Ikeda
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - K Imai
- Advanced Science Research Center, Japan Atomic Energy Agency, 2-4 Shirakata Shirane, Tokai-mura, Naka-gun, Ibaraki-ken 319-1195, Japan
| | - Y Imazu
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - M Inaba
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - A Iordanova
- University of California-Riverside, Riverside, California 92521, USA
| | - D Isenhower
- Abilene Christian University, Abilene, Texas 79699, USA
| | - D Ivanishchev
- PNPI, Petersburg Nuclear Physics Institute, Gatchina, Leningrad region 188300, Russia
| | - B V Jacak
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - S J Jeon
- Myongji University, Yongin, Kyonggido 449-728, Korea
| | - M Jezghani
- Georgia State University, Atlanta, Georgia 30303, USA
| | - X Jiang
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - Z Ji
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - B M Johnson
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- Georgia State University, Atlanta, Georgia 30303, USA
| | - E Joo
- Korea University, Seoul 02841, Korea
| | - K S Joo
- Myongji University, Yongin, Kyonggido 449-728, Korea
| | - D Jouan
- IPN-Orsay, Univ. Paris-Sud, CNRS/IN2P3, Université Paris-Saclay, BP1, F-91406 Orsay, France
| | - D S Jumper
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - J H Kang
- Yonsei University, IPAP, Seoul 120-749, Korea
| | - J S Kang
- Hanyang University, Seoul 133-792, Korea
| | - D Kawall
- Department of Physics, University of Massachusetts, Amherst, Massachusetts 01003-9337, USA
| | - A V Kazantsev
- National Research Center "Kurchatov Institute," Moscow 123098, Russia
| | - J A Key
- University of New Mexico, Albuquerque, New Mexico 87131, USA
| | - V Khachatryan
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - A Khanzadeev
- PNPI, Petersburg Nuclear Physics Institute, Gatchina, Leningrad region 188300, Russia
| | - A Khatiwada
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - K Kihara
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - C Kim
- Korea University, Seoul 02841, Korea
| | - D H Kim
- Ewha Womans University, Seoul 120-750, Korea
| | - D J Kim
- Helsinki Institute of Physics and University of Jyväskylä, P.O.Box 35, FI-40014 Jyväskylä, Finland
| | - E-J Kim
- Jeonbuk National University, Jeonju, 54896, Korea
| | - H-J Kim
- Yonsei University, IPAP, Seoul 120-749, Korea
| | - M Kim
- Department of Physics and Astronomy, Seoul National University, Seoul 151-742, Korea
| | - T Kim
- Ewha Womans University, Seoul 120-750, Korea
| | - Y K Kim
- Hanyang University, Seoul 133-792, Korea
| | - D Kincses
- ELTE, Eötvös Loránd University, H-1117 Budapest, Pázmány P. s. 1/A, Hungary
| | - A Kingan
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - E Kistenev
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - J Klatsky
- Florida State University, Tallahassee, Florida 32306, USA
| | - D Kleinjan
- University of California-Riverside, Riverside, California 92521, USA
| | - P Kline
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - T Koblesky
- University of Colorado, Boulder, Colorado 80309, USA
| | - M Kofarago
- ELTE, Eötvös Loránd University, H-1117 Budapest, Pázmány P. s. 1/A, Hungary
- Institute for Particle and Nuclear Physics, Wigner Research Centre for Physics, Hungarian Academy of Sciences (Wigner RCP, RMKI) H-1525 Budapest 114, P.O. Box 49, Budapest, Hungary
| | - J Koster
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - D Kotov
- PNPI, Petersburg Nuclear Physics Institute, Gatchina, Leningrad region 188300, Russia
- Saint Petersburg State Polytechnic University, St. Petersburg 195251 Russia
| | - L Kovacs
- ELTE, Eötvös Loránd University, H-1117 Budapest, Pázmány P. s. 1/A, Hungary
| | - B Kurgyis
- ELTE, Eötvös Loránd University, H-1117 Budapest, Pázmány P. s. 1/A, Hungary
| | - K Kurita
- Physics Department, Rikkyo University, 3-34-1 Nishi-Ikebukuro, Toshima, Tokyo 171-8501, Japan
| | - M Kurosawa
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - Y Kwon
- Yonsei University, IPAP, Seoul 120-749, Korea
| | - J G Lajoie
- Iowa State University, Ames, Iowa 50011, USA
| | - D Larionova
- Saint Petersburg State Polytechnic University, St. Petersburg 195251 Russia
| | - A Lebedev
- Iowa State University, Ames, Iowa 50011, USA
| | - K B Lee
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - S H Lee
- Iowa State University, Ames, Iowa 50011, USA
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109-1040, USA
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - M J Leitch
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - M Leitgab
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - N A Lewis
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109-1040, USA
| | - S H Lim
- Pusan National University, Pusan 46241, Korea
- Yonsei University, IPAP, Seoul 120-749, Korea
| | - M X Liu
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - X Li
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - D A Loomis
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109-1040, USA
| | - D Lynch
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - S Lökös
- ELTE, Eötvös Loránd University, H-1117 Budapest, Pázmány P. s. 1/A, Hungary
| | - T Majoros
- Debrecen University, H-4010 Debrecen, Egyetem tér 1, Hungary
| | - Y I Makdisi
- Collider-Accelerator Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - M Makek
- Weizmann Institute, Rehovot 76100, Israel
- Department of Physics, Faculty of Science, University of Zagreb, Bijenička c. 32 HR-10002 Zagreb, Croatia
| | - A Manion
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - V I Manko
- National Research Center "Kurchatov Institute," Moscow 123098, Russia
| | - E Mannel
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - M McCumber
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - P L McGaughey
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - D McGlinchey
- University of Colorado, Boulder, Colorado 80309, USA
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - C McKinney
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - A Meles
- New Mexico State University, Las Cruces, New Mexico 88003, USA
| | - M Mendoza
- University of California-Riverside, Riverside, California 92521, USA
| | - B Meredith
- Columbia University, New York, New York 10027 and Nevis Laboratories, Irvington, New York 10533, USA
| | - Y Miake
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - A C Mignerey
- University of Maryland, College Park, Maryland 20742, USA
| | - A J Miller
- Abilene Christian University, Abilene, Texas 79699, USA
| | - A Milov
- Weizmann Institute, Rehovot 76100, Israel
| | - D K Mishra
- Bhabha Atomic Research Centre, Bombay 400 085, India
| | - J T Mitchell
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - M Mitrankova
- Saint Petersburg State Polytechnic University, St. Petersburg 195251 Russia
| | - Iu Mitrankov
- Saint Petersburg State Polytechnic University, St. Petersburg 195251 Russia
| | - S Miyasaka
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Department of Physics, Tokyo Institute of Technology, Oh-okayama, Meguro, Tokyo 152-8551, Japan
| | - S Mizuno
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - M M Mondal
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - P Montuenga
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - T Moon
- Korea University, Seoul 02841, Korea
- Yonsei University, IPAP, Seoul 120-749, Korea
| | - D P Morrison
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - T V Moukhanova
- National Research Center "Kurchatov Institute," Moscow 123098, Russia
| | - A Muhammad
- Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - B Mulilo
- Korea University, Seoul 02841, Korea
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Department of Physics, School of Natural Sciences, University of Zambia, Great East Road Campus, Box 32379 Lusaka, Zambia
| | - T Murakami
- Kyoto University, Kyoto 606-8502, Japan
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - J Murata
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Physics Department, Rikkyo University, 3-34-1 Nishi-Ikebukuro, Toshima, Tokyo 171-8501, Japan
| | - A Mwai
- Chemistry Department, Stony Brook University, SUNY, Stony Brook, New York 11794-3400, USA
| | - S Nagamiya
- KEK, High Energy Accelerator Research Organization, Tsukuba, Ibaraki 305-0801, Japan
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - J L Nagle
- University of Colorado, Boulder, Colorado 80309, USA
| | - M I Nagy
- ELTE, Eötvös Loránd University, H-1117 Budapest, Pázmány P. s. 1/A, Hungary
| | - I Nakagawa
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - H Nakagomi
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - K Nakano
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Department of Physics, Tokyo Institute of Technology, Oh-okayama, Meguro, Tokyo 152-8551, Japan
| | - C Nattrass
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - S Nelson
- Florida A&M University, Tallahassee, Florida 32307, USA
| | | | - M Nihashi
- Hiroshima University, Kagamiyama, Higashi-Hiroshima 739-8526, Japan
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - T Niida
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - R Nouicer
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - N Novitzky
- Helsinki Institute of Physics and University of Jyväskylä, P.O.Box 35, FI-40014 Jyväskylä, Finland
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - G Nukazuka
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - A S Nyanin
- National Research Center "Kurchatov Institute," Moscow 123098, Russia
| | - E O'Brien
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - C A Ogilvie
- Iowa State University, Ames, Iowa 50011, USA
| | - J Oh
- Pusan National University, Pusan 46241, Korea
| | | | - M Orosz
- Debrecen University, H-4010 Debrecen, Egyetem tér 1, Hungary
| | - J D Osborn
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109-1040, USA
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - A Oskarsson
- Department of Physics, Lund University, Box 118, SE-221 00 Lund, Sweden
| | - K Ozawa
- KEK, High Energy Accelerator Research Organization, Tsukuba, Ibaraki 305-0801, Japan
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - R Pak
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - V Pantuev
- Institute for Nuclear Research of the Russian Academy of Sciences, prospekt 60-letiya Oktyabrya 7a, Moscow 117312, Russia
| | - V Papavassiliou
- New Mexico State University, Las Cruces, New Mexico 88003, USA
| | - J S Park
- Department of Physics and Astronomy, Seoul National University, Seoul 151-742, Korea
| | - S Park
- Mississippi State University, Mississippi State, Mississippi 39762, USA
- Department of Physics and Astronomy, Seoul National University, Seoul 151-742, Korea
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - L Patel
- Georgia State University, Atlanta, Georgia 30303, USA
| | - M Patel
- Iowa State University, Ames, Iowa 50011, USA
| | - S F Pate
- New Mexico State University, Las Cruces, New Mexico 88003, USA
| | - J-C Peng
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - W Peng
- Vanderbilt University, Nashville, Tennessee 37235, USA
| | - D V Perepelitsa
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- University of Colorado, Boulder, Colorado 80309, USA
- Columbia University, New York, New York 10027 and Nevis Laboratories, Irvington, New York 10533, USA
| | - G D N Perera
- New Mexico State University, Las Cruces, New Mexico 88003, USA
| | - D Yu Peressounko
- National Research Center "Kurchatov Institute," Moscow 123098, Russia
| | - C E PerezLara
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - J Perry
- Iowa State University, Ames, Iowa 50011, USA
| | - R Petti
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - C Pinkenburg
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - R Pinson
- Abilene Christian University, Abilene, Texas 79699, USA
| | - R P Pisani
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - M Potekhin
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - A Pun
- Department of Physics and Astronomy, Ohio University, Athens, Ohio 45701, USA
| | - M L Purschke
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - P V Radzevich
- Saint Petersburg State Polytechnic University, St. Petersburg 195251 Russia
| | - J Rak
- Helsinki Institute of Physics and University of Jyväskylä, P.O.Box 35, FI-40014 Jyväskylä, Finland
| | - N Ramasubramanian
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | | | - K F Read
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - D Reynolds
- Chemistry Department, Stony Brook University, SUNY, Stony Brook, New York 11794-3400, USA
| | - V Riabov
- National Research Nuclear University, MEPhI, Moscow Engineering Physics Institute, Moscow 115409, Russia
- PNPI, Petersburg Nuclear Physics Institute, Gatchina, Leningrad region 188300, Russia
| | - Y Riabov
- PNPI, Petersburg Nuclear Physics Institute, Gatchina, Leningrad region 188300, Russia
- Saint Petersburg State Polytechnic University, St. Petersburg 195251 Russia
| | - D Richford
- Baruch College, City University of New York, New York, New York 10010, USA
| | - N Riveli
- Department of Physics and Astronomy, Ohio University, Athens, Ohio 45701, USA
| | - D Roach
- Vanderbilt University, Nashville, Tennessee 37235, USA
| | - S D Rolnick
- University of California-Riverside, Riverside, California 92521, USA
| | - M Rosati
- Iowa State University, Ames, Iowa 50011, USA
| | - Z Rowan
- Baruch College, City University of New York, New York, New York 10010, USA
| | - J G Rubin
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109-1040, USA
| | - J Runchey
- Iowa State University, Ames, Iowa 50011, USA
| | - N Saito
- KEK, High Energy Accelerator Research Organization, Tsukuba, Ibaraki 305-0801, Japan
| | - T Sakaguchi
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - H Sako
- Advanced Science Research Center, Japan Atomic Energy Agency, 2-4 Shirakata Shirane, Tokai-mura, Naka-gun, Ibaraki-ken 319-1195, Japan
| | - V Samsonov
- National Research Nuclear University, MEPhI, Moscow Engineering Physics Institute, Moscow 115409, Russia
- PNPI, Petersburg Nuclear Physics Institute, Gatchina, Leningrad region 188300, Russia
| | - M Sarsour
- Georgia State University, Atlanta, Georgia 30303, USA
| | - S Sato
- Advanced Science Research Center, Japan Atomic Energy Agency, 2-4 Shirakata Shirane, Tokai-mura, Naka-gun, Ibaraki-ken 319-1195, Japan
| | - S Sawada
- KEK, High Energy Accelerator Research Organization, Tsukuba, Ibaraki 305-0801, Japan
| | - B Schaefer
- Vanderbilt University, Nashville, Tennessee 37235, USA
| | - B K Schmoll
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - K Sedgwick
