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Bardia A, Krop IE, Kogawa T, Juric D, Tolcher AW, Hamilton EP, Mukohara T, Lisberg A, Shimizu T, Spira AI, Tsurutani J, Damodaran S, Papadopoulos KP, Greenberg J, Kobayashi F, Zebger-Gong H, Wong R, Kawasaki Y, Nakamura T, Meric-Bernstam F. Datopotamab Deruxtecan in Advanced or Metastatic HR+/HER2- and Triple-Negative Breast Cancer: Results From the Phase I TROPION-PanTumor01 Study. J Clin Oncol 2024:JCO2301909. [PMID: 38652877 DOI: 10.1200/jco.23.01909] [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: 09/01/2023] [Revised: 01/09/2024] [Accepted: 02/08/2024] [Indexed: 04/25/2024] Open
Abstract
PURPOSE Datopotamab deruxtecan (Dato-DXd) is an antibody-drug conjugate consisting of a humanized antitrophoblast cell-surface antigen 2 (TROP2) monoclonal antibody linked to a potent, exatecan-derived topoisomerase I inhibitor payload via a plasma-stable, selectively cleavable linker. PATIENTS AND METHODS TROPION-PanTumor01 (ClinicalTrials.gov identifier: NCT03401385) is a phase I, dose-escalation, and dose-expansion study evaluating Dato-DXd in patients with previously treated solid tumors. The primary study objective was to assess the safety and tolerability of Dato-DXd. Secondary objectives included evaluation of antitumor activity and pharmacokinetics. Results from patients with advanced/metastatic hormone receptor-positive/human epidermal growth factor receptor 2-negative (HR+/HER2-) breast cancer (BC) or triple-negative BC (TNBC) are reported. RESULTS At data cutoff (July 22, 2022), 85 patients (HR+/HER2- BC = 41, and TNBC = 44) had received Dato-DXd. The objective response rate by blinded independent central review was 26.8% (95% CI, 14.2 to 42.9) and 31.8% (95% CI, 18.6 to 47.6) for patients with HR+/HER2- BC and TNBC, respectively. The median duration of response was not evaluable in the HR+/HER2- BC cohort and 16.8 months in the TNBC cohort. The median progression-free survival in patients with HR+/HER2- BC and TNBC was 8.3 and 4.4 months, respectively. All-cause treatment-emergent adverse events (TEAEs; any grade, grade ≥3) were observed in 100% and 41.5% of patients with HR+/HER2- BC and 100% and 52.3% of patients with TNBC. Stomatitis was the most common TEAE (any grade, grade ≥3) in both HR+/HER2- BC (82.9%, 9.8%) and TNBC (72.7%, 11.4%) cohorts. CONCLUSION In patients with heavily pretreated advanced HR+/HER2- BC and TNBC, Dato-DXd demonstrated promising clinical activity and a manageable safety profile. Dato-DXd is currently being evaluated in phase III studies.
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Affiliation(s)
- Aditya Bardia
- Department of Medicine, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - Ian E Krop
- Yale Cancer Center, New Haven, CT
- Dana-Farber Cancer Institute, Boston, MA
| | - Takahiro Kogawa
- Department of Advanced Medical Development, Cancer Institute Hospital of JFCR, Tokyo, Japan
| | - Dejan Juric
- Department of Medicine, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - Anthony W Tolcher
- South Texas Accelerated Research Therapeutics, San Antonio, TX
- NEXT Oncology, San Antonio, TX
- Texas Oncology, San Antonio, TX
| | - Erika P Hamilton
- Sarah Cannon Research Institute, Nashville, TN
- Tennessee Oncology, PLLC, Nashville, TN
| | - Toru Mukohara
- Department of Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Aaron Lisberg
- Department of Medicine, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA
| | - Toshio Shimizu
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo, Japan
- Department of Pulmonary Medicine and Medical Oncology, Wakayama Medical University Hospital, Wakayama, Japan
| | | | - Junji Tsurutani
- Advanced Cancer Translational Research Institute, Showa University, Tokyo, Japan
| | - Senthil Damodaran
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Jonathan Greenberg
- Global Oncology Clinical Development, Daiichi Sankyo, Inc, Basking Ridge, NJ
- Global Oncology Clinical Development, Daiichi Sankyo Europe GmbH, Munich, Germany
| | | | - Hong Zebger-Gong
- Global Oncology Clinical Development, Daiichi Sankyo Europe GmbH, Munich, Germany
| | - Rie Wong
- Global Oncology Clinical Development, Daiichi Sankyo, Co, Ltd, Tokyo, Japan
| | - Yui Kawasaki
- Global Oncology Clinical Development, Daiichi Sankyo, Inc, Basking Ridge, NJ
