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Tariq A, Kwok M, Pearce A, Rhee H, Kyle S, Dunglison N, Esler R, Navaratnam A, Yaxley J, Thomas P, Pattison D, Roberts M. The role of dual tracer PSMA and FDG PET/CT in Renal Cell Carcinoma (RCC) compared to conventional imaging: A multi-institutional case series with intra-individual comparison. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)02749-x] [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: 10/19/2022] Open
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2
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Channon-Wells S, Kwok M, Booth J, Bamford A, Konstanty P, Hatcher J, Dixon G, Diggle PJ, Standing JF, Irwin AD. The use of continuous electronic prescribing data to infer trends in antimicrobial consumption and estimate the impact of stewardship interventions in hospitalized children. J Antimicrob Chemother 2021; 76:2464-2471. [PMID: 34109397 PMCID: PMC8361331 DOI: 10.1093/jac/dkab187] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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: 01/31/2021] [Accepted: 05/10/2021] [Indexed: 11/15/2022] Open
Abstract
Background Understanding antimicrobial consumption is essential to mitigate the development of antimicrobial resistance, yet robust data in children are sparse and methodologically limited. Electronic prescribing systems provide an important opportunity to analyse and report antimicrobial consumption in detail. Objectives We investigated the value of electronic prescribing data from a tertiary children’s hospital to report temporal trends in antimicrobial consumption in hospitalized children and compare commonly used metrics of antimicrobial consumption. Methods Daily measures of antimicrobial consumption [days of therapy (DOT) and DDDs] were derived from the electronic prescribing system between 2010 and 2018. Autoregressive moving-average models were used to infer trends and the estimates were compared with simulated point prevalence surveys (PPSs). Results More than 1.3 million antimicrobial administrations were analysed. There was significant daily and seasonal variation in overall consumption, which reduced annually by 1.77% (95% CI 0.50% to 3.02%). Relative consumption of meropenem decreased by 6.6% annually (95% CI −3.5% to 15.8%) following the expansion of the hospital antimicrobial stewardship programme. DOT and DDDs exhibited similar trends for most antimicrobials, though inconsistencies were observed where changes to dosage guidelines altered consumption calculation by DDDs, but not DOT. PPS simulations resulted in estimates of change over time, which converged on the model estimates, but with much less precision. Conclusions Electronic prescribing systems offer significant opportunities to better understand and report antimicrobial consumption in children. This approach to modelling administration data overcomes the limitations of using interval data and dispensary data. It provides substantially more detailed inferences on prescribing patterns and the potential impact of stewardship interventions.
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Affiliation(s)
- S Channon-Wells
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - M Kwok
- UCL School of Pharmacy, University College London, London, UK
| | - J Booth
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - A Bamford
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.,UCL Great Ormond Street Institute of Child Health, London, UK
| | - P Konstanty
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - J Hatcher
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.,UCL Great Ormond Street Institute of Child Health, London, UK
| | - G Dixon
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.,UCL Great Ormond Street Institute of Child Health, London, UK
| | - P J Diggle
- CHICAS, Lancaster Medical School, Lancaster University, Bailrigg, Lancaster, UK
| | - J F Standing
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.,UCL Great Ormond Street Institute of Child Health, London, UK
| | - A D Irwin
- Infection Management and Prevention Service, Queensland Children's Hospital, Brisbane, Queensland, Australia.,UQ Centre for Clinical Research, The University of Queensland, Brisbane, Queensland, Australia
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Bao K, Cheung K, Chow JH, Leung C, Tsui W, Lau A, Tse T, Wan S, Kwok M, Wong K. 1709P Cancer patients' perspectives on the real-world impact of COVID-19 pandemic: A multidisciplinary survey. Ann Oncol 2020. [PMCID: PMC7506366 DOI: 10.1016/j.annonc.2020.08.1773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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4
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Loh YS, Tan S, Kwok M, Stark MJ, Marks DC. Reduction of biological response modifiers in the supernatant of washed paediatric red blood cells. Vox Sang 2016; 111:365-373. [PMID: 27864978 DOI: 10.1111/vox.12442] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [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: 01/07/2016] [Revised: 06/01/2016] [Accepted: 07/07/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Washing of red blood cells (RBC) can reduce unwanted biological response modifiers (BRMs) that can mediate transfusion complications in infants. The aim of this study was to examine the in vitro quality and the changes in BRMs following washing in paediatric RBC units. MATERIALS AND METHODS A pool and split design was used to prepare RBC (either 1 or 4 days old; n = 26 pairs). One unit was washed with 0·9% saline by centrifugation and then resuspended in SAG-M, while the other remained unwashed. Each RBC unit was divided to produce four units of paediatric-sized components. Samples were taken after 3 h and subsequently on days 1, 2, 7 and 14 post-wash. RESULTS Washing of RBC resulted in some red cell loss, with a minor increase in haemolysis. Washing effectively reduced supernatant potassium and IgA, as well as cytokines and complement proteins. RBC microparticles were significantly reduced in RBC washed at 1, but not 4 days post-collection. Incubation with supernatant from unwashed but not washed RBC led to endothelial cell activation, with increased cell surface expression of CD62E (E-selectin) and CD106 (VCAM). CONCLUSION Although washing affected some aspects of the in vitro quality of RBC, it effectively reduced the concentration and activity of BRMs in the supernatant of RBC. Such a reduction may be clinically beneficial in selected patient groups.