- University of California-Riverside, Riverside, California 92521, USA
| | - J Seele
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - R Seidl
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - A Sen
- Iowa State University, Ames, Iowa 50011, USA
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - R Seto
- University of California-Riverside, Riverside, California 92521, USA
| | - P Sett
- Bhabha Atomic Research Centre, Bombay 400 085, India
| | - A Sexton
- University of Maryland, College Park, Maryland 20742, USA
| | - D Sharma
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - I Shein
- IHEP Protvino, State Research Center of Russian Federation, Institute for High Energy Physics, Protvino 142281, Russia
| | - M Shibata
- Nara Women's University, Kita-uoya Nishi-machi Nara 630-8506, Japan
| | - T-A Shibata
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Department of Physics, Tokyo Institute of Technology, Oh-okayama, Meguro, Tokyo 152-8551, Japan
| | - K Shigaki
- Hiroshima University, Kagamiyama, Higashi-Hiroshima 739-8526, Japan
| | - M Shimomura
- Iowa State University, Ames, Iowa 50011, USA
- Nara Women's University, Kita-uoya Nishi-machi Nara 630-8506, Japan
| | - Z Shi
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - P Shukla
- Bhabha Atomic Research Centre, Bombay 400 085, India
| | - A Sickles
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - C L Silva
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - D Silvermyr
- Department of Physics, Lund University, Box 118, SE-221 00 Lund, Sweden
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - B K Singh
- Department of Physics, Banaras Hindu University, Varanasi 221005, India
| | - C P Singh
- Department of Physics, Banaras Hindu University, Varanasi 221005, India
| | - V Singh
- Department of Physics, Banaras Hindu University, Varanasi 221005, India
| | - M Slunečka
- Charles University, Faculty of Mathematics and Physics, 180 00 Troja, Prague, Czech Republic
| | - K L Smith
- Florida State University, Tallahassee, Florida 32306, USA
| | - R A Soltz
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - W E Sondheim
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - S P Sorensen
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - I V Sourikova
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - P W Stankus
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - M Stepanov
- Department of Physics, University of Massachusetts, Amherst, Massachusetts 01003-9337, USA
| | - S P Stoll
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - T Sugitate
- Hiroshima University, Kagamiyama, Higashi-Hiroshima 739-8526, Japan
| | - A Sukhanov
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - T Sumita
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - J Sun
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - Z Sun
- Debrecen University, H-4010 Debrecen, Egyetem tér 1, Hungary
| | - J Sziklai
- Institute for Particle and Nuclear Physics, Wigner Research Centre for Physics, Hungarian Academy of Sciences (Wigner RCP, RMKI) H-1525 Budapest 114, P.O. Box 49, Budapest, Hungary
| | - R Takahama
- Nara Women's University, Kita-uoya Nishi-machi Nara 630-8506, Japan
| | - A Takahara
- Center for Nuclear Study, Graduate School of Science, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - A Taketani
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - K Tanida
- Advanced Science Research Center, Japan Atomic Energy Agency, 2-4 Shirakata Shirane, Tokai-mura, Naka-gun, Ibaraki-ken 319-1195, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- Department of Physics and Astronomy, Seoul National University, Seoul 151-742, Korea
| | - M J Tannenbaum
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - S Tarafdar
- Vanderbilt University, Nashville, Tennessee 37235, USA
- Weizmann Institute, Rehovot 76100, Israel
| | - A Taranenko
- National Research Nuclear University, MEPhI, Moscow Engineering Physics Institute, Moscow 115409, Russia
- Chemistry Department, Stony Brook University, SUNY, Stony Brook, New York 11794-3400, USA
| | - A Timilsina
- Iowa State University, Ames, Iowa 50011, USA
| | - T Todoroki
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
- Tomonaga Center for the History of the Universe, University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - M Tomášek
- Czech Technical University, Zikova 4, 166 36 Prague 6, Czech Republic
| | - H Torii
- Center for Nuclear Study, Graduate School of Science, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - M Towell
- Abilene Christian University, Abilene, Texas 79699, USA
| | - R Towell
- Abilene Christian University, Abilene, Texas 79699, USA
| | - R S Towell
- Abilene Christian University, Abilene, Texas 79699, USA
| | - I Tserruya
- Weizmann Institute, Rehovot 76100, Israel
| | - Y Ueda
- Hiroshima University, Kagamiyama, Higashi-Hiroshima 739-8526, Japan
| | - B Ujvari
- Debrecen University, H-4010 Debrecen, Egyetem tér 1, Hungary
| | - H W van Hecke
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - M Vargyas
- ELTE, Eötvös Loránd University, H-1117 Budapest, Pázmány P. s. 1/A, Hungary
- Institute for Particle and Nuclear Physics, Wigner Research Centre for Physics, Hungarian Academy of Sciences (Wigner RCP, RMKI) H-1525 Budapest 114, P.O. Box 49, Budapest, Hungary
| | - J Velkovska
- Vanderbilt University, Nashville, Tennessee 37235, USA
| | - M Virius
- Czech Technical University, Zikova 4, 166 36 Prague 6, Czech Republic
| | - V Vrba
- Czech Technical University, Zikova 4, 166 36 Prague 6, Czech Republic
- Institute of Physics, Academy of Sciences of the Czech Republic, Na Slovance 2, 182 21 Prague 8, Czech Republic
| | - E Vznuzdaev
- PNPI, Petersburg Nuclear Physics Institute, Gatchina, Leningrad region 188300, Russia
| | - X R Wang
- New Mexico State University, Las Cruces, New Mexico 88003, USA
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - Z Wang
- Baruch College, City University of New York, New York, New York 10010, USA
| | - D Watanabe
- Hiroshima University, Kagamiyama, Higashi-Hiroshima 739-8526, Japan
| | - Y Watanabe
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - Y S Watanabe
- Center for Nuclear Study, Graduate School of Science, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
- KEK, High Energy Accelerator Research Organization, Tsukuba, Ibaraki 305-0801, Japan
| | - F Wei
- New Mexico State University, Las Cruces, New Mexico 88003, USA
| | - S Whitaker
- Iowa State University, Ames, Iowa 50011, USA
| | - S Wolin
- University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - C P Wong
- Georgia State University, Atlanta, Georgia 30303, USA
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - C L Woody
- Physics Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - M Wysocki
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - B Xia
- Department of Physics and Astronomy, Ohio University, Athens, Ohio 45701, USA
| | - L Xue
- Georgia State University, Atlanta, Georgia 30303, USA
| | - S Yalcin
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - Y L Yamaguchi
- Center for Nuclear Study, Graduate School of Science, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794-3800, USA
| | - A Yanovich
- IHEP Protvino, State Research Center of Russian Federation, Institute for High Energy Physics, Protvino 142281, Russia
| | - I Yoon
- Department of Physics and Astronomy, Seoul National University, Seoul 151-742, Korea
| | - I Younus
- Physics Department, Lahore University of Management Sciences, Lahore 54792, Pakistan
| | - I E Yushmanov
- National Research Center "Kurchatov Institute," Moscow 123098, Russia
| | - W A Zajc
- Columbia University, New York, New York 10027 and Nevis Laboratories, Irvington, New York 10533, USA
| | - A Zelenski
- Collider-Accelerator Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - L Zou
- University of California-Riverside, Riverside, California 92521, USA
| |
Collapse
|
18
|
Oh J, Jin SY, Shim S. Breakage and Disappearance of a Part of the Midline Catheter Tip During Insertion. Niger J Clin Pract 2023; 26:841-843. [PMID: 37470662 DOI: 10.4103/njcp.njcp_752_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
Midline catheters have been proposed as alternatives to central venous catheters and peripherally inserted central catheters. Midline catheters reduce the incidence of overall needle stick injuries during hospitalization, have lower complication rates than central venous catheters or peripherally inserted central catheters, and provide potential cost benefits for hospitals. Complications with midline catheters are similar to those of other intravenous catheters, and intravenous catheter breakage is very rare and invasive. We report a case wherein a midline catheter tip was broken during insertion and removed by open surgery. For the safe use of midline catheters, accurate and delicate insertion techniques should be practiced. More case studies are warranted to verify the usefulness and convenience of various types of midline catheters for their universal use.
Collapse
Affiliation(s)
- J Oh
- Department of Anesthesia and Pain Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - S Y Jin
- Department of Anesthesia and Pain Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - S Shim
- Department of Anesthesia and Pain Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| |
Collapse
|
19
|
Kim BR, Lim L, Choi Y, Yi NJ, Lee KW, Suh KS, Yu KS, Sohn JY, Jeong R, Oh J, Ryu HG. Continuous versus Intermittent Infusion of Human Antithrombin III Concentrate in the Immediate Postoperative Period after Liver Transplantation. Clin Transl Sci 2023. [PMID: 37038357 DOI: 10.1111/cts.13521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/15/2023] [Accepted: 03/26/2023] [Indexed: 04/12/2023] Open
Abstract
Antithrombin-III (AT-III) concentrates have been used in the immediate postoperative period after liver transplantation to prevent critical thrombosis. We aimed to investigate more appropriate method for AT-III concentrate administration to maintain plasma AT-III activity level within targeted range. In this randomized controlled trial, 130 adult patients undergoing living-donor liver transplantation were randomized to either intermittent group or continuous group. In intermittent group, 500 international units (IU) of AT-III concentrate were administered after liver transplantation and repeated every 6 hours for 72 hours. In continuous group, 3000 IU of AT-III was continuously infused for 71 hours after a loading dose of 2000 IU over 1 hour. Plasma AT-III activity level was measured at 12, 24, 48, 72, and 84 hours from the first AT-III administration. The primary outcome was the target (80-120%) attainment rate at 72 hours. Target attainment rates at other time points and associated complications were collected as secondary outcomes. A total of 107 patients were included in the analysis. The target attainment rates at 72 hours post-dose were 30% and 62% in intermittent group and continuous group, respectively. (p=0.003) Compared to intermittent group, patients in continuous group reached the target level more rapidly (12 vs. 24 hours, median time, p<0.001) and was more likely to remain in the target range until 84 hours. For maintaining the target plasma AT-III activity level after living-donor liver transplantation, continuous infusion of AT-III seemed to be more appropriate compared to the conventional intermittent infusion regimen.
Collapse
Affiliation(s)
- Bo Rim Kim
- Department of Anesthesiology and Pain Medicine, Korea University Guro Hospital, Seoul, Korea
- Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea
| | - Leerang Lim
- Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea
| | - YoungRok Choi
- Department of Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea
| | - Nam-Joon Yi
- Department of Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea
| | - Kwang-Woong Lee
- Department of Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea
| | - Kyung-Suk Suh
- Department of Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea
| | - Kyung-Sang Yu
- Clinical Pharmacology & Therapeutics, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea
| | - Jin Young Sohn
- Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea
| | - Raewon Jeong
- Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea
| | - Jaeseong Oh
- Clinical Pharmacology & Therapeutics, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea
| | - Ho Geol Ryu
- Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea
| |
Collapse
|
20
|
Hwang I, Ji SC, Oh J, Kim H, Cha H, Kim J, Lee CS, Yu KS, Lee S. Randomised clinical trial: Safety, tolerability, pharmacodynamics and pharmacokinetics of zastaprazan (JP-1366), a novel potassium-competitive acid blocker, in healthy subjects. Aliment Pharmacol Ther 2023; 57:763-772. [PMID: 36732884 DOI: 10.1111/apt.17406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/07/2022] [Accepted: 01/19/2023] [Indexed: 02/04/2023]
Abstract
BACKGROUND Zastaprazan (JP-1366) is a novel potassium-competitive acid blocker with favourable preclinical safety and efficacy profile being developed for the treatment of acid-related diseases. AIMS To investigate the safety, tolerability, pharmacodynamics and pharmacokinetics of zastaprazan. METHODS A randomised, open-label, placebo- and active-controlled, single and multiple ascending dose clinical trial was conducted in healthy Korean male subjects. Intragatric pH and serum gastrin were measured to assess the pharmacodynamics, while serial blood and urine samples were collected to assess the pharmacokinetics. Pharmacogenomic evaluation was conducted to explore genetic variants, which can affect the pharmacodynamics and pharmacokinetics. Safety and tolerability including hepatotoxicity were evaluated. RESULTS Suppression of gastric acid secretion increased as the dose of zastaprazan increased. The percentage of time that gastric pH was over 4 (%Time pH >4) with zastaprazan 20 mg (85.19%) and 40 mg (91.84%) were similar to or greater than that with esomeprazole 40 mg (72.06%). Zastaprazan was rapidly absorbed within 2 h and eliminated with a half-life of 6-10 h. Pharmacogenomic analysis found no genetic variant of drug metabolising enzymes including CYP2C19 or drug transporters associated with the exposure of zastaprazan. Zastaprazan was well tolerated with no clinically significant changes in safety and tolerability assessments. CONCLUSIONS Zastaprazan was safe and well tolerated after a single oral dose up to 60 mg and multiple oral doses up to 40 mg. It also showed rapid, potent suppression of gastric acid secretion. Pharmacodynamic and pharmacokinetic profile of zastaprazan was suitable for treatment of patients with acid-related diseases.