| | | | - Funda Meric-Bernstam
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX
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Fujino A, Kuniyeda K, Nozaki T, Ozeki M, Ohyama T, Sato I, Kamibeppu K, Tanaka A, Uemura N, Kanmuri K, Nakamura K, Kobayashi F, Suenobu S, Nomura T, Hayashi A, Nagao M, Kato A, Aramaki-Hattori N, Imagawa K, Ishikawa K, Ochi J, Horiuchi S, Nagabukuro H. The Prospective Natural History Study of Patients with Intractable Venous Malformation and Klippel-Trenaunay Syndrome to Guide Designing a Proof-of-Concept Clinical Trial for Novel Therapeutic Intervention. Lymphat Res Biol 2024; 22:27-36. [PMID: 38112724 DOI: 10.1089/lrb.2023.0023] [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: 12/21/2023] Open
Abstract
Background: The natural history of venous malformation (VM) and Klippel-Trenaunay Syndrome (KTS) has not been quantitatively studied. To obtain benchmarks to guide designing clinical trials to assess safety and efficacy of novel drug candidates, the clinical course of the patients was followed for 6 months. Methods and Results: This is a multicenter prospective observational study evaluating the change rate in lesion volume from baseline with magnetic resonance images, as the primary endpoint. In addition, disease severities, performance status (PS), pain visual analog scale (VAS) score, quality of life (QoL), infections, and coagulation markers were also evaluated. Thirty-four patients (VM = 17, KTS = 17, 1-53 of age; median 15.9 years) with measurable lesion volume were analyzed. There was no statistically significant difference in the lesion volume between baseline and day 180, and the mean change rate (standard deviation) was 1.06 (0.28). There were no baseline characteristics that affected the change in lesion volume over 6 months. However, there were patients who showed more than 20% volume change and it was suggested that the lesion volume was largely impacted by local infection. There were no statistically significant changes in pain VAS score, severity, PS, QoL score, D-dimer, and platelet count over 6 months within all patients analyzed. Conclusion: The results showed the representative natural course of VM and KTS for a 6-month period with objective change of lesion volume and other factors, suggesting that it is scientifically reasonable to conduct a Phase 2 proof-of-concept study without a placebo arm, using the results of this study as the control. Clinical Trial Registration: NCT04285723, NCT04589650.
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Affiliation(s)
- Akihiro Fujino
- Division of Pediatric Surgery, National Center for Child Health and Development, Setagaya-ku, Japan
| | - Kanako Kuniyeda
- ARTham Therapeutics, Inc., Yakohama, Japan
- Department of Clinical Pharmacology and Therapeutics, Faculty of Medicine, Oita University, Yufu, Japan
| | - Taiki Nozaki
- Department of Radiology, St. Luke's International Hospital, Chuo-ku, Japan
| | - Michio Ozeki
- Department of Pediatrics, Graduate School of Medicine, Gifu University, Gifu, Japan
| | | | - Iori Sato
- Division of Health Science and Nursing, Department of Family Nursing, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Japan
| | - Kiyoko Kamibeppu
- Division of Health Science and Nursing, Department of Family Nursing, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Japan
| | - Akira Tanaka
- ARTham Therapeutics, Inc., Yakohama, Japan
- Department of Clinical Pharmacology and Therapeutics, Faculty of Medicine, Oita University, Yufu, Japan
| | - Naoto Uemura
- Department of Clinical Pharmacology and Therapeutics, Faculty of Medicine, Oita University, Yufu, Japan
| | | | | | | | - Souichi Suenobu
- Division of General Pediatrics and Emergency Medicine, Department of Pediatrics, Faculty of Medicine, Oita University, Yufu, Japan
| | - Tadashi Nomura
- Department of Plastic Surgery, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Ayato Hayashi
- Department of Plastic and Reconstructive Surgery, Juntendo University Urayasu Hospital, Urayasu, Japan
| | - Munetomo Nagao
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Tohoku University, Sendai, Japan
| | - Aiko Kato
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Oita University, Yufu, Japan
| | - Noriko Aramaki-Hattori