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Affiliation(s)
- Y S Loh
- Research and Development, Australian Red Cross Blood Service, Sydney, NSW, Australia
| | - S Tan
- Research and Development, Australian Red Cross Blood Service, Sydney, NSW, Australia
| | - M Kwok
- Research and Development, Australian Red Cross Blood Service, Sydney, NSW, Australia
| | - M J Stark
- School of Paediatrics and Reproductive Health, The Robinson Institute, University of Adelaide, Adelaide, NSW, Australia
| | - D C Marks
- Research and Development, Australian Red Cross Blood Service, Sydney, NSW, Australia
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Johnson L, Kwok M, Marks DC. Preparation of red blood cell concentrates and plasma units from whole blood held overnight using a hollow-fibre separation system. Transfus Med 2015; 25:13-9. [PMID: 25808374 DOI: 10.1111/tme.12192] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [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: 04/30/2014] [Revised: 02/22/2015] [Accepted: 03/10/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND The ErySep system represents an alternative to centrifuge-based whole blood (WB) separation, using gravity and filtration through hollow-fibres (0·2 µm pore size) to produce red blood cell (RBC) and plasma components. The aim of this study was to characterise the quality of ErySep RBC and plasma units compared with standard products from WB held overnight. METHODS/MATERIALS Two ABO-compatible WB units (n = 24) were pooled and split to produce matched products. One of the WB units was separated into components using the ErySep system (ErySep; n = 12), whereas the other units were separated by centrifugation (control; n = 12). RBC units were stored at 2-6 °C and assessed for in vitro quality over 42 days of storage. Plasma was frozen at -30 °C and tested upon thawing. RESULTS Processing WB with the ErySep system took longer than controls. The ErySep RBC units were of an appropriate volume (307 ± 17 mL) and contained sufficient Hb (50 ± 2 g unit(-1) ). ErySep RBC components contained more microparticles relative to controls at expiry. The plasma volume, total protein, coagulation factor activity (fibrinogen, FV, FVIII) and number of microparticles was lower in the ErySep units compared with controls. CONCLUSION Following overnight hold of WB, the ErySep system was capable of producing RBC components that met specifications. However, the ErySep plasma components did not meet quality specifications.
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Affiliation(s)
- L Johnson
- Research and Development, Australian Red Cross Blood Service, Sydney, Australia
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Kwok M, Chow C, Henriksen K, Foster S, Jones A, Bentley-Taylor M, Kwok K. PREVALENCE OF RHEUMATIC HEART DISEASE IN URBAN AND RURAL ANGOLA BY ECHOCARDIOGRAPHY. Can J Cardiol 2014. [DOI: 10.1016/j.cjca.2014.07.122] [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: 10/24/2022] Open
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7
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Winter KM, Johnson L, Kwok M, Reid S, Alarimi Z, Wong JKL, Dennington PM, Marks DC. Understanding the effects of gamma-irradiation on potassium levels in red cell concentrates stored in SAG-M for neonatal red cell transfusion. Vox Sang 2014; 108:141-50. [DOI: 10.1111/vox.12194] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Revised: 07/30/2014] [Accepted: 08/11/2014] [Indexed: 11/30/2022]
Affiliation(s)
- K. M. Winter
- Research and Development; Australian Red Cross Blood Service; Sydney NSW Australia
| | - L. Johnson
- Research and Development; Australian Red Cross Blood Service; Sydney NSW Australia
| | - M. Kwok
- Research and Development; Australian Red Cross Blood Service; Sydney NSW Australia
| | - S. Reid
- Research and Development; Australian Red Cross Blood Service; Sydney NSW Australia
| | - Z. Alarimi
- Medical, Transplantation and Quality Services; Australian Red Cross Blood Service; Sydney NSW Australia
| | - J. K. L. Wong
- Medical, Transplantation and Quality Services; Australian Red Cross Blood Service; Sydney NSW Australia
| | - P. M. Dennington
- Medical, Transplantation and Quality Services; Australian Red Cross Blood Service; Sydney NSW Australia
| | - D. C. Marks
- Research and Development; Australian Red Cross Blood Service; Sydney NSW Australia
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Cheung Y, Kwok M, Chan E, Kwan P. Rapid detection ofHLA-A*31:01allele in DNA and blood samples using loop-mediated isothermal amplification. Br J Dermatol 2014; 171:90-6. [PMID: 24593191 DOI: 10.1111/bjd.12897] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2014] [Indexed: 12/13/2022]