Collapse
Affiliation(s)
- Inyoung Hwang
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Republic of Korea
| | - Sang Chun Ji
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Republic of Korea
| | - Jaeseong Oh
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Republic of Korea
| | - Hyojin Kim
- Onconic Therapeutics Inc., Seoul, Republic of Korea
| | - Hyunju Cha
- Onconic Therapeutics Inc., Seoul, Republic of Korea
| | - John Kim
- Onconic Therapeutics Inc., Seoul, Republic of Korea
| | | | - Kyung-Sang Yu
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Republic of Korea
| | - SeungHwan Lee
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Republic of Korea
| |
Collapse
|
21
|
Girardi F, Matz M, Stiller C, You H, Marcos Gragera R, Valkov MY, Bulliard JL, De P, Morrison D, Wanner M, O'Brian DK, Saint-Jacques N, Coleman MP, Allemani C, Hamdi-Chérif M, Kara L, Meguenni K, Regagba D, Bayo S, Cheick Bougadari T, Manraj SS, Bendahhou K, Ladipo A, Ogunbiyi OJ, Somdyala NIM, Chaplin MA, Moreno F, Calabrano GH, Espinola SB, Carballo Quintero B, Fita R, Laspada WD, Ibañez SG, Lima CA, Da Costa AM, De Souza PCF, Chaves J, Laporte CA, Curado MP, de Oliveira JC, Veneziano CLA, Veneziano DB, Almeida ABM, Latorre MRDO, Rebelo MS, Santos MO, Azevedo e Silva G, Galaz JC, Aparicio Aravena M, Sanhueza Monsalve J, Herrmann DA, Vargas S, Herrera VM, Uribe CJ, Bravo LE, Garcia LS, Arias-Ortiz NE, Morantes D, Jurado DM, Yépez Chamorro MC, Delgado S, Ramirez M, Galán Alvarez YH, Torres P, Martínez-Reyes F, Jaramillo L, Quinto R, Castillo J, Mendoza M, Cueva P, Yépez JG, Bhakkan B, Deloumeaux J, Joachim C, Macni J, Carrillo R, Shalkow Klincovstein J, Rivera Gomez R, Perez P, Poquioma E, Tortolero-Luna G, Zavala D, Alonso R, Barrios E, Eckstrand A, Nikiforuk C, Woods RR, Noonan G, Turner D, Kumar E, Zhang B, Dowden JJ, Doyle GP, Saint-Jacques N, Walsh G, Anam A, De P, McClure CA, Vriends KA, Bertrand C, Ramanakumar AV, Davis L, Kozie S, Freeman T, George JT, Avila RM, O’Brien DK, Holt A, Almon L, Kwong S, Morris C, Rycroft R, Mueller L, Phillips CE, Brown H, Cromartie B, Ruterbusch J, Schwartz AG, Levin GM, Wohler B, Bayakly R, Ward KC, Gomez SL, McKinley M, Cress R, Davis J, Hernandez B, Johnson CJ, Morawski BM, Ruppert LP, Bentler S, Charlton ME, Huang B, Tucker TC, Deapen D, Liu L, Hsieh MC, Wu XC, Schwenn M, Stern K, Gershman ST, Knowlton RC, Alverson G, Weaver T, Desai J, Rogers DB, Jackson-Thompson J, Lemons D, Zimmerman HJ, Hood M, Roberts-Johnson J, Hammond W, Rees JR, Pawlish KS, Stroup A, Key C, Wiggins C, Kahn AR, Schymura MJ, Radhakrishnan S, Rao C, Giljahn LK, Slocumb RM, Dabbs C, Espinoza RE, Aird KG, Beran T, Rubertone JJ, Slack SJ, Oh J, Janes TA, Schwartz SM, Chiodini SC, Hurley DM, Whiteside MA, Rai S, Williams MA, Herget K, Sweeney C, Kachajian J, Keitheri Cheteri MB, Migliore Santiago P, Blankenship SE, Conaway JL, Borchers R, Malicki R, Espinoza J, Grandpre J, Weir HK, Wilson R, Edwards BK, Mariotto A, Rodriguez-Galindo C, Wang N, Yang L, Chen JS, Zhou Y, He YT, Song GH, Gu XP, Mei D, Mu HJ, Ge HM, Wu TH, Li YY, Zhao DL, Jin F, Zhang JH, Zhu FD, Junhua Q, Yang YL, Jiang CX, Biao W, Wang J, Li QL, Yi H, Zhou X, Dong J, Li W, Fu FX, Liu SZ, Chen JG, Zhu J, Li YH, Lu YQ, Fan M, Huang SQ, Guo GP, Zhaolai H, Wei K, Chen WQ, Wei W, Zeng H, Demetriou AV, Mang WK, Ngan KC, Kataki AC, Krishnatreya M, Jayalekshmi PA, Sebastian P, George PS, Mathew A, Nandakumar A, Malekzadeh R, Roshandel G, Keinan-Boker L, Silverman BG, Ito H, Koyanagi Y, Sato M, Tobori F, Nakata I, Teramoto N, Hattori M, Kaizaki Y, Moki F, Sugiyama H, Utada M, Nishimura M, Yoshida K, Kurosawa K, Nemoto Y, Narimatsu H, Sakaguchi M, Kanemura S, Naito M, Narisawa R, Miyashiro I, Nakata K, Mori D, Yoshitake M, Oki I, Fukushima N, Shibata A, Iwasa K, Ono C, Matsuda T, Nimri O, Jung KW, Won YJ, Alawadhi E, Elbasmi A, Ab Manan A, Adam F, Nansalmaa E, Tudev U, Ochir C, Al Khater AM, El Mistiri MM, Lim GH, Teo YY, Chiang CJ, Lee WC, Buasom R, Sangrajrang S, Suwanrungruang K, Vatanasapt P, Daoprasert K, Pongnikorn D, Leklob A, Sangkitipaiboon S, Geater SL, Sriplung H, Ceylan O, Kög I, Dirican O, Köse T, Gurbuz T, Karaşahin FE, Turhan D, Aktaş U, Halat Y, Eser S, Yakut CI, Altinisik M, Cavusoglu Y, Türkköylü A, Üçüncü N, Hackl M, Zborovskaya AA, Aleinikova OV, Henau K, Van Eycken L, Atanasov TY, Valerianova Z, Šekerija M, Dušek L, Zvolský M, Steinrud Mørch L, Storm H, Wessel Skovlund C, Innos K, Mägi M, Malila N, Seppä K, Jégu J, Velten M, Cornet E, Troussard X, Bouvier AM, Guizard AV, Bouvier V, Launoy G, Dabakuyo Yonli S, Poillot ML, Maynadié M, Mounier M, Vaconnet L, Woronoff AS, Daoulas M, Robaszkiewicz M, Clavel J, Poulalhon C, Desandes E, Lacour B, Baldi I, Amadeo B, Coureau G, Monnereau A, Orazio S, Audoin M, D’Almeida TC, Boyer S, Hammas K, Trétarre B, Colonna M, Delafosse P, Plouvier S, Cowppli-Bony A, Molinié F, Bara S, Ganry O, Lapôtre-Ledoux B, Daubisse-Marliac L, Bossard N, Uhry Z, Estève J, Stabenow R, Wilsdorf-Köhler H, Eberle A, Luttmann S, Löhden I, Nennecke AL, Kieschke J, Sirri E, Justenhoven C, Reinwald F, Holleczek B, Eisemann N, Katalinic A, Asquez RA, Kumar V, Petridou E, Ólafsdóttir EJ, Tryggvadóttir L, Murray DE, Walsh PM, Sundseth H, Harney M, Mazzoleni G, Vittadello F, Coviello E, Cuccaro F, Galasso R, Sampietro G, Giacomin A, Magoni M, Ardizzone A, D’Argenzio A, Di Prima AA, Ippolito A, Lavecchia AM, Sutera Sardo A, Gola G, Ballotari P, Giacomazzi E, Ferretti S, Dal Maso L, Serraino D, Celesia MV, Filiberti RA, Pannozzo F, Melcarne A, Quarta F, Andreano A, Russo AG, Carrozzi G, Cirilli C, Cavalieri d’Oro L, Rognoni M, Fusco M, Vitale MF, Usala M, Cusimano R, Mazzucco W, Michiara M, Sgargi P, Boschetti L, Marguati S, Chiaranda G, Seghini P, Maule MM, Merletti F, Spata E, Tumino R, Mancuso P, Cassetti T, Sassatelli R, Falcini F, Giorgetti S, Caiazzo AL, Cavallo R, Piras D, Bella F, Madeddu A, Fanetti AC, Maspero S, Carone S, Mincuzzi A, Candela G, Scuderi T, Gentilini MA, Rizzello R, Rosso S, Caldarella A, Intrieri T, Bianconi F, Contiero P, Tagliabue G, Rugge M, Zorzi M, Beggiato S, Brustolin A, Gatta G, De Angelis R, Vicentini M, Zanetti R, Stracci F, Maurina A, Oniščuka M, Mousavi M, Steponaviciene L, Vincerževskienė I, Azzopardi MJ, Calleja N, Siesling S, Visser O, Johannesen TB, Larønningen S, Trojanowski M, Macek P, Mierzwa T, Rachtan J, Rosińska A, Kępska K, Kościańska B, Barna K, Sulkowska U, Gebauer T, Łapińska JB, Wójcik-Tomaszewska J, Motnyk M, Patro A, Gos A, Sikorska K, Bielska-Lasota M, Didkowska JA, Wojciechowska U, Forjaz de Lacerda G, Rego RA, Carrito B, Pais A, Bento MJ, Rodrigues J, Lourenço A, Mayer-da-Silva A, Coza D, Todescu AI, Valkov MY, Gusenkova L, Lazarevich O, Prudnikova O, Vjushkov DM, Egorova A, Orlov A, Pikalova LV, Zhuikova LD, Adamcik J, Safaei Diba C, Zadnik V, Žagar T, De-La-Cruz M, Lopez-de-Munain A, Aleman A, Rojas D, Chillarón RJ, Navarro AIM, Marcos-Gragera R, Puigdemont M, Rodríguez-Barranco M, Sánchez Perez MJ, Franch Sureda P, Ramos Montserrat M, Chirlaque López MD, Sánchez Gil A, Ardanaz E, Guevara M, Cañete-Nieto A, Peris-Bonet R, Carulla M, Galceran J, Almela F, Sabater C, Khan S, Pettersson D, Dickman P, Staehelin K, Struchen B, Egger Hayoz C, Rapiti E, Schaffar R, Went P, Mousavi SM, Bulliard JL, Maspoli-Conconi M, Kuehni CE, Redmond SM, Bordoni A, Ortelli L, Chiolero A, Konzelmann I, Rohrmann S, Wanner M, Broggio J, Rashbass J, Stiller C, Fitzpatrick D, Gavin A, Morrison DS, Thomson CS, Greene G, Huws DW, Grayson M, Rawcliffe H, Allemani C, Coleman MP, Di Carlo V, Girardi F, Matz M, Minicozzi P, Sanz N, Ssenyonga N, James D, Stephens R, Chalker E, Smith M, Gugusheff J, You H, Qin Li S, Dugdale S, Moore J, Philpot S, Pfeiffer R, Thomas H, Silva Ragaini B, Venn AJ, Evans SM, Te Marvelde L, Savietto V, Trevithick R, Aitken J, Currow D, Fowler C, Lewis C. Global survival trends for brain tumors, by histology: analysis of individual records for 556,237 adults diagnosed in 59 countries during 2000-2014 (CONCORD-3). Neuro Oncol 2023; 25:580-592. [PMID: 36355361 PMCID: PMC10013649 DOI: 10.1093/neuonc/noac217] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Survival is a key metric of the effectiveness of a health system in managing cancer. We set out to provide a comprehensive examination of worldwide variation and trends in survival from brain tumors in adults, by histology. METHODS We analyzed individual data for adults (15-99 years) diagnosed with a brain tumor (ICD-O-3 topography code C71) during 2000-2014, regardless of tumor behavior. Data underwent a 3-phase quality control as part of CONCORD-3. We estimated net survival for 11 histology groups, using the unbiased nonparametric Pohar Perme estimator. RESULTS The study included 556,237 adults. In 2010-2014, the global range in age-standardized 5-year net survival for the most common sub-types was broad: in the range 20%-38% for diffuse and anaplastic astrocytoma, from 4% to 17% for glioblastoma, and between 32% and 69% for oligodendroglioma. For patients with glioblastoma, the largest gains in survival occurred between 2000-2004 and 2005-2009. These improvements were more noticeable among adults diagnosed aged 40-70 years than among younger adults. CONCLUSIONS To the best of our knowledge, this study provides the largest account to date of global trends in population-based survival for brain tumors by histology in adults. We have highlighted remarkable gains in 5-year survival from glioblastoma since 2005, providing large-scale empirical evidence on the uptake of chemoradiation at population level. Worldwide, survival improvements have been extensive, but some countries still lag behind. Our findings may help clinicians involved in national and international tumor pathway boards to promote initiatives aimed at more extensive implementation of clinical guidelines.
Collapse
Affiliation(s)
- Fabio Girardi
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK.,Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK.,Division of Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Melissa Matz
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK
| | - Charles Stiller
- National Cancer Registration and Analysis Service, Public Health England, London, UK
| | - Hui You
- Cancer Information Analysis Unit, Cancer Institute NSW, St Leonards, New South Wales, Australia
| | - Rafael Marcos Gragera
- Epidemiology Unit and Girona Cancer Registry, Catalan Institute of Oncology, Girona, Spain
| | - Mikhail Y Valkov
- Department of Radiology, Radiotherapy and Oncology, Northern State Medical University, Arkhangelsk, Russia
| | - Jean-Luc Bulliard
- Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.,Neuchâtel and Jura Tumour Registry, Neuchâtel, Switzerland
| | - Prithwish De
- Surveillance and Cancer Registry, and Research Office, Clinical Institutes and Quality Programs, Ontario Health, Toronto, Ontario, Canada
| | - David Morrison
- Scottish Cancer Registry, Public Health Scotland, Edinburgh, UK
| | - Miriam Wanner
- Cancer Registry Zürich, Zug, Schaffhausen and Schwyz, University Hospital Zürich, Zürich, Switzerland
| | - David K O'Brian
- Alaska Cancer Registry, Alaska Department of Health and Social Services, Anchorage, Alaska, USA
| | - Nathalie Saint-Jacques
- Department of Medicine and Community Health and Epidemiology, Centre for Clinical Research, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Michel P Coleman
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK.,Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK
| | - Claudia Allemani
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
22
|
Martins LF, Oh J, Melgar A, Harper M, Wall EW, Hristov AN. Effects of phytonutrients and yeast culture supplementation on lactational performance and nutrient use efficiency in dairy cows. J Dairy Sci 2023; 106:1746-1756. [PMID: 36586803 DOI: 10.3168/jds.2022-22482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 10/05/2022] [Indexed: 12/31/2022]
Abstract
Yeast culture and phytonutrients are dietary supplements with distinct modes of action, and they may have additive effects on the performance of dairy cattle. The objective of this study was to investigate the effects of a preparation of phytonutrients and a yeast culture from Saccharomyces cerevisiae on lactational performance, total-tract digestibility of nutrients, urinary nitrogen losses, energy metabolism markers, and blood cells in dairy cows. Thirty-six mid-lactation Holstein cows (10 primiparous and 26 multiparous) were used in an 8-wk randomized complete block design experiment with a 2-wk covariate period, 2 wk for adaptation to the diets, and a 4-wk experimental period for data and samples collection. Following a 2-wk covariate period, cows were blocked by days in milk, parity, and milk yield and randomly assigned to 1 of 3 treatments (12 cows per treatment): basal diet supplemented with 14 g/cow per day yeast culture (YC; S. cerevisiae), basal diet supplemented with 1.0 g/cow per day phytonutrients (PN; 5.5% cinnamaldehyde, 9.5% eugenol, and 3.5% capsicum oleoresin), or basal diet supplemented with a combination of YC and PN (YCPN). Treatments were top-dressed once daily on the total mixed ration at time of feeding. Dry matter intake, milk yield, and feed efficiency were not affected by treatments. Milk composition and energy-corrected milk yield were also not affected by supplementation of YC, PN, and YCPN. There were no differences in intake or total-tract digestibility of dietary nutrients among treatments. Compared with YC, the PN and YCPN treatments tended to decrease the proportion of short-chain fatty acids in milk fat. There was an additive effect of YC and PN supplementation on urinary urea nitrogen (UUN) excretion relative to total nitrogen intake. Cows fed a diet supplemented with YCPN had lower UUN excretion than cows in YC and tended to have lower UUN excretion compared with PN. Blood monocytes count and percentage were decreased in cows fed PN and YCPN diets compared with YC. Treatments did not affect concentrations of blood β-hydroxybutyrate and total fatty acids. Overall, lactational performance, digestibility of nutrients, energy metabolism markers, and blood cells were not affected by YC, PN, or YCPN supplementation. A combination of PN and YC had an additive effect on nitrogen excretion in dairy cows.