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Shinjuku-ku, Japan
| | - Kotaro Imagawa
- Department of Plastic surgery, Tokai University, Isehara, Japan
| | - Kosuke Ishikawa
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Junko Ochi
- Department of Radiology, Suita Tokushukai Hospital, Tokushukai Medical Group, Suita, Japan
| | - Saya Horiuchi
- Department of Radiology, St. Luke's International Hospital, Chuo-ku, Japan
| | - Hiroshi Nagabukuro
- ARTham Therapeutics, Inc., Yakohama, Japan
- Department of Clinical Pharmacology and Therapeutics, Faculty of Medicine, Oita University, Yufu, Japan
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Kobayashi F, Watanabe J, Koizumi M, Sata N. Efficacy and safety of mesh non-fixation in patients undergoing laparo-endoscopic repair of groin hernia: a systematic review and meta-analysis. Hernia 2023; 27:1415-1427. [PMID: 37955811 DOI: 10.1007/s10029-023-02919-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 10/22/2023] [Indexed: 11/14/2023]
Abstract
PURPOSE To examine updated evidence on the efficacy and safety of mesh non-fixation in patients undergoing laparo-endoscopic repair of groin hernias. METHODS We searched MEDLINE, Cochrane Central Library, Embase, ClinicalTrials. gov, and ICTRP databases to identify randomized controlled trials. The primary outcomes were recurrence, chronic pain, and return to daily life. The certainty of evidence (CoE) was assessed by grading recommendations, assessments, developments, and evaluations. We performed a subgroup analysis based on the surgical type. This study was registered with PROSPERO (CRD 42022368929). RESULTS We included 25 trials with 3,668 patients (4,038 hernias) were included. Mesh non-fixation resulted in little to no difference in hernia recurrence (relative risk [RR]:1.40, 95% confidence interval [CI]:0.59-3.31; I2 = 0%; moderate CoE) and chronic pain (RR:0.48, 95% CI:0.13-1.78; I2 = 77%; moderate CoE), but reduced return to daily life (mean difference [MD]: - 1.79 days, 95% CI: - 2.79 to -0.80; I2 = 96%; low CoE). In subgroup analyses, the transabdominal preperitoneal approach (TAPP) (MD: - 2.97 days, 95% CI: - 4.87 to - 1.08; I2 = 97%) reduced return to daily life than total extraperitoneal inguinal approach (MD: - 0.24 days, 95% CI - 0.71 to 0.24; I2 = 61%) (p = 0.006). CONCLUSIONS Mesh nonfixation improves the return to daily life without increasing the risk of hernia recurrence or chronic pain. Surgeons and patients may discuss mesh nonfixation options to accommodate a patient's desired return to daily life. Further trials focusing on TAPP are required to confirm these findings.
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Affiliation(s)
- F Kobayashi
- Department of Surgery, Division of Gastroenterological, General, and Transplant Surgery, Jichi Medical University, Shimotsuke city, Tochigi, Japan
| | - J Watanabe
- Department of Surgery, Division of Gastroenterological, General, and Transplant Surgery, Jichi Medical University, Shimotsuke city, Tochigi, Japan.
- Division of Community and Family Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke city, Tochigi, 329-0498, Japan.
| | - M Koizumi
- Department of Surgery, Division of Gastroenterological, General, and Transplant Surgery, Jichi Medical University, Shimotsuke city, Tochigi, Japan
| | - N Sata
- Department of Surgery, Division of Gastroenterological, General, and Transplant Surgery, Jichi Medical University, Shimotsuke city, Tochigi, Japan
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Shimizu T, Sands J, Yoh K, Spira A, Garon EB, Kitazono S, Johnson ML, Meric-Bernstam F, Tolcher AW, Yamamoto N, Greenberg J, Kawasaki Y, Zebger-Gong H, Kobayashi F, Phillips P, Lisberg AE, Heist RS. First-in-Human, Phase I Dose-Escalation and Dose-Expansion Study of Trophoblast Cell-Surface Antigen 2-Directed Antibody-Drug Conjugate Datopotamab Deruxtecan in Non-Small-Cell Lung Cancer: TROPION-PanTumor01. J Clin Oncol 2023; 41:4678-4687. [PMID: 37327461 PMCID: PMC10564307 DOI: 10.1200/jco.23.00059] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 04/11/2023] [Accepted: 05/10/2023] [Indexed: 06/18/2023] Open
Abstract