Affiliation(s)
- Y.K. Cheung
- Department of Medicine and Therapeutics; The Chinese University of Hong Kong; Prince of Wales Hospital; Hong Kong SAR China
| | - M. Kwok
- Department of Medicine and Therapeutics; The Chinese University of Hong Kong; Prince of Wales Hospital; Hong Kong SAR China
| | - E. Chan
- Department of Medicine and Therapeutics; The Chinese University of Hong Kong; Prince of Wales Hospital; Hong Kong SAR China
| | - P. Kwan
- Department of Medicine and Therapeutics; The Chinese University of Hong Kong; Prince of Wales Hospital; Hong Kong SAR China
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Wilkie DM, Carr JA, Siegenthaler A, Lenger B, Liu M, Kwok M. Field observations of time-place behaviour in scavenging birds. Behav Processes 2014; 38:77-88. [PMID: 24897632 DOI: 10.1016/0376-6357(96)00026-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/1996] [Indexed: 11/16/2022]
Abstract
Encoding the spatial location and the time at which significant biological events occur is thought to be a fundamental way in which one form of memory is organized in animals (Gallistel, 1990, The Organization of Learning. MIT Press, Cambridge, MA). If this is true, one would expect to find evidence of this process in a wide variety of animals and in a wide number of situations. We report field observations of scavenging birds at two outdoor locations at which people tend to congregate and eat food, primarily around midday. Scavenging birds appeared to anticipate this peak in food availability and arrived at these locations before the number of people was at a maximum; time of day, not the absolute number of people, was the best predictor of the number of birds at both sites. At a third location where food is not consumed this relationship was not observed. Taken together these observations support the notion that animals represent the spatial and temporal characteristics of biologically important events and use this knowledge to forage efficiently.
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Affiliation(s)
- D M Wilkie
- Department of Psychology, The University of British Columbia, Vancouver, BC, V6TIZ4, Canada
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Laslett L, Quinn S, Darian-Smith E, Kwok M, Fedorova T, March L, Jones G. AB0970 Treatment with 4jointz reduces knee pain over twelve weeks of treatment in patients with clinical knee osteoarthritis: A randomised controlled trial. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.970] [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: 11/04/2022]
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11
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Johnson L, Winter KM, Kwok M, Reid S, Marks DC. Evaluation of the quality of blood components prepared using the Reveos automated blood processing system. Vox Sang 2013; 105:225-35. [DOI: 10.1111/vox.12051] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Revised: 04/05/2013] [Accepted: 04/07/2013] [Indexed: 01/03/2023]
Affiliation(s)
- L. Johnson
- Applied and Developmental Research; Research and Development; Australian Red Cross Blood Service; Sydney; Australia
| | - K. M. Winter
- Applied and Developmental Research; Research and Development; Australian Red Cross Blood Service; Sydney; Australia
| | - M. Kwok
- Applied and Developmental Research; Research and Development; Australian Red Cross Blood Service; Sydney; Australia
| | - S. Reid
- Applied and Developmental Research; Research and Development; Australian Red Cross Blood Service; Sydney; Australia
| | - D. C. Marks
- Applied and Developmental Research; Research and Development; Australian Red Cross Blood Service; Sydney; Australia
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12
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Johnson L, Loh YS, Kwok M, Marks DC. In vitroassessment of buffy-coat derived platelet components suspended in SSP+ treated with the INTERCEPT Blood system. Transfus Med 2013; 23:121-9. [DOI: 10.1111/tme.12020] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Revised: 01/29/2013] [Accepted: 01/30/2013] [Indexed: 12/01/2022]
Affiliation(s)
- L. Johnson
- Research and Development; Australian Red Cross Blood Service; Sydney; Australia
| | - Y. S. Loh
- Research and Development; Australian Red Cross Blood Service; Sydney; Australia
| | - M. Kwok
- Research and Development; Australian Red Cross Blood Service; Sydney; Australia
| | - D. C. Marks
- Research and Development; Australian Red Cross Blood Service; Sydney; Australia