Collapse
Affiliation(s)
- L F Martins
- Department of Animal Science, The Pennsylvania State University, University Park 16802
| | - J Oh
- Department of Animal Science, The Pennsylvania State University, University Park 16802
| | - A Melgar
- Department of Animal Science, The Pennsylvania State University, University Park 16802
| | - M Harper
- Department of Animal Science, The Pennsylvania State University, University Park 16802
| | - E W Wall
- Pancosma, Geneva, Switzerland CH-1218
| | - A N Hristov
- Department of Animal Science, The Pennsylvania State University, University Park 16802.
| |
Collapse
|
23
|
Oh J, Oh JM, Cho SY. METTL3-mediated downregulation of splicing factor SRSF11 is associated with carcinogenesis and poor survival of cancer patients. Eur Rev Med Pharmacol Sci 2023; 27:2561-2570. [PMID: 37013774 DOI: 10.26355/eurrev_202303_31793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
Abstract
OBJECTIVE N6-methyladenosine (m6A) is one of the most abundant post-transcriptional modifications in eukaryotic RNA. As m6A modifications play an important role in RNA processing, abnormal m6A regulation caused by aberrant expression of m6A regulators is closely related to carcinogenesis. In this study, we aimed to determine the role of METTL3 expression in carcinogenesis, regulation of splicing factor expression by METTL3, and their effects in survival period and cancer-related metabolisms. MATERIALS AND METHODS We investigated the correlation between each splicing factor and METTL3 in breast invasive ductal carcinoma (BRCA), colon adenocarcinoma (COAD), lung adenocarcinoma (LUAD) and gastric adenocarcinoma (STAD). Survival analysis was performed based on the expression of each splicing factor. To determine the molecular mechanism of SRSF11 in carcinogenesis, gene set enrichment analysis using RNA sequencing data was performed according to SRSF11 expression. RESULTS Among the 64 splicing factors used for correlation analysis, 13 splicing factors showed a positive correlation with METTL3 in all four cancer types. We found that when METTL3 expression was decreased, the expression of SRSF11 was also decreased in all four types of cancer tissue when compared to that in normal tissue. Decreased SRSF11 expression was associated with poor survival in patients with BRCA, COAD, LUAD, and STAD. Gene set enrichment analysis according to SRSF11 expression showed that the p53/apoptosis, inflammation/immune response, and ultraviolet/reactive oxygen species stimulus-response pathways were enriched in cancers with decreased SRSF11 expression. CONCLUSIONS These results suggest that METTL3 regulates SRSF11 expression, which could influence mRNA splicing in m6A modified cancer cells. METTL3-mediated downregulation of SRSF11 expression in cancer patients correlates with poor prognosis.
Collapse
Affiliation(s)
- J Oh
- Department of Translational Medicine, Seoul National University College of Medicine, Seoul, South Korea.
| | | | | |
Collapse
|
24
|
Chung WK, Hwang I, Kim B, Jung J, Yu KS, Jang IJ, Oh J. Pharmacokinetics, safety and tolerability of valbenazine in Korean CYP2D6 normal and intermediate metabolizers. Clin Transl Sci 2023; 16:512-523. [PMID: 36514192 PMCID: PMC10014685 DOI: 10.1111/cts.13466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 10/20/2022] [Accepted: 11/16/2022] [Indexed: 12/15/2022] Open
Abstract
Valbenazine is a selective vesicular monoamine transporter 2 (VMAT2) inhibitor approved for tardive dyskinesia treatment by the US Food and Drug Administration; its major active metabolite (NBI-98782) is a 45-fold more potent inhibitor of VMAT2 than the parent drug. This study aimed to evaluate the pharmacokinetics (PKs), safety, and tolerability and the effect of cytochrome P450 2D6 (CYP2D6) genotypes to the PKs after the administration of valbenazine in Korean participants. A randomized, double-blind, placebo-controlled, single- and multiple-dose study was conducted in healthy Korean male participants. The single-dose study was conducted for both 40 and 80 mg valbenazine and the multiple dose study was conducted for 40 mg. After a 1-week washout, the 40 mg dose group participants received valbenazine 40 mg or placebo once daily for 8 days. Serial blood samples were collected up to 96 h postdose for PK analysis. The CYP2D6 genotypes of the participants were retrospectively analyzed. A total of 50 participants were randomized, and 43 and 20 participants completed the single- and multiple-dose phases of the study, respectively. After single doses, the PK characteristics of valbenazine and its metabolites were similar between the 40 and 80 mg dose groups. After multiple doses, the mean accumulation ratios of valbenazine and NBI-98782 were ~1.6 and 2.4, respectively. Plasma concentrations of valbenazine and NBI-98782 were similar between CYP2D6 normal and intermediate metabolizers. Valbenazine was well-tolerated in healthy Koreans, and its PK characteristics were similar to results previously reported in Americans.
Collapse
Affiliation(s)
- Woo Kyung Chung
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Korea
| | - Inyoung Hwang
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Korea
| | - Byungwook Kim
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Korea
| | - Jihyun Jung
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Korea
| | - Kyung-Sang Yu
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Korea
| | - In-Jin Jang
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Korea
| | - Jaeseong Oh
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Korea
| |
Collapse
|
25
|
Kim B, Im DW, Won H, Sunwoo J, Han SS, Lee H, Kim DK, Oh KH, Joo KW, Kim YS, Cho JY, Lee S, Oh J, Jang IJ, Kim YC. Effect of hemodialysis on the pharmacokinetics and pharmacodynamics of evogliptin. Diabetes Obes Metab 2023; 25:1769-1776. [PMID: 36852751 DOI: 10.1111/dom.15034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 02/17/2023] [Accepted: 02/24/2023] [Indexed: 03/01/2023]
Abstract
AIM To investigate the possible effect of hemodialysis (HD) on the pharmacokinetics (PKs) and pharmacodynamics (PDs) of evogliptin, a dipeptidyl peptidase-4 (DPP-4) inhibitor. METHODS A single-dose, open-label, parallel-group study of eight end-stage renal disease (ESRD) patients and eight matched healthy subjects was conducted. ESRD patients received a single oral dose of evogliptin 5 mg after and before HD with a 2-week washout between each dose, and healthy subjects received a single oral dose of evogliptin 5 mg. Serial blood, dialysate and urine samples were collected to assess the PK and PD profiles of evogliptin. To compare PK parameters before and after HD, geometric mean ratios (GMRs) and 90% confidence intervals (CIs) were calculated. RESULTS The GMRs and its 90% CIs for the maximum concentration (Cmax ) and area under the concentration-time curve from time 0 to the last measurable timepoint (AUClast ) of evogliptin when administered before HD compared to after HD were 0.7293 (0.6171-0.8620) and 0.9480 (0.8162-1.1010), respectively. The maximum DPP-4 inhibitory effect (Emax ), area under the DPP-4 inhibitory effect-time curve (AUEClast ), and time duration of more than 80% DPP-4 inhibition (Fi80) were comparable when evogliptin was administered before and after HD. Compared to healthy subjects, the mean AUClast of evogliptin was approximately 1.4-fold greater in ESRD patients, but the difference is unlikely to affect the safety and efficacy of evogliptin. CONCLUSION The effect of HD on the PKs and PDs of evogliptin was not clinically significant; therefore, dose adjustment according to HD status is not necessary. This article is protected by copyright. All rights reserved.
Collapse
Affiliation(s)
- Byungwook Kim
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Republic of Korea
| | - Dha Woon Im
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Heejae Won
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Republic of Korea
| | - Jung Sunwoo
- Clinical Trials Center, Chungnam National University Hospital, Daejeon, Korea
| | - Seung Seok Han
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hajeong Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Dong Ki Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Kook-Hwan Oh
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Kwon Wook Joo
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Yon Su Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Joo-Youn Cho
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Republic of Korea
| | - SeungHwan Lee
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Republic of Korea
| | - Jaeseong Oh
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Republic of Korea
| | - In-Jin Jang
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Republic of Korea
| | - Yong Chul Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| |
Collapse
|
26
|
Oh J, Yang E, Jang IJ, Lee H, Yoo H, Chung JY, Lee S, Oh J. Pharmacodynamic and Pharmacokinetic Drug Interactions between Fexuprazan, a Novel Potassium-Competitive Inhibitor, and Aspirin, in Healthy Subjects. Pharmaceutics 2023; 15:pharmaceutics15020549. [PMID: 36839870 PMCID: PMC9958674 DOI: 10.3390/pharmaceutics15020549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/29/2023] [Accepted: 01/31/2023] [Indexed: 02/10/2023] Open
Abstract
Acid-reducing agents are commonly used for the prevention of aspirin-induced gastrointestinal complications such as peptic ulcers. As a novel potassium-competitive acid blocker, fexuprazan is expected to prevent aspirin-induced gastrointestinal complications. This randomized, open-label study aimed to evaluate the pharmacodynamic and pharmacokinetic interactions between aspirin and fexuprazan in healthy Koreans. Subjects randomized to the aspirin group received 500 mg aspirin in combination with 80 mg fexuprazan. For the fexuprazan group, fexuprazan 80 mg was administered alone and then in combination with aspirin 500 mg. Platelet aggregation inhibited by aspirin and the pharmacokinetic parameters of aspirin and fexuprazan were compared between monotherapy and combination therapy. A total of 22 subjects completed the study. The platelet aggregation-inhibitory activity and systemic exposure to aspirin were not significantly affected by fexuprazan coadministration. The systemic exposure of fexuprazan was decreased up to 20% by aspirin coadministration, which was not regarded as clinically meaningful considering the previously reported exposure-response relationship. In conclusion, there were no clinically relevant pharmacodynamic or pharmacokinetic interactions between aspirin and fexuprazan. This finding suggests the potential of fexuprazan for the prevention of aspirin-induced gastrointestinal complications, serving as a baseline for optimizing its therapeutic application with aspirin.
Collapse
Affiliation(s)
- JungJin Oh
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul 03080, Republic of Korea
| | - Eunsol Yang
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul 03080, Republic of Korea
- Medical Research Center, Seoul National University, Seoul 03080, Republic of Korea
| | - In-Jin Jang
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul 03080, Republic of Korea
| | - Hyejung Lee
- Daewoong Pharmaceutical Co., Ltd., Seoul 06170, Republic of Korea
| | - Hokyun Yoo
- Daewoong Pharmaceutical Co., Ltd., Seoul 06170, Republic of Korea
| | - Jae-Yong Chung
- Department of Clinical Pharmacology and Therapeutics, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea
| | - SeungHwan Lee
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul 03080, Republic of Korea
| | - Jaeseong Oh
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul 03080, Republic of Korea
- Correspondence:
| |
Collapse
|
27
|
Ji SH, Huh KY, Oh J, Jeong HJ, Jang YE, Kim EH, Lee JH, Kim JT, Kim HS. Conventional reversal of rocuronium-induced neuromuscular blockade by sugammadex in Korean children: pharmacokinetics, efficacy, and safety analyses. Front Pharmacol 2023; 14:1127932. [PMID: 37124204 PMCID: PMC10133539 DOI: 10.3389/fphar.2023.1127932] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 04/05/2023] [Indexed: 05/02/2023] Open
Abstract
Background: Sugammadex is known to reverse neuromuscular blockade induced by non-depolarizing agents. In children, the recommended dose for reversal of moderate neuromuscular blockade is 2 mg/kg. We investigated the pharmacokinetics and pharmacodynamics of sugammadex in Korean children. Methods: Children (2-17 years of age) undergoing brain or spine surgery were enrolled and randomly assigned to control (neostigmine) and 2, 4, or 8 mg/kg sugammadex groups. Following induction of anesthesia and monitoring of the response to train-of-four stimulation, 1 mg/kg rocuronium was intravenously administered. Upon reappearance of the second twitch to train-of-four stimulation, the study drug was administered according to group allocation. The plasma concentrations of rocuronium and sugammadex were serially measured at nine predefined time points following study drug administration. To determine efficacy, we measured the time elapsed from drug administration to recovery of T4/T1 ≥ 0.9. For pharmacokinetics, non-compartmental analysis was performed and we monitored adverse event occurrence from the time of study drug administration until 24 h post-surgery. Results: Among the 29 enrolled participants, the sugammadex (2 mg/kg) and control groups showed recovery times [median (interquartile range)] of 1.3 (1.0-1.9) and 7.7 (5.3-21.0) min, respectively (p = 0.002). There were no significant differences in recovery time among the participants in sugammadex groups. The pharmacokinetics of sugammadex were comparable to those of literature findings. Although two hypotensive events related to sugammadex were observed, no intervention was necessary. Conclusion: The findings of this pharmacokinetic analysis and efficacy study of sugammadex in Korean children indicated that sugammadex (2 mg/kg) may be safely administered for reversing moderate neuromuscular blockade. Some differences in pharmacokinetics of sugammadex were observed according to age. Clinical Trial Registration: http://clinicaltrials.gov (NCT04347486).