PURPOSE This first-in-human, dose-escalation and dose-expansion study evaluated the safety, tolerability, and antitumor activity of datopotamab deruxtecan (Dato-DXd), a novel trophoblast cell-surface antigen 2 (TROP2)-directed antibody-drug conjugate in solid tumors, including advanced non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS Adults with locally advanced/metastatic NSCLC received 0.27-10 mg/kg Dato-DXd once every 3 weeks during escalation or 4, 6, or 8 mg/kg Dato-DXd once every 3 weeks during expansion. Primary end points were safety and tolerability. Secondary end points included objective response rate (ORR), survival, and pharmacokinetics. RESULTS Two hundred ten patients received Dato-DXd, including 180 in the 4-8 mg/kg dose-expansion cohorts. This population had a median of three prior lines of therapy. The maximum tolerated dose was 8 mg/kg once every 3 weeks; the recommended dose for further development was 6 mg/kg once every 3 weeks. In patients receiving 6 mg/kg (n = 50), median duration on study, including follow-up, and median exposure were 13.3 and 3.5 months, respectively. The most frequent any-grade treatment-emergent adverse events (TEAEs) were nausea (64%), stomatitis (60%), and alopecia (42%). Grade ≥3 TEAEs and treatment-related AEs occurred in 54% and 26% of patients, respectively. Interstitial lung disease adjudicated as drug-related (two grade 2 and one grade 4) occurred in three of 50 patients (6%). The ORR was 26% (95% CI, 14.6 to 40.3), and median duration of response was 10.5 months; median progression-free survival and overall survival were 6.9 months (95% CI, 2.7 to 8.8 months) and 11.4 months (95% CI, 7.1 to 20.6 months), respectively. Responses occurred regardless of TROP2 expression. CONCLUSION Promising antitumor activity and a manageable safety profile were seen with Dato-DXd in heavily pretreated patients with advanced NSCLC. Further investigation as first-line combination therapy in advanced NSCLC and as monotherapy in the second-line setting and beyond is ongoing.
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Affiliation(s)
- Toshio Shimizu
- National Cancer Center Hospital, Tokyo, Japan
- Wakayama Medical University Hospital, Wakayama, Japan
| | | | - Kiyotaka Yoh
- National Cancer Center Hospital East, Chiba, Japan
| | - Alexander Spira
- Virginia Cancer Specialists (VCS) Research Institute, Fairfax, VA
| | | | | | - Melissa L. Johnson
- Sarah Cannon Research Institute, Tennessee Oncology, PLLC/OneOncology, Nashville, TN
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Meric-Bernstam F, Krop I, Juric D, Kogawa T, Hamilton E, Spira AI, Mukohara T, Tsunoda T, Damodaran S, Greenberg J, Gu W, Kobayashi F, Zebger-Gong H, Kawasaki Y, Wong R, Bardia A. Abstract PD13-08: PD13-08 Phase 1 TROPION-PanTumor01 Study Evaluating Datopotamab Deruxtecan (Dato-DXd) in Unresectable or Metastatic Hormone Receptor–Positive/HER2–Negative Breast Cancer (BC). Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-pd13-08] [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] [Indexed: 03/06/2023]
Abstract
Abstract
Background: Datopotamab deruxtecan (Dato-DXd) is an antibody-drug conjugate (ADC) consisting of a humanized anti-TROP2 IgG1 monoclonal antibody covalently linked to a highly potent topoisomerase I (Topo I) inhibitor payload via a stable, tumor-selective, tetrapeptide-based cleavable linker. Dato-DXd demonstrated compelling single-agent antitumor activity in heavily pretreated patients (pts) with metastatic triple-negative BC (Krop, SABCS 2021). This is the first report of results from the TROPION-PanTumor01 study in pts with unresectable or metastatic hormone receptor–positive (HR+)/human epidermal growth factor receptor 2–negative (HER2−; including HER2-low and HER2-zero) BC.
Methods: TROPION-PanTumor01 (NCT03401385) is a phase 1, multicenter, open-label, 2-part dose-escalation/expansion study evaluating Dato-DXd in previously treated pts with solid tumors. Based on previous clinical findings and exposure-response results from pts with NSCLC, Dato-DXd 6 mg/kg IV Q3W is being evaluated in pts with unresectable or metastatic HR+/HER2− BC that progressed on standard therapies. The primary objectives were safety and tolerability. Tumor responses, including ORR (complete response [CR] + partial response [PR]) and DCR (CR + PR + stable disease [SD]), were assessed per RECIST version 1.1 by blinded independent central review.