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13
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Laslett LL, Quinn SJ, Darian-Smith E, Kwok M, Fedorova T, Körner H, Steels E, March L, Jones G. Treatment with 4Jointz reduces knee pain over 12 weeks of treatment in patients with clinical knee osteoarthritis: a randomised controlled trial. Osteoarthritis Cartilage 2012; 20:1209-16. [PMID: 22863612 DOI: 10.1016/j.joca.2012.07.019] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2012] [Revised: 07/15/2012] [Accepted: 07/24/2012] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To assess the efficacy of thrice daily topical 4Jointz utilizing Acteev technology (a combination of a standardized comfrey extract and a pharmaceutical grade tannic acid, 3.5 g/day) on osteoarthritic knee pain, markers of inflammation and cartilage breakdown over 12 weeks. PATIENTS AND METHODS Adults aged 50-80 years (n = 133) with clinical knee OA were randomised to receive 4Jointz or placebo in addition to existing medications. Pain and function were measured using a visual analogue scale (VAS) and the Knee Injury and Osteoarthritis Outcome Score (KOOS) scale at baseline, 4, 8 and 12 weeks. Inflammation was measured analysing IL-6 expression and CTX-2 presence as representative for cartilage breakdown using ELISA, at baseline and 12 weeks. RESULTS Pain scores significantly reduced in the group who received 4Jointz compared to the group who received placebo after 12 weeks using both the VAS (-9.9 mm, P = 0.034) and the KOOS pain scale (+5.7, P = 0.047). Changes in IL-6 and CTX-2 were not significant (-0.04, P = 0.5; -0.01, P = 0.68). Post-hoc analyses suggested that treatment may be most effective in women (VAS -16.8 mm, P = 0.008) and those with milder radiographic osteoarthritis (OA) (VAS -16.1 mm, P = 0.009). Rates of adverse events were similar in both groups, excepting local rash that was more common amongst participants receiving 4Jointz (21% vs 1.6%, IRR 13.2, P = 0.013), but only 26% (n = 4) of participants with rashes discontinued treatment. There were no changes in systemic blood results. CONCLUSIONS Topical treatment using 4Jointz reduced pain but had no effect on inflammation or cartilage breakdown over 12 weeks of treatment. TRIAL REGISTRATION Australia and New Zealand Clinical Trials registry ACTRN12610000877088.
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Affiliation(s)
- L L Laslett
- Menzies Research Institute Tasmania, University of Tasmania, Australia.
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Ng C, Wong R, Yeung E, Hsin M, Kwok M, Wan I, Wan S, Underwood M. P022 Real Time Monitoring of Blood Transfusion in Intensive Care Following Cardiac Surgery. Int J Cardiol 2011. [DOI: 10.1016/s0167-5273(11)70046-8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Wong R, Ng C, Yeung E, Hsin M, Kwok M, Wan I, Wan S, Underwood M. P023 Management and Outcome of Surgery for Acute Post Myocardial Infarction Ventricular Septal Defect. Int J Cardiol 2011. [DOI: 10.1016/s0167-5273(11)70047-x] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Chuah C, Barnes DJ, Kwok M, Corbin A, Deininger MWN, Druker BJ, Melo JV. Zoledronate inhibits proliferation and induces apoptosis of imatinib-resistant chronic myeloid leukaemia cells. Leukemia 2005; 19:1896-904. [PMID: 16167056 DOI: 10.1038/sj.leu.2403949] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Although imatinib mesylate has revolutionized the treatment of chronic myeloid leukaemia (CML), resistance to the drug, manifesting as relapse after an initial response or persistence of disease, remains a therapeutic challenge. In order to overcome this, alternative or additional targeting of signaling pathways downstream of Bcr-Abl may provide the best option for improving clinical response. Bisphosphonates, such as zoledronate, have been shown to inhibit the oncogenicity of Ras, an important downstream effector of Bcr-Abl. In this study, we show that zoledronate is equally effective in inhibiting the proliferation and clonogenicity of both imatinib-sensitive and -resistant CML cells, regardless of their mechanism of resistance. This is achieved by the induction of S-phase cell cycle arrest and apoptosis, through the inhibition of prenylation of Ras and Ras-related proteins by zoledronate. The combination of imatinib and zoledronate also augmented the activity of either drug alone and this occurred in imatinib-resistant CML cells as well. Since zoledronate is already available for clinical use, these results suggest that it may be an effective addition to the armamentarium of drugs for the treatment of CML.