Collapse
Affiliation(s)
- Sang-Hwan Ji
- Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Ki Young Huh
- Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Clinical Pharmacology and Therapeutics, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jaeseong Oh
- Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Clinical Pharmacology and Therapeutics, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hee-Jeong Jeong
- Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Young-Eun Jang
- Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Eun-Hee Kim
- Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Ji-Hyun Lee
- Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jin-Tae Kim
- Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hee-Soo Kim
- Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Republic of Korea
- *Correspondence: Hee-Soo Kim,
| |
Collapse
|
28
|
Bopp L, Martinez ML, Schumacher C, Lukas D, Oh J, Brodesser S, Brachvogel B, Geltink RK, Fabri M. 018 Imiquimod perturbs amino acid metabolism in human CD8+ T cells. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
|
29
|
Park S, Lee YW, Oh J, Kim SJ, Lee S, Lee H. Pharmacokinetic evaluation of radiolabeled intraocular anti-CLEC14a antibody in preclinical animal species and application in humans. Clin Transl Sci 2022; 15:2938-2946. [PMID: 36129122 PMCID: PMC9747121 DOI: 10.1111/cts.13412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/30/2022] [Accepted: 08/05/2022] [Indexed: 01/26/2023] Open
Abstract
Anti-angiogenic antibodies are widely used in the treatment of neovascular macular degeneration. Human antibody targeting C-type lectin domain family 14 member A (CLEC14a) is potential therapeutic agents owing to its antiangiogenic activity. In the present study, we aimed to predict the human intraocular pharmacokinetic (PK) properties of an anti-CLEC14a antibody. I-125 labeled aflibercept and anti-CLEC14a antibody were intravitreally injected into mice, rats, and rabbits. Single photon emission computed tomography/computed tomography imaging was performed, and the intraocular radioactivity concentration (%ID/ml) was obtained. The PK parameters in those three animal species were obtained by compartmental analysis. The PK parameters in humans were estimated by allometric scaling of the animal PK parameters with consideration of the hydrodynamic radius of the antibody. The mean half-life values of intraocular I-125-labeled aflibercept in mice, rats, and rabbits were 1.13 days, 1.25 days, and 4.91 days, respectively, by analysis with a one-compartment model. The predicted human half-life of intraocular aflibercept was 5.75 days based on vitreal volume by allometric scaling. The half-life values of intraocular I-125-labeled anti-CLEC14a in mice, rats and rabbits were 1.05 days, 1.84 days, and 6.37 days, respectively, by analysis with a one-compartment model. The predicted human half-life of intraocular anti-CLEC14a was 10.29 days based on vitreal volume. According to the hydrodynamic volume of the anti-CLEC14a, the predicted human half-life of intraocular anti-CLEC14a was 9.81 days. The PK characteristics of the intraocular anti-CLEC14a antibody were evaluated noninvasively in animals using I-125 labeling, and the intraocular PK characteristics in humans were predicted using these animal data. This methodology can be applied for the development of new antiangiogenic antibodies to treat macular degeneration.
Collapse
Affiliation(s)
- Sohyun Park
- Department of Nuclear MedicineNational Cancer CenterGoyang‐siGyeonggi‐doKorea,Division of Convergence TechnologyNational Cancer CenterGoyang‐siGyeonggi‐doKorea
| | - Youn Woo Lee
- Department of Nuclear MedicineSeoul National University Bundang HospitalSeongnam‐siGyeonggi‐doKorea
| | - Jaeseong Oh
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of Medicine and HospitalSeoulKorea
| | - Su Jin Kim
- Department of Nuclear MedicineSeoul National University Bundang HospitalSeongnam‐siGyeonggi‐doKorea
| | - Sukmook Lee
- Department of Biopharmaceutical ChemistryKookmin UniversitySeoulKorea
| | - Ho‐Young Lee
- Department of Nuclear MedicineSeoul National University Bundang HospitalSeongnam‐siGyeonggi‐doKorea,Office of eHealth Research and BusinessSeoul National University Bundang HospitalSeongnam‐siGyeonggi‐doKorea
| |
Collapse
|
30
|
Kim BR, Oh J, Lim L, Sohn JY, Choi Y, Yi NJ, Lee KW, Suh KS, Ryu HG. Comparison between continuous versus intermittent infusion of human antithrombin III concentrate in the immediate postoperative period after liver transplantation. Korean Journal of Transplantation 2022. [DOI: 10.4285/atw2022.f-2616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Bo Rim Kim
- Department of Anesthesiology and Pain Medicine, Korea University Guro Hospital, Seoul, Korea
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Jaeseong Oh
- Clinical Pharmacology and Therapeutics, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Leerang Lim
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Jin Young Sohn
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - YoungRok Choi
- Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Nam-Joon Yi
- Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Kwang-Woong Lee
- Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Kyung-Suk Suh
- Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Ho Geol Ryu
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| |
Collapse
|
31
|
Lee J, Lee J, Jeon S, Lee J, Jang I, Yang JO, Park S, Lee B, Choi J, Choi BO, Gee HY, Oh J, Jang IJ, Lee S, Baek D, Koh Y, Yoon SS, Kim YJ, Chae JH, Park WY, Bhak JH, Choi M. A database of 5305 healthy Korean individuals reveals genetic and clinical implications for an East Asian population. Exp Mol Med 2022; 54:1862-1871. [PMID: 36323850 PMCID: PMC9628380 DOI: 10.1038/s12276-022-00871-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 07/21/2022] [Accepted: 08/08/2022] [Indexed: 11/29/2022] Open
Abstract
Despite substantial advances in disease genetics, studies to date have largely focused on individuals of European descent. This limits further discoveries of novel functional genetic variants in other ethnic groups. To alleviate the paucity of East Asian population genome resources, we established the Korean Variant Archive 2 (KOVA 2), which is composed of 1896 whole-genome sequences and 3409 whole-exome sequences from healthy individuals of Korean ethnicity. This is the largest genome database from the ethnic Korean population to date, surpassing the 1909 Korean individuals deposited in gnomAD. The variants in KOVA 2 displayed all the known genetic features of those from previous genome databases, and we compiled data from Korean-specific runs of homozygosity, positively selected intervals, and structural variants. In doing so, we found loci, such as the loci of ADH1A/1B and UHRF1BP1, that are strongly selected in the Korean population relative to other East Asian populations. Our analysis of allele ages revealed a correlation between variant functionality and evolutionary age. The data can be browsed and downloaded from a public website ( https://www.kobic.re.kr/kova/ ). We anticipate that KOVA 2 will serve as a valuable resource for genetic studies involving East Asian populations.
Collapse
Affiliation(s)
- Jeongeun Lee
- grid.31501.360000 0004 0470 5905Interdisciplinary Program in Bioengineering, Graduate School, Seoul National University, Seoul, 03080 Republic of Korea
| | - Jean Lee
- grid.31501.360000 0004 0470 5905Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, 03080 Republic of Korea
| | - Sungwon Jeon
- grid.42687.3f0000 0004 0381 814XDepartment of Biomedical Engineering, College of Information and Biotechnology, Ulsan National Institute of Science and Technology (UNIST), Ulsan, 44919 Republic of Korea
| | - Jeongha Lee
- grid.31501.360000 0004 0470 5905Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, 03080 Republic of Korea
| | - Insu Jang
- grid.249967.70000 0004 0636 3099Korea BioInformation Center (KOBIC), Korea Research Institute of Bioscience and Biotechnology (KRIBB), Daejeon, 34141 Republic of Korea
| | - Jin Ok Yang
- grid.249967.70000 0004 0636 3099Korea BioInformation Center (KOBIC), Korea Research Institute of Bioscience and Biotechnology (KRIBB), Daejeon, 34141 Republic of Korea ,grid.37172.300000 0001 2292 0500Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, 34141 Republic of Korea
| | - Soojin Park
- grid.31501.360000 0004 0470 5905Department of Pediatrics, Seoul National University College of Medicine, Seoul, 03080 Republic of Korea
| | - Byungwook Lee
- grid.249967.70000 0004 0636 3099Korea BioInformation Center (KOBIC), Korea Research Institute of Bioscience and Biotechnology (KRIBB), Daejeon, 34141 Republic of Korea
| | - Jinwook Choi
- grid.31501.360000 0004 0470 5905Interdisciplinary Program in Bioengineering, Graduate School, Seoul National University, Seoul, 03080 Republic of Korea ,grid.31501.360000 0004 0470 5905Department of Biomedical Engineering, Seoul National University College of Medicine, Seoul, 03080 Republic of Korea
| | - Byung-Ok Choi
- grid.264381.a0000 0001 2181 989XDepartment of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06351 Republic of Korea
| | - Heon Yung Gee
- grid.15444.300000 0004 0470 5454Department of Pharmacology, Brain Korea 21 PLUS Project for Medical Sciences, Yonsei University College of Medicine, Seoul, 03722 Republic of Korea
| | - Jaeseong Oh
- grid.31501.360000 0004 0470 5905Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, 03080 Republic of Korea
| | - In-Jin Jang
- grid.31501.360000 0004 0470 5905Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, 03080 Republic of Korea
| | - Sanghyuk Lee
- grid.255649.90000 0001 2171 7754Department of Bio-Information Science, Ewha Womans University, Seoul, 03760 Republic of Korea
| | - Daehyun Baek
- grid.31501.360000 0004 0470 5905School of Biological Sciences, Seoul National University, Seoul, 08826 Republic of Korea
| | - Youngil Koh
- grid.412484.f0000 0001 0302 820XDepartment of Internal Medicine, Seoul National University Hospital, Seoul, 03080 Republic of Korea
| | - Sung-Soo Yoon
- grid.412484.f0000 0001 0302 820XDepartment of Internal Medicine, Seoul National University Hospital, Seoul, 03080 Republic of Korea
| | - Young-Joon Kim
- grid.15444.300000 0004 0470 5454Department of Biochemistry, College of Life Science and Biotechnology, Yonsei University, Seoul, 03722 Republic of Korea
| | - Jong-Hee Chae
- grid.31501.360000 0004 0470 5905Department of Pediatrics, Seoul National University College of Medicine, Seoul, 03080 Republic of Korea ,grid.412484.f0000 0001 0302 820XDepartment of Genomic Medicine, Seoul National University Hospital, Seoul, 03080 Republic of Korea
| | - Woong-Yang Park
- grid.414964.a0000 0001 0640 5613Samsung Genome Institute, Samsung Medical Center, Seoul, 06351 Republic of Korea
| | - Jong Hwa Bhak
- grid.42687.3f0000 0004 0381 814XDepartment of Biomedical Engineering, College of Information and Biotechnology, Ulsan National Institute of Science and Technology (UNIST), Ulsan, 44919 Republic of Korea
| | - Murim Choi
- grid.31501.360000 0004 0470 5905Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, 03080 Republic of Korea
| |
Collapse
|
32
|
Goodman B, Oh J, Ferastraoaru D. SUGAMMADEX ANAPHYLAXIS. Ann Allergy Asthma Immunol 2022. [DOI: 10.1016/j.anai.2022.08.753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
33
|
Gutkin P, Skinner L, Jiang A, Donaldson S, Loo B, Oh J, Von Eyben R, Bredfeldt J, Breneman J, Constine L, Faught A, Haas-Kogan D, Holmes J, Krasin M, Larkin C, Marcus K, Maxim P, Murphy B, Palmer J, Perkins S, Terezakis S, Bush K, Hiniker S. A 10-Center Prospective Clinical Trial of the Audio-Visual Assisted Therapeutic Ambience in Radiotherapy (AVATAR) System for Anesthesia Avoidance in Pediatric Patients. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
|
34
|
Kim W, Jo JC, Koh Y, Yang D, Yoon D, Kwon J, Lee GW, Yoo K, Oh J, Lee J, Kim H. 207MO Efficacy and safety of IMC-001, anti-PD-L1 antibody, in patients with relapsed or refractory extranodal NK/T cell lymphoma, nasal type (R/R ENKTL). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022] Open
|
35
|
Hui C, Marquez C, Simiele E, Blomain E, Oh J, Bertaina A, Klein O, Shyr D, Jiang A, Hoppe R, Kovalchuk N, Hiniker S. Volumetric Modulated Arc Therapy Total Body Irradiation (VMAT-TBI) in Pediatric and Adolescent/Young Adult Patients Undergoing Stem Cell Transplantation: Early Outcomes and Toxicities. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
36
|
Na JY, Yoon DY, Yoo H, Lee S, Yu K, Jang I, Yoo S, Kim Y, Oh J. Safety, tolerability, pharmacokinetic, and pharmacodynamic characteristics of vutiglabridin: A first-in-class, first-in-human study. Clin Transl Sci 2022; 15:2744-2757. [PMID: 36176051 PMCID: PMC9652434 DOI: 10.1111/cts.13401] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 08/17/2022] [Accepted: 08/26/2022] [Indexed: 01/26/2023] Open
Abstract
This study aimed to evaluate the safety, tolerability, pharmacokinetics, and pharmacodynamics of vutiglabridin, a potential anti-obesity treatment under development, for the first time in humans. A randomized, placebo-controlled, single- and multiple-ascending dose study (SAD and MAD, respectively) was performed in healthy Koreans and Whites. Subjects randomly received a single oral dose of 30-720 mg vutiglabridin or placebo at a ratio of 8:2 in the SAD study or 240-480 mg vutiglabridin or placebo once daily for 14 days in the MAD study. Food effect was also evaluated in 240 mg single dose group. Pharmacokinetics were evaluated through plasma concentrations, and pharmacodynamic biomarkers related to obesity or inflammation were analyzed. Safety and tolerability were assessed throughout the study. Single and multiple doses of vutiglabridin were generally well-tolerated. The pharmacokinetic parameters show less than dose-proportionality increase, and plasma concentrations increased more than two-fold after multiple administrations. The mean half-life of Koreans and Whites in the MAD study was 110 and 73 h, respectively. The systemic exposure of vutiglabridin was significantly increased when taken with a high-fat meal, and the systemic exposure was lower in Whites than in Koreans. Vutiglabridin was well-tolerated in healthy Koreans and Whites. The plasma concentration increased less than the dose-proportionality manner. These results justify further investigation of vutiglabridin in patients with obesity.