Results: As of the April 29, 2022, data cutoff, 41 pts had received Dato-DXd (median follow-up, 10.9 mo [range, 7-13]); 9 pts were ongoing. The primary cause of treatment discontinuation was disease progression (63%; progressive disease [PD] or clinical progression). Median age was 57 y (range, 33-75); 54% had de novo metastatic disease. Pts were heavily pretreated (Table) with a median of 5 (range, 3-10) prior regimens in the advanced setting; 95% had prior CDK4/6i (adjuvant/metastatic). Median time from initial treatment for metastatic disease to the first dose of Dato-DXd was 42.7 mo (range, 10.2-131.1). Treatment-emergent adverse events (TEAEs; all cause) were observed in 98% (any grade) and 41% (grade ≥3) of pts. Most common TEAEs (any grade, grade ≥3) were stomatitis (80%, 10%), nausea (56%, 0%), fatigue (46%, 2%), and alopecia (37%, 0%). Serious TEAEs were observed in 6 pts (15%); 1 pt died due to dyspnea, which was not considered to be treatment related. Dose reductions occurred in 5 pts due to stomatitis (n=3), fatigue (n=2), keratitis (n=1), and decreased appetite (n=1) (>1 AE per pt); 14 pts had treatment delayed due to stomatitis (n=8), retinopathy (n=1), dysphagia (n=1), fatigue (n=1), malaise (n=1), COVID-19 (n=1), cellulitis (n=1), urinary tract infection (n=1), decreased lymphocyte count (n=1), and nasal congestion (n=1; >1 AE per pt). Three pts discontinued treatment due to keratitis (n=1) and pneumonitis (n=2); 1 case of pneumonitis was adjudicated as grade 2 drug-related interstitial lung disease. The ORR was 29% (11 confirmed PRs; 1 pending confirmation), the DCR was 85% (35/41), and the clinical benefit rate (CR + PR + SD ≥6 mo) was 41% (17/41).
Conclusions: Dato-DXd demonstrated a manageable safety profile and encouraging antitumor activity, with high disease control in heavily pretreated pts, the majority having received prior CDK4/6i. Based on these findings, the TROPION-Breast01 (NCT05104866) randomized phase 3 study comparing 2L+ Dato-DXd vs investigator’s choice chemotherapy is currently enrolling pts with HR+/HER2− BC.
Prior Therapies in the Adjuvant or Metastatic Setting
Citation Format: Funda Meric-Bernstam, Ian Krop, Dejan Juric, Takahiro Kogawa, Erika Hamilton, Alexander I. Spira, Toru Mukohara, Takuya Tsunoda, Senthil Damodaran, Jonathan Greenberg, Wen Gu, Fumiaki Kobayashi, Hong Zebger-Gong, Yui Kawasaki, Rie Wong, Aditya Bardia. PD13-08 Phase 1 TROPION-PanTumor01 Study Evaluating Datopotamab Deruxtecan (Dato-DXd) in Unresectable or Metastatic Hormone Receptor–Positive/HER2–Negative Breast Cancer (BC) [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr PD13-08.
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Affiliation(s)
| | - Ian Krop
- 2Yale School of Medicine, New Haven, Connecticut
| | - Dejan Juric
- 3Massachusetts General Hospital Cancer Center, Department of Medicine, Harvard Medical School, Boston, MA
| | - Takahiro Kogawa
- 4Department of Advanced Medical Development, Cancer Institute Hospital of JFCR, Tokyo, Japan
| | | | | | - Toru Mukohara
- 7National Cancer Center Hospital East, Kashiwa, Japan
| | - Takuya Tsunoda
- 8Division of Medical Oncology, Showa University, School of Medicine, Tokyo, Japan
| | | | - Jonathan Greenberg
- 10Daiichi Sankyo, Inc., Basking Ridge, NJ and Daiichi Sankyo Europe GmbH, Munich, Germany
| | - Wen Gu
- 11Daiichi Sankyo, Inc., Basking Ridge, NJ
| | | | - Hong Zebger-Gong
- 13Daiichi Sankyo, Inc., Basking Ridge, NJ and Daiichi Sankyo Europe GmbH, Munich, Germany
| | | | - Rie Wong
- 15Daiichi Sankyo, Co., Ltd., Tokyo, Japan
| | - Aditya Bardia
- 16Massachusetts General Hospital Cancer Center, Boston, Massachusetts
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Bardia A, Krop I, Meric-Bernstam F, Tolcher AW, Mukohara T, Lisberg A, Shimizu T, Hamilton E, Spira AI, Papadopoulos KP, Greenberg J, Gu W, Kobayashi F, Zebger-Gong H, Kawasaki Y, Wong R, Kogawa T. Abstract P6-10-03: Datopotamab Deruxtecan (Dato-DXd) in Advanced Triple-Negative Breast Cancer (TNBC): Updated Results From the Phase 1 TROPION-PanTumor01 Study. Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-p6-10-03] [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] [Indexed: 03/06/2023]