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Affiliation(s)
- C Chuah
- Imperial College London, Hammersmith Hospital, London, UK
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Nakano E, Taiwo FA, Nugent D, Griffiths HR, Aldred S, Paisi M, Kwok M, Bhatt P, Hill MHE, Moat S, Powers HJ. Downstream effects on human low density lipoprotein of homocysteine exported from endothelial cells in an in vitro system. J Lipid Res 2005; 46:484-93. [PMID: 15576841 DOI: 10.1194/jlr.m400339-jlr200] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A model system is presented using human umbilical vein endothelial cells (HUVECs) to investigate the role of homocysteine (Hcy) in atherosclerosis. HUVECs are shown to export Hcy at a rate determined by the flux through the methionine/Hcy pathway. Additional methionine increases intracellular methionine, decreases intracellular folate, and increases Hcy export, whereas additional folate inhibits export. An inverse relationship exists between intracellular folate and Hcy export. Hcy export may be regulated by intracellular S-adenosyl methionine rather than by Hcy. Human LDLs exposed to HUVECs exporting Hcy undergo time-related lipid oxidation, a process inhibited by the thiol trap dithionitrobenzoate. This is likely to be related to the generation of hydroxyl radicals, which we show are associated with Hcy export. Although Hcy is the major oxidant, cysteine also contributes, as shown by the effect of glutamate. Finally, the LDL oxidized in this system showed a time-dependent increase in uptake by human macrophages, implying an upregulation of the scavenger receptor. These results suggest that continuous export of Hcy from endothelial cells contributes to the generation of extracellular hydroxyl radicals, with associated oxidative modification of LDL and incorporation into macrophages, a key step in atherosclerosis. Factors that regulate intracellular Hcy metabolism modulate these effects.
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Affiliation(s)
- E Nakano
- Human Nutrition Unit, University of Sheffield, Coleridge House, The Northern General Hospital, Sheffield S5 7AU, United Kingdom
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Naranjo CA, Poulos CX, Lanctôt KL, Bremner KE, Kwok M, Umana M. Ritanserin, a central 5-HT2 antagonist, in heavy social drinkers: desire to drink, alcohol intake and related effects. Addiction 1995; 90:893-905. [PMID: 7663312 DOI: 10.1046/j.1360-0443.1995.9078933.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Ritanserin, a 5-HT2 receptor antagonist, decreased alcohol intake in some, but not all, animal studies and in an open clinical study. We tested the short-term effects of ritanserin in 39 (35 male, four female) heavy social drinkers (consuming at least 28 drinks/week), aged 19-63 years, who were not seeking treatment. After an intake assessment, they received placebo for 7 days in a single-blind baseline. They were then randomly assigned to one of three double-blind treatments for 14 days: ritanserin 5 mg/day (n = 12), ritanserin 10 mg/day (n = 13) or placebo (n = 14). Subjects recorded daily outpatient alcohol intake. Feelings of intoxication and interest, desire, craving and liking for alcohol were rated retrospectively at each weekly study visit. Experimental drinking sessions were conducted after baseline (EDS1) and treatment (EDS2); in each session subjects were offered 18 mini-drinks (total = six standard) and rated their desire to drink, intoxication and mood (POMS). Outpatient results: ritanserin 5 mg/day decreased desire and craving for alcohol (vs. baseline, p < 0.05) but not alcohol intake. Liking of alcohol decreased from baseline with ritanserin 10 mg/day (p = 0.01) and placebo (p = 0.05). Changes in alcohol intake from baseline with ritanserin 10 mg/day (increase, p > 0.05) and placebo (decrease, p > 0.05) were different (p < 0.05). EDS results: in EDS2, desire ratings for the first three mini-drinks were lower after ritanserin 5 mg/day than after ritanserin 10 mg/day (p < 0.05), but the decreases were not statistically significant when EDS1 desire ratings were controlled for. Ritanserin 10 mg/day increased alcohol-induced feelings of intoxication and friendliness, compared with placebo (p < 0.05). Both ritanserin 5 mg/day and 10 mg/day enhanced alcohol-induced decreases in fatigue, compared with placebo (p < 0.05). These results indicate that ritanserin may have differential effects on alcohol intake, desire, craving and liking, intoxication and some of alcohol's effects on mood. However, they suggest that ritanserin has limited efficacy in reducing alcohol intake in heavy drinkers.
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Affiliation(s)
- C A Naranjo
- Psychopharmacology Research Program, Sunnybrook Health Science Centre, University of Toronto, Ontario, Canada
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