Collapse
Affiliation(s)
- Joo Young Na
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of Medicine and HospitalSeoulKorea
| | - Deok Yong Yoon
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of Medicine and HospitalSeoulKorea
| | - Hyounggyoon Yoo
- Department of Clinical Pharmacology and Therapeutics, CHA Bundang Medical CenterSeongnamKorea
| | - SeungHwan Lee
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of Medicine and HospitalSeoulKorea
| | - Kyung‐Sang Yu
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of Medicine and HospitalSeoulKorea
| | - In‐Jin Jang
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of Medicine and HospitalSeoulKorea
| | | | | | - Jaeseong Oh
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of Medicine and HospitalSeoulKorea
| |
Collapse
|
37
|
Ji S, Huh KY, Oh J, Jeong H, Jang Y, Kim E, Lee J, Kim J, Kim H. Reversal of rocuronium-induced intense neuromuscular blockade by sugammadex in Korean children: A pharmacokinetic and pharmacodynamic analysis. Clin Transl Sci 2022; 16:92-103. [PMID: 36181377 PMCID: PMC9841294 DOI: 10.1111/cts.13429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 08/09/2022] [Accepted: 09/21/2022] [Indexed: 02/06/2023] Open
Abstract
Sugammadex, a selective antagonist of steroidal non-depolarizing neuromuscular blocking agents, has been used in children in limited circumstances. However, neither pharmacokinetics (PKs) nor recovery profile of sugammadex for intense neuromuscular blockade reversal in children have been reported. This prospective study aimed to obtain a PK model of sugammadex and evaluate its efficacy and safety for intense neuromuscular blockade reversal in children. Forty children (age, 2-17 years) who underwent surgery that required early neuromuscular blockade reversal were enrolled. After neuromuscular blockade with 1 mg∙kg-1 of rocuronium, sugammadex (2, 4, and 8 mg∙kg-1 ) or a conventional dose of neostigmine (0.03 mg∙kg-1 ) was administered randomly after confirmation of zero post-tetanic count. The plasma concentrations of rocuronium and sugammadex were measured 2 min after rocuronium injection; immediately before, 2, 5, 15, 60, 120, 240, and 480 min after the study drug injection. Response to train-of-four stimulation was continuously recorded. Noncompartmental analysis and population PK modeling were performed. For pharmacodynamics, the recovery profile was measured. Three-compartment PK model was established for sugammadex. The median (interquartile range [IQR]) time from injection of 8 mg∙kg-1 of sugammadex to recovery of T4 /T1 greater than or equal to 0.9 at train-of-four stimulation was 1.1 (IQR: 0.88-1.8) min. No adverse events related to sugammadex were observed. We present a PK analysis of sugammadex for rocuronium-induced intense neuromuscular blockade reversal in children with its recovery profile. The time to recover T4 /T1 greater than or equal to 0.9 at train-of-four stimulation with 8 mg∙kg-1 of sugammadex was less than 3 min and comparable to that in adults.
Collapse
Affiliation(s)
- Sang‐Hwan Ji
- Seoul National University College of MedicineSeoulKorea,Department of Anesthesiology and Pain MedicineSeoul National University HospitalSeoulKorea
| | - Ki Young Huh
- Seoul National University College of MedicineSeoulKorea,Department of Clinical Pharmacology and TherapeuticsSeoul National University HospitalSeoulKorea
| | - Jaeseong Oh
- Seoul National University College of MedicineSeoulKorea,Department of Clinical Pharmacology and TherapeuticsSeoul National University HospitalSeoulKorea
| | - Hee‐Jeong Jeong
- Seoul National University College of MedicineSeoulKorea,Department of Anesthesiology and Pain MedicineSeoul National University HospitalSeoulKorea
| | - Young‐Eun Jang
- Seoul National University College of MedicineSeoulKorea,Department of Anesthesiology and Pain MedicineSeoul National University HospitalSeoulKorea
| | - Eun‐Hee Kim
- Seoul National University College of MedicineSeoulKorea,Department of Anesthesiology and Pain MedicineSeoul National University HospitalSeoulKorea
| | - Ji‐Hyun Lee
- Seoul National University College of MedicineSeoulKorea,Department of Anesthesiology and Pain MedicineSeoul National University HospitalSeoulKorea
| | - Jin‐Tae Kim
- Seoul National University College of MedicineSeoulKorea,Department of Anesthesiology and Pain MedicineSeoul National University HospitalSeoulKorea
| | - Hee‐Soo Kim
- Seoul National University College of MedicineSeoulKorea,Department of Anesthesiology and Pain MedicineSeoul National University HospitalSeoulKorea
| |
Collapse
|
38
|
Kim SE, Chun KH, Oh J, Yu HT, Lee CJ, Kim TH, Pak HN, Lee MH, Joung B, Kang SM. Prediction of response to cardiac resynchronization therapy using cardiac magnetic resonance imaging in non-ischemic dilated cardiomyopathy. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Cardiac resynchronization therapy (CRT) is a well-established therapy for symptomatic heart failure with reduced ejection fraction, but the response is different for individuals. Although many modalities have been conducted to predict CRT response, cardiac magnetic resonance (CMR) to predict CRT response has still insufficient usefulness.
Purpose
We determine whether the parameters including late gadolinium enhancement (LGE) identified in CMR could act as predictors of CRT response.
Methods
We retrospectively investigated 124 patients with non-ischemic dilated cardiomyopathy who underwent CMR before CRT implantation between Jan 2010 and July 2021 in a single center. CRT response was defined as a decrease in left ventricular end-systolic volume (LVESV) >15% on echocardiography after at least 3 months after CRT implantation.
Results
Among the study population (mean age 65.7±11.2 years, mean EF 25±6.5%, 50% of female), 85 (69%) patients were defined as CRT responder. The CRT responders had more left bundle branch block (LBBB) compared with non-responders [79 (92.9%) vs. 23 (59.0%), p<0.001], but there was a no difference of QRS duration (158.7 vs 165.0ms, p=0.054) between two groups. CMR analysis showed that there were no significant differences in the left ventricular (LV) chamber volume and LV ejection fraction between CRT-responder and non-responder. However, the right ventricular (RV) chamber volume was smaller (RV end-diastolic volume index, 86.3 vs 103.5 ml/m2, p=0.039; RV end-systolic volume index, 49.3 vs 68.5 ml/m2, p=0.013) and the RV ejection fraction (RVEF) was higher (46.9 vs 37.6%, p=0.002) in CRT-responders compared with non-responders. The LGE on CMR was more shown in non-responders than in CRT-responders [33 (84.6%) vs 45 (52.9%), p<0.001]. In CMR parameters, RV dysfunction (RVEF <45%) [Odds ratio (OR), 0.21 (0.05–0.93), p=0.045] and LGE [OR, 0.21 (0.05–0.58), p=0.01] were significantly associated with poor CRT response.
Conclusions
The presence of LGE and RV dysfunction on CMR were associated with poor CRT response in patients with non-ischemic dilated cardiomyopathy. Further investigation with CMR for pre-CRT patients is needed to support these results.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
- S E Kim
- Severance Cardiovascular Hospital, Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - K H Chun
- NHIS Ilsan Hospital, Cardiology , Goyang , Korea (Republic of)
| | - J Oh
- Severance Cardiovascular Hospital, Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - H T Yu
- Severance Cardiovascular Hospital, Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - C J Lee
- Severance Cardiovascular Hospital, Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - T H Kim
- Severance Cardiovascular Hospital, Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - H N Pak
- Severance Cardiovascular Hospital, Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - M H Lee
- Severance Cardiovascular Hospital, Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - B Joung
- Severance Cardiovascular Hospital, Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - S M Kang
- Severance Cardiovascular Hospital, Yonsei University College of Medicine , Seoul , Korea (Republic of)
| |
Collapse
|
39
|
Oh J, Yoon M, Lee SH, Lee CJ, Park S, Lee SH, Kang SM. Genetic analysis of Korean non-ischemic dilated cardiomyopathy using next generation sequencing. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Non-ischemic dilated cardiomyopathy (NIDCM) is a genetic disorder that causes heart failure and life-threatening arrhythmia. However, there has been no study about the up-to-date genetic analysis for NIDCM in Korean. Therefore, we performed the genetic analysis of Korean NIDCM patients (pts) using next generation sequencing (NGS).
Methods
We analyzed clinical and echocardiographic data of 203 NIDCM in a single center from July 2017 to May 2020. All pts underwent NGS analysis with customized panel including 369 genes. Genetic variants were classified as pathogenic, likely pathogenic mutations or variants of uncertain significance regarding American College of Medical Genetics guideline.
Results
A total of 203 NIDCM pts (57±15 years old, 32.0% male, LVEF 28%) had NGS analysis. Thirty-seven (18.2%) pts had pathogenic or likely pathogenic mutations. The most prevalent mutated genes were TTN (n=16, 43.2%). TNNT2 (n=6, 16.2%), MYBPC3 (n=6, 16.2%) and MYH7 (n=3, 8.1%) mutated genes were common in the following order. The patients with positive panel mutation had no significant difference in initial LVEF (27% vs. 28%, p=0.216) and prevalence of atrial fibrillation (37.8% vs. 44.6%, p=0.454) compared with patients with negative panel mutation. During the median follow-up period of 40 months, there was no significant difference in composite outcome (all-cause death, heart transplantation, LVAD, heart failure re-admission, fatal arrhythmia) (35.3% vs. 32.2%, p=0.729) or presence of improved EF (≥10 points increase from baseline LVEF, and a second measurement of LVEF >40%) (41.2% vs. 50.0%, p=0.354) between the two groups.
Conclusion
This is the first study of NGS analysis in Korean NIDCM pts. We could find disease-related pathogenic or likely pathogenic mutations in 18.2% NIDCM patients. Further prospective, large study should be warranted to elucidate the effect of genetic mutation in clinical manifestation and prognosis of NIDCM in Korean population.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
- J Oh
- Yonsei University College of Medicine, Cardiology Division , Seoul , Korea (Republic of)
| | - M Yoon
- Yonsei University College of Medicine, Cardiology Division , Seoul , Korea (Republic of)
| | - S H Lee
- Yonsei University College of Medicine, Cardiology Division , Seoul , Korea (Republic of)
| | - C J Lee
- Yonsei University College of Medicine, Cardiology Division , Seoul , Korea (Republic of)
| | - S Park
- Yonsei University College of Medicine, Cardiology Division , Seoul , Korea (Republic of)
| | - S H Lee
- Yonsei University College of Medicine, Cardiology Division , Seoul , Korea (Republic of)
| | - S M Kang
- Yonsei University College of Medicine, Cardiology Division , Seoul , Korea (Republic of)
| |
Collapse
|
40
|
Chun KH, Oh J, Lee CJ, Kang SM. In-hospital glycemic variability and all-cause mortality in patients hospitalized with acute heart failure: analysis of the KorAHF registry. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Glycemic variability (GV) is known to be a poor prognostic marker in various diseases including cardiovascular disease.
Purpose
We investigated the association of GV with all-cause mortality in patients with acute heart failure (HF).
Methods
The Korean Acute Heart Failure registry enrolled patients hospitalized for acute HF from 2011 to 2014. Among survivors of the index hospitalization, we analyzed those who had ≥3 blood glucose measurements before discharge. Patients were divided into two groups based on their coefficient of variation (%CV) as an indicator of GV. We investigated all-cause mortality at 6 month and 1 year after discharge.
Results
The study analyzed 2,617 patients (median age 72 years, 53% male). During the median follow-up period of 11 months, 583 (22%) patients died. Compared to alive patients, patients who died had a significantly higher diabetes prevalence (46% vs. 41%, P=0.035) and higher %CV (31.0% vs. 27.5%, P<0.001). Kaplan-Meier curve analysis revealed that a high GV (%CV >21%) was associated with lower cumulative survival to all-cause death compared with a low GV (%CV ≤21%) (log-rank P<0.001). Multivariate Cox proportional analysis showed that a high GV was associated with an increased risk of 6-month mortality (hazard ratio [HR] 2.02, 95% CI 1.58–2.59, P<0.001) and one-year mortality (HR 1.57, 95% CI 1.29–1.91, P<0.001). The risk of high GV for one-year mortality was significant in non-diabetic patients (HR 1.98, 95% CI 1.55–2.53, P<0.001), but not in diabetic patients (HR 1.24, 95% CI 0.91–1.69, P=0.176; P-for-interaction=0.030).
Conclusion
A high GV (%CV >21%) before discharge was associated with all-cause mortality within 1 year, especially in non-diabetic acute HF patients.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
- K H Chun
- Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - J Oh
- Yonsei University College of Medicine, Severance Cardiovascular Hospital , Seoul , Korea (Republic of)
| | - C J Lee
- Yonsei University College of Medicine, Severance Cardiovascular Hospital , Seoul , Korea (Republic of)
| | - S M Kang
- Yonsei University College of Medicine, Severance Cardiovascular Hospital , Seoul , Korea (Republic of)
| |
Collapse
|
41
|
Kronzer E, Pislaru S, Padang R, Oguz D, Nkomo V, Oh J, Alkhouli M, Guerrero M, Reeder G, Eleid M, Rihal C, Thaden J. Impact of proportionate versus disproportionate mitral regurgitation on acute procedural changes and clinical outcomes following transcatheter mitral valve repair. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Transcatheter mitral edge-to-edge repair (TEER) with MitraClip offers a less invasive alternative for patients with severe, symptomatic mitral regurgitation (MR) who are considered high risk for surgery. However, patient selection for TEER remains challenging given the variability in underlying MR pathology and current discordance among studies regarding predictors of procedural efficacy and clinical outcomes.
Purpose
This study aimed to assess acute procedural changes and long-term outcomes in patients who underwent TEER according to the proportionality of MR, defined as the ratio of the effective regurgitant orifice area (EROA) and left ventricular end-diastolic volume (LVEDV).