Abstract
Abstract
Background: Datopotamab deruxtecan (Dato-DXd) is an antibody-drug conjugate (ADC) consisting of a humanized anti-TROP2 IgG1 mAb covalently linked to a highly potent topoisomerase I (Topo I) inhibitor payload via a stable, tumor selective, tetrapeptide-based cleavable linker. Dato-DXd has previously shown encouraging activity in heavily pretreated patients (pts) with metastatic TNBC (Krop, SABCS 2021). Here we report updated results from the TROPION-PanTumor01 study in pts with advanced/metastatic TNBC. Methods: TROPION-PanTumor01 (NCT03401385) is a phase 1, multicenter, open-label, 2-part dose-escalation/expansion study evaluating Dato-DXd in previously treated pts with solid tumors. Based on previous clinical and exposure-response results from pts with NSCLC, Dato-DXd 6 mg/kg IV Q3W is being evaluated in pts with advanced TNBC that relapsed/progressed on standard therapies; 2 pts received 8 mg/kg prior to selection of 6 mg/kg. The primary objectives were safety and tolerability. Tumor responses, including objective response rate (ORR; complete response [CR] + partial response [PR]) and disease control rate (DCR; CR + PR + stable disease [SD]), were assessed per RECIST v1.1 by blinded independent central review. Results: As of April 29, 2022, 44 pts received Dato-DXd (median follow-up, 16.6 mo [range, 13-22]) at the time of data cutoff. The primary cause of treatment discontinuation was disease progression (86%; PD or clinical progression), and 4 pts are still receiving therapy. Median age was 53 y (range, 32-82); 32% had de novo metastatic disease. Pts were heavily pretreated with a median of 3 (range, 1-10) prior regimens in the metastatic setting. Prior treatments included taxanes (91%), anthracyclines (75%), capecitabine (61%), platinum (52%), immunotherapy (43%), Topo I inhibitor–based ADC therapy (32%), and PARPi (18%). Treatment-emergent adverse events (TEAEs; all cause) occurred in 100% (any grade) and 50% (grade ≥3) of pts, respectively. Most common TEAEs (any grade, grade ≥3) were stomatitis (73%, 11%), nausea (66%, 2%), vomiting (39%, 5%), fatigue (34%, 7%), and alopecia (36%, 0%). One pt had grade 3 decreased neutrophil count; no cases of interstitial lung disease (ILD) or grade ≥3 diarrhea were observed. Serious TEAEs were reported in 9 pts (20%); no deaths associated with adverse events (AEs) were observed. Dose reductions occurred in 8 pts (18%) due to stomatitis (n=3), fatigue (n=2), dry eye (n=1), retinal exudates (n=1), and dysgeusia (n=1); 12 pts (27%) delayed treatment due to stomatitis (n=5), dry eye (n=1), keratitis (n=1), blurred vision (n=1), fatigue (n=1), bronchitis (n=1), skin infection (n=1), musculoskeletal chest pain (n=1), dysgeusia (n=1), chronic obstructive pulmonary disease (n=1), and dyspnea (n=1; >1 AE per pt). One pt (2%) discontinued treatment due to grade 1 pneumonitis (which was centrally adjudicated as not ILD). ORR in all pts was 32% (1 CR, 13 PRs), DCR was 80% (35/44), and clinical benefit rate (CR + PR + SD ≥6 mo) was 34% (15/44). Median duration of response was not yet reached; median progression-free survival (mPFS) was 4.3 mo (95% CI, 3.0-7.3), and median overall survival (mOS) was 12.9 mo (95% CI, 10.1-14.7). In the subset of pts without prior Topo I inhibitor–based ADC therapy and with measurable disease at baseline, ORR was 44% (12/27). Among all pts without prior Topo I inhibitor–based ADC therapy (n=30), mPFS was 7.3 mo (95% CI, 3.0-NE), and mOS was 14.3 mo (95% CI, 10.5-NE). Conclusions: Dato-DXd continues to demonstrate encouraging and durable antitumor activity, along with a manageable safety profile, in heavily pretreated pts with metastatic TNBC. Based on these findings, the phase 3 randomized TROPION-Breast02 (NCT05374512) trial comparing Dato-DXd vs chemotherapy as 1L therapy for pts with metastatic TNBC is currently underway.