Methods
We analyzed patients who underwent TEER at our institution between 2014 and 2020 with available biplane left ventricular volume measurement. Relevant clinical comorbidities, demographics, and anthropometrics, along with pertinent pre- and post-procedural echocardiogram measurements, were obtained by review of the electronic medical record. The EROA to LVEDV index was calculated for all patients who were then stratified by quartiles. Patients with an EROA/LVEDV index in the lowest quartile were defined as having the most proportionate MR and those with an index in the highest quartile were defined as the most disproportionate MR. Baseline and post-TEER parameters were used to assess acute procedural and longitudinal outcomes.
Results
Baseline clinical and echocardiographic parameters of the 230 subjects according to quartile are shown in the table. Following TEER, there was a larger reduction in the left ventricular end-diastolic diameter and increased MR reduction with increasingly disproportionate MR (p=0.03 and p=0.05, respectively). The change in ejection fraction pre- versus post-TEER did not significantly differ across groups (p=0.64). Median follow up time was 1.7 (0.7–3.5) years; mortality occurred in 77 patients (33.5%) and heart failure hospitalizations occurred in 20 patients (8.7%) during follow up. No significant difference in all-cause mortality or post-procedural heart failure hospitalizations was identified across groups.
Conclusions
In our series, patients with proportionate MR were similarly symptomatic to those with disproportionate MR but had less severe MR with increased comorbidities. Post-TEER MR grade was similar between groups. Longer-term follow up in larger groups of patients is needed to determine the clinical implications.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
- E Kronzer
- Mayo Clinic Hospital-Rochester , Rochester , United States of America
| | - S Pislaru
- Mayo Clinic Hospital-Rochester , Rochester , United States of America
| | - R Padang
- Mayo Clinic Hospital-Rochester , Rochester , United States of America
| | - D Oguz
- Mayo Clinic Hospital-Rochester , Rochester , United States of America
| | - V Nkomo
- Mayo Clinic Hospital-Rochester , Rochester , United States of America
| | - J Oh
- Mayo Clinic Hospital-Rochester , Rochester , United States of America
| | - M Alkhouli
- Mayo Clinic Hospital-Rochester , Rochester , United States of America
| | - M Guerrero
- Mayo Clinic Hospital-Rochester , Rochester , United States of America
| | - G Reeder
- Mayo Clinic Hospital-Rochester , Rochester , United States of America
| | - M Eleid
- Mayo Clinic Hospital-Rochester , Rochester , United States of America
| | - C Rihal
- Mayo Clinic Hospital-Rochester , Rochester , United States of America
| | - J Thaden
- Mayo Clinic Hospital-Rochester , Rochester , United States of America
| |
Collapse
|
42
|
Jin U, Lee CJ, Yoon M, Ha J, Oh J, Park S, Lee SH, Kang SM. The association between frailty and physical performance in elderly patients with heart failure. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Frailty is known to be an important prognostic indicator in heart failure (HF). The Korean version of the frail scale for Koreans (K-FRAIL) has been developed and verified. The purpose of this study is to analyze the relationship between the K-FRAIL scale and physical performance, including muscular fitness and aerobic capacity in patients with HF.
Methods
This study included 143 HF patients aged over 65 years from a single tertiary hospital. In these subjects, muscular fitness was assessed using the handgrip test and knee extensor strength measurement, and aerobic capacity was assessed by cardiopulmonary exercise test and 6-minute walk test. Frailty status was measured using the K-FRAIL questionnaire and was classified as robust (K-FRAIL scale: 0), prefrail (1–2), and frail (3–5).
Results
Mean age of participants with robust (N=37), prefrail (N=75), and frail (N=31) were 72.5, 73.5, and 76.3 years, respectively. There was no difference in sex and left ventricular ejection fraction (LVEF) among groups, but the estimated glomerular filtration rate (eGFR) was significantly lower as frailty status increased (75.6±17.2 vs. 70.0±20.5 vs. 56.1±23.7 mL/min/1.73 m2; P<0.001). Hand-grip strength and knee extensor muscle strength did not differ among groups. However, peak oxygen consumption (peak VO2; 22.8±5.0 vs. 19.3±4.6 vs. 16.9±4.7 mL/kg/min, P<0.001) and 6-min walk distance (458.4±68.2 vs. 404.5±92.3 vs. 311.2±120.5 m; p<0.001) significantly decreased according to frailty severity. In multivariate regression analysis adjusted for age, sex, haemoglobin, eGFR and LVEF, peak VO2 (β=−0.311; P=0.002) and 6-min walk distance (β=−0.384; P<0.001) showed a significant inverse association with the K-FRAIL scale. With the cut-off value from receiver-operating characteristic curve analysis, peak VO2 (hazard ratio, 5.08; p=0.023) and 6MWT (hazard ratio, 3.99; p=0.020) were independent predictor of frailty according to K-FRAIL scale.
Conclusion
In elderly HF patients, physical performance differs according to frailty status, peak VO2 and 6-min walk distance correlates with the K-FRAIL scale better than muscular fitness.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
- U Jin
- Ajou University School of Medicine, Department of Cardiology , Suwon , Korea (Republic of)
| | - C J Lee
- Yonsei University College of Medicine, Division of Cardiology, Severance Cardiovascular Hospital and Cardiovascular Research Institute , Seoul , Korea (Republic of)
| | - M Yoon
- Seoul National University Bundang Hospital, Department of Cardiology , Seongnam , Korea (Republic of)
| | - J Ha
- Yonsei University College of Medicine, Division of Cardiology, Severance Cardiovascular Hospital and Cardiovascular Research Institute , Seoul , Korea (Republic of)
| | - J Oh
- Yonsei University College of Medicine, Division of Cardiology, Severance Cardiovascular Hospital and Cardiovascular Research Institute , Seoul , Korea (Republic of)
| | - S Park
- Yonsei University College of Medicine, Division of Cardiology, Severance Cardiovascular Hospital and Cardiovascular Research Institute , Seoul , Korea (Republic of)
| | - S H Lee
- Yonsei University College of Medicine, Division of Cardiology, Severance Cardiovascular Hospital and Cardiovascular Research Institute , Seoul , Korea (Republic of)
| | - S M Kang
- Yonsei University College of Medicine, Division of Cardiology, Severance Cardiovascular Hospital and Cardiovascular Research Institute , Seoul , Korea (Republic of)
| |
Collapse
|
43
|
Guerrero M, Eleid MF, Wang DD, Pursnani A, Kodali S, George I, Palacios I, Makkar R, Satler L, Kaptzan T, Lewis B, Thaden J, Oh J, O'Neill W, Rihal C. 4 year outcomes in a prospective evaluation of transcatheter mitral valve-in-valve, valve-in-ring and valve-in-mitral annular calcification: results from the MITRAL trial. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The MITRAL Trial (Mitral Implantation of TRAnscatheter vaLves) evaluates the safety and feasibility of balloon-expandable aortic transcatheter heart valves in patients with severe mitral valve disease with mitral annular calcification (MAC), failed surgical rings or failed bioprostheses.
Purpose
We sought to evaluate 4-year outcomes of patients enrolled in the MITRAL trial.
Methods
This is a prospective study that enrolled 91 high surgical risk patients at 13 sites in the U.S. 30 patients underwent Mitral Valve-in-Valve (MViV), 30 Valve-in-Ring (MViR) and 31 Valve-in-MAC (ViMAC). 4-year outcomes of these patients were evaluated in this analysis. Primary endpoints and key serious adverse events including deaths were adjudicated by an independent Clinical Events Committee. Cardiac computed tomography (CT) and echocardiographic images were evaluated by independent CT and Echocardiographic Core Laboratories.
Results
Mean age was 74.3±8.9 years. Most patients undergoing MViV and ViMAC were female (MVIV=63.3%, MViR=36.7% and ViMAC=71%). Mean STS score was 9.2±6.6% (MViV 10.2±6.5%, MViR 8.7±4.7%, ViMAC=8.6±8.2%). All-cause mortality at 4 years was higher for ViMAC and MViR: MViV=6.9% (cardiovascular 3.4%), MViR=48.1% (cardiovascular 18.5%), ViMAC=51.9% (cardiovascular 29.6%), p=0.002 (Figure 1). At 4 years, all survivors had ≤1+ mitral regurgitation and most had none or trace mitral regurgitation (MViV=87.5, MViR=33.3% and ViMAC=100%). Mean mitral valve gradients remained stable (MViV=5.9±2.2 mmHg, MViR= 6.6±5.1 mmHg, ViMAC=5.1±1.0 mmHg), Figure 2. Most survivors experienced significant improvement of symptoms and were in NYHA class I-II at 4-year follow-up (MViV=78.9%, MViR=66.7% and ViMAC=66.7%).
Conclusions
MViV is associated with excellent outcomes at 4 years. MViR and ViMAC were associated with higher mortality at 4 years. However, most survivors in all groups experienced sustained improvement of symptoms and stable THV performance at 4 years. Whether survival bias had an impact on THV performance and improved symptoms at follow-up is not known and deserves further evaluation.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Unrestricted Research Grant from Edwards Lifesciences.
Collapse
Affiliation(s)
- M Guerrero
- Mayo Clinic , Rochester , United States of America
| | - M F Eleid
- Mayo Clinic , Rochester , United States of America
| | - D D Wang
- Henry Ford Hospital , Detroit , United States of America
| | - A Pursnani
- Evanston Hospital Northshore , Evanston , United States of America
| | - S Kodali
- Columbia University Medical Center , New York , United States of America
| | - I George
- Columbia University Medical Center , New York , United States of America
| | - I Palacios
- Massachusetts General Hospital , Boston , United States of America
| | - R Makkar
- Cedars-Sinai Medical Center , Los Angeles , United States of America
| | - L Satler
- Medstar Washington Hospital Centre, Washington , DC , United States of America
| | - T Kaptzan
- Mayo Clinic , Rochester , United States of America
| | - B Lewis
- Mayo Clinic , Rochester , United States of America
| | - J Thaden
- Mayo Clinic , Rochester , United States of America
| | - J Oh
- Mayo Clinic , Rochester , United States of America
| | - W O'Neill
- Henry Ford Hospital , Detroit , United States of America
| | - C Rihal
- Mayo Clinic , Rochester , United States of America
| |
Collapse
|
44
|
Chun KH, Oh J, Lee CJ, Kang SM. Impact of metformin on the all-cause mortality in diabetic patients hospitalized with acute heart failure. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Although the hypothesis that metformin is beneficial for diabetic patients with heart failure (HF) has been steadily raised, there have been no solid data on the efficacy of metformin in acute HF patients.
Purpose
We investigated the impact of metformin on all-cause mortality in hospitalized acute HF patients with type 2 diabetes.
Methods
The Korean Acute Heart Failure registry enrolled patients hospitalized for acute HF from 2011 to 2014. Among this cohort, we analyzed patients with diabetes. We investigated all-cause mortality at 1 year after discharge. Propensity score matching (1:1 matching) and Cox proportional hazard models were used to assess difference in all-cause mortality.
Results
The study analyzed 1,976 diabetic patients (median age 72 years, mean left ventricular ejection fraction (LVEF) 34%, 54.5% male). Among them, 712 (36%) patients were on metformin. After 1:1 propensity score matching, 1,424 patients (712 metformin users vs. 712 non-users) were analyzed. During the median follow-up period of 11 months, 146 (21%) metformin non-users died and 108 (15%) metformin users died. Kaplan-Meier curves showed a higher all-cause mortality rate in non-users than in metformin users (Log-rank P=0.0025). After adjustment for clinically relevant variables, metformin was associated with lower risk for all-cause mortality (HR 0.713, 95% CI 0.551–0.922, P=0.01). In subgroup analyses, metformin use was significantly associated with a lower all-cause mortality in higher eGFR group (≥60 ml/min/1.73 m2, HR 0.531, 95% CI 0.357–0.790, P=0.002), but not in lower eGFR group (<60 ml/min/1.73 m2, HR 0.905, 95% CI 0.643–1.275, P=0.569, P-for-interaction=0.033). There was no significant interaction of metformin use for all-cause mortality between the subgroups with LVEF ≤40% and LVEF >40% (P-for-interaction=0.906).
Conclusion
Metformin use was associated with a lower risk for 1-year all-cause mortality in diabetic acute HF patients, especially in high eGFR group.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
- K H Chun
- Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - J Oh
- Yonsei University College of Medicine, Severance Cardiovascular Hospital , Seoul , Korea (Republic of)
| | - C J Lee
- Yonsei University College of Medicine, Severance Cardiovascular Hospital , Seoul , Korea (Republic of)
| | - S M Kang
- Yonsei University College of Medicine, Severance Cardiovascular Hospital , Seoul , Korea (Republic of)
| |
Collapse
|
45
|
Hwang S, Lee S, Kim E, Hwang I, Cho J, Chung J, Jang I, Oh J. The pharmacokinetic, safety, and tolerability profiles of eslicarbazepine acetate are comparable between Korean and White subjects. Clin Transl Sci 2022; 15:2116-2126. [PMID: 35727711 PMCID: PMC9468563 DOI: 10.1111/cts.13344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 05/10/2022] [Accepted: 05/17/2022] [Indexed: 01/25/2023] Open
Abstract
Eslicarbazepine acetate (ESL) is a prodrug antiseizure medication for the treatment of focal seizures. ESL shows a well-established pharmacokinetic (PK)-pharmacodynamic relationship and has similar extrinsic epilepsy-related factors across ethnicities. This study evaluated and compared ESL safety, tolerability, and PK characteristics between Korean and White subjects. A randomized, double-blind, placebo-controlled, single- and multiple-dose escalation study was conducted in healthy Korean and White adults. Participants randomly received a single dose and multiple oral doses of ESL (400-1600 mg) or placebo once daily for 11 days at a ratio of 8:2. Serial blood samples were collected to determine the plasma concentration of ESL and its metabolites (eslicarbazepine, [R-licarbazepine and oxcarbazepine). Safety and tolerability were assessed throughout the study. A total of 29 Korean and 20 White subjects completed the study. The PK profiles of the metabolites of ESL were similar between Korean and White subjects. The geometric mean ratio (90% confidence interval) of Korean to White subjects for the area under the concentration-time curve within a dosing interval of eslicarbazepine was 1.06 (0.97-1.17) and 0.96 (0.87-1.06) after multiple oral doses of 400 and 1600 mg ESL, respectively. Other PK parameters were also similar between the two ethnic groups. ESL was well-tolerated in healthy Korean and White subjects, and its PK characteristics were similar between the two ethnic groups. The results of this study support to use the same dosage regimen of ESL in both White and Korean patients with seizures.
Collapse
Affiliation(s)
- Sejung Hwang
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of MedicineSeoulKorea,Integrated Major in Innovative Medical ScienceSeoul National University Graduate SchoolSeoulKorea
| | - Soyoung Lee
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of MedicineSeoulKorea,Kidney Research InstituteSeoul National University Medical Research CenterSeoulKorea
| | - Eunwoo Kim
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of MedicineSeoulKorea
| | - Inyoung Hwang
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of MedicineSeoulKorea
| | - Joo‐Youn Cho
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of MedicineSeoulKorea,Department of Biomedical SciencesSeoul National University College of MedicineSeoulKorea
| | - Jae‐Yong Chung
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of MedicineSeoulKorea,Integrated Major in Innovative Medical ScienceSeoul National University Graduate SchoolSeoulKorea,Department of Clinical Pharmacology and TherapeuticsSeoul National University Bundang HospitalSeongnamKorea
| | - In‐Jin Jang
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of MedicineSeoulKorea
| | - Jaeseong Oh
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of MedicineSeoulKorea
| |
Collapse
|
46
|
Hwang I, Lee SW, Oh J, Lee S, Jang IJ, Yu KS. Dose-dependent reduction of lymphocyte count and heart rate after multiple administration of LC51-0255, a novel sphingosine-1-phosphate receptor 1 modulator, in healthy subjects. Front Pharmacol 2022; 13:930615. [PMID: 36071831 PMCID: PMC9442045 DOI: 10.3389/fphar.2022.930615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 07/13/2022] [Indexed: 11/13/2022] Open
Abstract
Aim: Sphingosine-1-phosphate receptor mediates the egress of lymphocytes from lymphoid organs, and its inhibition results in a decreased number of circulating lymphocytes. The aim of the current study was to investigate the safety and pharmacodynamic and pharmacokinetic characteristics of a novel sphingosine-1-phosphate receptor modulator, LC51-0255.Methods: A phase 1 randomized, double-blind, placebo-controlled, multiple dosing, dose-escalation study was conducted on healthy Korean male subjects.Results: After single and daily administration of LC51-0255 for 21 days, a dose-dependent decrease in lymphocyte count and heart rate was observed through 0.25–2 mg dose range of LC51-0255. The mean elimination half-life of LC51-0255 was 76–95 h. LC51-0255 was accumulated with a mean accumulation ratio of 5.17–6.64. During the study, LC51-0255 was generally well tolerated. The most common treatment-emergent adverse event was bradycardia. No clinically significant event of arrhythmia, including AV block, was observed. No clinically significant difference in blood pressure was observed between the dose groups. In other safety assessments, no clinically significant abnormalities were observed, except for bradycardia.Conclusion: Daily administration of LC51-0255 in the range of 0.25–2 mg resulted in a dose-dependent reduction of lymphocyte counts and heart rate. LC51-0255 is generally safe and well tolerated in healthy volunteers.
Collapse
Affiliation(s)
- Inyoung Hwang
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, South Korea
| | - Sang Won Lee
- Department of Clinical Pharmacology and Therapeutics, Hanyang University Seoul Hospital, Seoul, South Korea
| | - Jaeseong Oh
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, South Korea
| | - SeungHwan Lee
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, South Korea
| | - In-Jin Jang
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, South Korea
| | - Kyung-Sang Yu
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, South Korea
- *Correspondence: Kyung-Sang Yu,
| |
Collapse
|
47
|
Ahn S, Oh J, Kim D, Son H, Hwang S, Shin H, Kim EY, Lee H, Lee W, Moon J, Lee S, Jung K, Park K, Jung K, Lee S, Yu K, Chu K, Lee SK. Effects of
CYP2C19
genetic polymorphisms on the pharmacokinetics of lacosamide in Korean patients with epilepsy. Epilepsia 2022; 63:2958-2969. [DOI: 10.1111/epi.17399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 08/18/2022] [Accepted: 08/18/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Seon‐Jae Ahn
- Department of Neurology Seoul National University Hospital Seoul South Korea
- Hospital Medicine Center Seoul National University Hospital Seoul South Korea
| | - Jaeseong Oh
- Department of Clinical Pharmacology and Therapeutics Seoul National University Hospital Seoul South Korea
| | - Do‐Yong Kim
- Department of Neurology Seoul National University Hospital Seoul South Korea
| | - Hyoshin Son
- Hospital Medicine Center Seoul National University Hospital Seoul South Korea
- Department of Neurosurgery Seoul National University Hospital Seoul South Korea
| | - Sungeun Hwang
- Department of Neurology Ewha Womans University Mokdong Hospital Seoul South Korea
| | - Hye‐Rim Shin
- Department of Neurology Dankook University Hospital Cheonan‐si Chungcheongnam‐do South Korea
| | - Eun Young Kim
- Department of Neurology Chungnam National University Sejong Hospital Sejong South Korea
| | - Han‐Sang Lee
- Department of Neurology Seoul National University Hospital Seoul South Korea
- Hospital Medicine Center Seoul National University Hospital Seoul South Korea
| | - Woo‐Jin Lee
- Hospital Medicine Center Seoul National University Hospital Seoul South Korea
| | - Jangsup Moon
- Department of Neurology Seoul National University Hospital Seoul South Korea
- Department of Genomic Medicine Seoul National University Hospital Seoul South Korea
| | - Soon‐Tae Lee
- Department of Neurology Seoul National University Hospital Seoul South Korea
| | - Keun‐Hwa Jung
- Department of Neurology Seoul National University Hospital Seoul South Korea
| | - Kyung‐Il Park
- Department of Neurology Seoul National University Hospital Seoul South Korea
- Department of Neurology Seoul National University Hospital Healthcare System Gangnam Center Seoul South Korea
| | - Ki‐Young Jung
- Department of Neurology Seoul National University Hospital Seoul South Korea
| | - SeungHwan Lee
- Department of Clinical Pharmacology and Therapeutics Seoul National University Hospital Seoul South Korea
| | - Kyung‐Sang Yu
- Department of Clinical Pharmacology and Therapeutics Seoul National University Hospital Seoul South Korea
| | - Kon Chu
- Department of Neurology Seoul National University Hospital Seoul South Korea
| | - Sang Kun Lee
- Department of Neurology Seoul National University Hospital Seoul South Korea
| |
Collapse
|
48
|
Martins LF, Oh J, Harper M, Melgar A, Räisänen SE, Chen X, Nedelkov K, Karnezos TP, Hristov AN. Effects of an exogenous enzyme preparation extracted from a mixed culture of Aspergillus spp. on lactational performance, metabolism, and digestibility in primiparous and multiparous cows. J Dairy Sci 2022; 105:7344-7353. [PMID: 35879158 DOI: 10.3168/jds.2022-21990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 05/04/2022] [Indexed: 11/19/2022]
Abstract
The objective of this study was to investigate the effects of an exogenous enzyme preparation from Aspergillus oryzae and Aspergillus niger on lactational performance of dairy cows. Forty-eight Holstein cows (32 primiparous and 16 multiparous) averaging (± SD) 36.3 ± 8.7 kg/d milk yield and 141 ± 52 d in milk were enrolled in a 10-wk randomized complete block design experiment (total of 24 blocks) and assigned to 1 of 2 treatments: basal diet, no enzyme supplementation (CON) or the basal diet supplemented with 4.2 g/kg dry matter intake (DMI) of an exogenous enzyme preparation containing amylolytic and fibrolytic activities (ENZ). After a 2-wk covariate period, premixes with the enzyme preparation or control were top-dressed daily by mixing with approximately 500 g of total mixed ration. Production data were collected daily and averaged by week. Milk samples were collected every other week, and milk composition was averaged by week. Blood, fecal, and urine samples were collected over 2 consecutive days at 0, 4, 8, 12, and 36 h after feeding during the last week of the experiment. Compared with CON, cows fed ENZ tended to increase DMI and had increased milk concentrations of true protein, lactose, and other solids. Milk fat content tended to be higher in CON cows. A treatment × parity interaction was found for some of the production variables. Primiparous cows receiving ENZ had greater yields of milk, energy-corrected milk, milk true protein, and lactose compared with CON primiparous cows; these production variables did not differ between treatments for multiparous cows. Intake and total-tract digestibility of nutrients did not differ between treatments. Concentrations of blood glucose and total fatty acids were not affected by ENZ supplementation, but β-hydroxybutyrate concentration tended to be greater in ENZ cows. Overall, the exogenous enzyme preparation used in this study increased milk protein and lactose concentrations in all cows, and milk production in primiparous but not multiparous cows. The differential production response between primiparous and multiparous cows was likely a result of a greater increase in DMI with ENZ supplementation in the younger animals.
Collapse
Affiliation(s)
- L F Martins
- Department of Animal Sciences, The Pennsylvania State University, University Park 16802
| | - J Oh
- Department of Animal Sciences, The Pennsylvania State University, University Park 16802; Cargill Animal Nutrition, Seongnam, South Korea 13630.
| | - M Harper
- Department of Animal Sciences, The Pennsylvania State University, University Park 16802; CSA Animal Nutrition, Mill Creek, PA 17060
| | - A Melgar
- Department of Animal Sciences, The Pennsylvania State University, University Park 16802; Agricultural Innovation Institute of Panama (IDIAP), City of Knowledge, Panama 07144
| | - S E Räisänen
- Department of Animal Sciences, The Pennsylvania State University, University Park 16802; Department of Agricultural Sciences, University of Helsinki, PO Box 28, FI-00014, Finland
| | - X Chen
- Department of Animal Sciences, The Pennsylvania State University, University Park 16802; Livestock Production Science Branch, Agri-Food Biosciences Institute, Hillsborough, Co. Down, BT26 6DR, United Kingdom
| | - K Nedelkov
- Department of Animal Sciences, The Pennsylvania State University, University Park 16802; Faculty of Veterinary Medicine, Trakia University, Stara Zagora, Bulgaria 6000
| | | | - A N Hristov
- Department of Animal Sciences, The Pennsylvania State University, University Park 16802.
| |
Collapse
|
49
|
Abstract
Objectives Digital therapeutics (DTx) are software-based therapeutic interventions based on clinical evidence. Randomized clinical trials (RCTs) are often the source of clinical evidence, similar to conventional drugs or medical devices. However, novel approaches such as the use of real-world data or digital biomarkers are also utilized. This article aimed to review how DTx products have been clinically evaluated. Methods DTx products approved by the US Food and Drug Administration as of 2020 were reviewed and products with sufficient published information were selected. Pivotal clinical trials were analyzed according to the elements of the Consolidated Standards of Reporting Trials (CONSORT) guideline. Case reviews were presented for other clinical evaluation strategies, considering the small number of publications. Results Most approved DTx products used RCTs for clinical evaluations. Similar to conventional RCTs, parallel-group designs with statistical hypothesis testing were adopted. However, DTx trials were often not blinded due to practical issues and involved various comparator groups. In addition, DTx products could be readily evaluated in home-based settings and delivered through the internet. Other evaluation approaches included retrospective analyses using insurance claims data or usage data, which enabled long-term evaluations of effectiveness. Digital biomarkers obtained from real-time and continuous log data were also used to improve the objectiveness of endpoints. Conclusions RCTs accounted for the majority of DTx evaluations. The designs of DTx trials were comparable to those of drug or device trials, but blinding and comparator elements were often different. Furthermore, the use of real-world data and digital biomarkers are also being tried.
Collapse
Affiliation(s)
- Ki Young Huh
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Korea
| | - Jaeseong Oh
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Korea
| | - SeungHwan Lee
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Korea
| | - Kyung-Sang Yu
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Korea
| |
Collapse
|
50
|
Park Y, Na JY, Cho JY, Oh J, Rhee SJ. Key Considerations for Phase 2 or 3 Clinical Study Design of Anti-Inflammatory Agent for COVID-19 Treatment. Front Pharmacol 2022; 13:842836. [PMID: 35721224 PMCID: PMC9201470 DOI: 10.3389/fphar.2022.842836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 05/09/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose: Current understanding of COVID-19 disease progression suggests a major role for the “cytokine storm” as an important contributor to COVID-19 mortality. To prevent an exaggerated immune response and improve COVID-19 patient endpoints, anti-inflammatory therapeutics have been proposed as clinically useful in severe patients with COVID-19. The purpose of this study was to propose a clinical trial design for the development of anti-inflammatory agents for the treatment of COVID-19, taking into account the physiological and immunological process of COVID-19 and the treatment mechanism of anti-inflammatory agents. Methods: We reviewed and analyzed the guidelines for the development of COVID-19 treatments and the treatment of COVID-19 by regulatory agencies and previously conducted clinical trials on anti-inflammatory drugs for COVID-19. Finally, after discussing with an advisory group, a synopsis was presented for an example protocol for a COVID-19 anti-inflammatory agent phase 2 or 3 study that considers the drug mechanism and the disease progression of COVID-19. Results: A randomized, placebo-controlled, double-blind parallel-group design was suggested as a phase 2 or 3 trial design for developing an anti-inflammatory agent as a COVID-19 treatment. A key item of the example protocol specific to anti-inflammatory agents was the inclusion and exclusion criteria, taking into account the immunosuppressive effects of the drug, clinical time course of COVID-19 disease, and treatment guidelines for COVID-19. Time to recovery is the primary endpoint associated with clinical efficacy and is generally well accepted by many experts. Conclusion: Through this suggested phase 2 or 3 study design of an anti-inflammatory drug for COVID-19, we provide a basis for a study design that can be utilized in clinical development by pharmaceutical companies which are developing a potential anti-inflammatory agent for COVID-19.
Collapse
Affiliation(s)
- Yewon Park
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, South Korea
| | - Joo Young Na
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, South Korea
| | - Joo-Youn Cho
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, South Korea
| | - Jaeseong Oh
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, South Korea
| | - Su-Jin Rhee
- Department of Pharmacy, Wonkwang University College of Pharmacy, Iksan, South Korea
| |
Collapse
|