Citation Format: Aditya Bardia, Ian Krop, Funda Meric-Bernstam, Anthony W. Tolcher, Toru Mukohara, Aaron Lisberg, Toshio Shimizu, Erika Hamilton, Alexander I. Spira, Kyriakos P. Papadopoulos, Jonathan Greenberg, Wen Gu, Fumiaki Kobayashi, Hong Zebger-Gong, Yui Kawasaki, Rie Wong, Takahiro Kogawa. Datopotamab Deruxtecan (Dato-DXd) in Advanced Triple-Negative Breast Cancer (TNBC): Updated Results From the Phase 1 TROPION-PanTumor01 Study [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P6-10-03.
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Affiliation(s)
- Aditya Bardia
- 1Massachusetts General Hospital Cancer Center, Boston, Massachusetts
| | - Ian Krop
- 2Yale School of Medicine, New Haven, Connecticut
| | | | - Anthony W. Tolcher
- 4South Texas Accelerated Research Therapeutics, San Antonio, TX; NEXT Oncology, San Antonio, TX; Texas Oncology, San Antonio, TX
| | - Toru Mukohara
- 5National Cancer Center Hospital East, Kashiwa, Japan
| | - Aaron Lisberg
- 6Department of Medicine, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA
| | | | | | | | | | - Jonathan Greenberg
- 11Daiichi Sankyo, Inc., Basking Ridge, NJ and Daiichi Sankyo Europe GmbH, Munich, Germany
| | - Wen Gu
- 12Daiichi Sankyo, Inc., Basking Ridge, NJ
| | | | - Hong Zebger-Gong
- 14Daiichi Sankyo, Inc., Basking Ridge, NJ and Daiichi Sankyo Europe GmbH, Munich, Germany
| | | | - Rie Wong
- 16Daiichi Sankyo, Co., Ltd., Tokyo, Japan
| | - Takahiro Kogawa
- 17Department of Advanced Medical Development, Cancer Institute Hospital of JFCR, Tokyo, Japan
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7
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Fujii M, Nishinaka T, Inatomi A, Katagiri N, Kobayashi F, Imaoka S, Tanaka S, Mizuno T, Tsukiya T, Umeki A, Matsumiya G. Impact of Left Ventricular Unloading Under Circulatory Support with Venoarterial ECMO in Heart Failure Animal Model. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1609] [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: 10/18/2022] Open
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8
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Krop I, Juric D, Shimizu T, Tolcher A, Spira A, Mukohara T, Lisberg AE, Kogawa T, Papadopoulos KP, Hamilton E, Damodaran S, Greenberg J, Gu W, Kobayashi F, Guevara F, Jikoh T, Kawasaki Y, Meric-Bernstam F, Bardia A. Abstract GS1-05: Datopotamab deruxtecan in advanced/metastatic HER2- breast cancer: Results from the phase 1 TROPION-PanTumor01 study. Cancer Res 2022. [DOI: 10.1158/1538-7445.sabcs21-gs1-05] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Datopotamab deruxtecan (Dato-DXd) is an antibody-drug conjugate consisting of a humanized anti-TROP2 IgG1 monoclonal antibody conjugated to a potent topoisomerase I inhibitor payload via a stable tetrapeptide-based cleavable linker. Preliminary results from the phase 1 TROPION-PanTumor01 study demonstrate that Dato-DXd has encouraging antitumor activity and a manageable safety profile in patients with non-small cell lung cancer (NSCLC) (Meric-Bernstam, ASCO 2021) and those with triple-negative breast cancer (TNBC) (Bardia, ESMO BC 2021). Updated results from the TNBC cohort are presented here. Methods: TROPION-PanTumor01 (NCT03401385) is a phase 1, multi-center, open-label, 2-part study evaluating Dato-DXd in previously treated patients with solid tumors. Based on the dose-escalation results in patients with NSCLC, Dato-DXd 6 mg/kg intravenously every 3 weeks is being evaluated in patients with advanced/metastatic TNBC and HR+/HER2− breast cancer who relapsed/progressed on standard therapies. Two patients with TNBC received Dato-DXd 8 mg/kg prior to selection of 6 mg/kg for dose expansion. Safety and efficacy were assessed, including objective response rate (ORR) per RECIST version 1.1 by blinded independent central review (BICR). Results: As of the April 6, 2021, data cutoff, 43 patients with TNBC had received ≥1 dose of Dato-DXd, with 27 patients (63%) continuing and 16 patients (37%) discontinuing treatment all due to disease progression. The median age was 53 years (range, 32-82 years). Forty-one patients (95%) had received ≥2 prior lines of therapy; 19 patients (44%) had received prior immunotherapy and 7 (16%) had received prior sacituzumab govitecan. The median duration of treatment was 2.8 months (range, 0.7-6.9 months). The median follow-up was 3.9 months (range, 0.3-9.2 months). Among 38 patients evaluable for response, the ORR by BICR was 39% (15 partial responses [PR]), with 12 confirmed and 3 pending confirmation. The disease control rate was 84% (32/38). The median time to response was 1.35 months (1.2-3.2 months) for the 12 confirmed PRs. All-cause treatment-emergent adverse events (TEAEs; any grade, grade ≥3) were observed in 95% and 35% of patients, respectively; 2 events were grade 4 and 0 grade 5. The most common TEAEs (any grade [≥30%], grade ≥3) included nausea (58%, 0%), stomatitis (53%, 9%), alopecia (35%, N/A), vomiting (35%, 2%), and fatigue (33%, 7%). One patient had grade 3 decreased neutrophil count; no cases of grade ≥3 diarrhea were observed. No cases of treatment-related interstitial lung disease as adjudicated by an independent committee were reported. Serious TEAEs were observed in 5 patients (12%); no TEAEs were associated with death. Dose reductions occurred in 9 patients due to stomatitis, fatigue, mucosal inflammation, dry eye, retinal exudates, and blurred vision (multiple counts per TEAE). Three patients had dose interruptions due to stomatitis, mucosal inflammation, bronchitis, and musculoskeletal chest pain. No patients discontinued treatment due to adverse events. Conclusions: Preliminary results showed that Dato-DXd demonstrates promising antitumor activity with a manageable safety profile in patients with previously treated advanced/metastatic TNBC; confirmatory studies in patients with breast cancer are warranted.
Citation Format: Ian Krop, Dejan Juric, Toshio Shimizu, Anthony Tolcher, Alexander Spira, Toru Mukohara, Aaron E. Lisberg, Takahiro Kogawa, Kyriakos P. Papadopoulos, Erika Hamilton, Senthil Damodaran, Jonathan Greenberg, Wen Gu, Fumiaki Kobayashi, Ferdinand Guevara, Takahiro Jikoh, Yui Kawasaki, Funda Meric-Bernstam, Aditya Bardia. Datopotamab deruxtecan in advanced/metastatic HER2- breast cancer: Results from the phase 1 TROPION-PanTumor01 study [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr GS1-05.
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Affiliation(s)
- Ian Krop
- Dana-Farber Cancer Institute, Boston, MA
| | - Dejan Juric
- Department of Hematology/Oncology, Massachusetts General Hospital Cancer Center Harvard Medical School, Boston, MA
| | | | | | | | - Toru Mukohara
- Department of Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | | | - Takahiro Kogawa
- Advanced Medical Development Center, Cancer Institute Hospital of JFCR, Tokyo, Japan
| | | | - Erika Hamilton
- Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TX
| | | | | | - Wen Gu
- Daiichi Sankyo Inc, Basking Ridge, NJ
| | | | | | | | | | | | - Aditya Bardia
- Department of Hematology/Oncology, Massachusetts General Hospital Cancer Center Harvard Medical School, Boston, MA
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Garon E, Johnson M, Lisberg A, Spira A, Yamamoto N, Heist R, Sands J, Yoh K, Meric-Bernstam F, Kitazono S, Greenberg J, Kobayashi F, Guevara F, Kawasaki Y, Shimizu T. MA03.02 TROPION-PanTumor01: Updated Results From the NSCLC Cohort of the Phase 1 Study of Datopotamab Deruxtecan in Solid Tumors. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.118] [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: 10/20/2022]
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Garon E, Johnson M, Lisberg A, Spira A, Yamamoto N, Heist R, Sands J, Yoh K, Meric-Bernstam F, Kitazono S, Greenberg J, Kobayashi F, Kawasaki Y, Jukofsky L, Nakamura K, Shimizu T. LBA49 Efficacy of datopotamab deruxtecan (Dato-DXd) in patients (pts) with advanced/metastatic (adv/met) non-small cell lung cancer (NSCLC) and actionable genomic alterations (AGAs): Preliminary results from the phase I TROPION-PanTumor01 study. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.2128] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Shimizu T, Lisberg AE, Sands JM, Greenberg J, Phillips P, Tajima N, Kawasaki Y, Gu J, Kobayashi F, Yamamoto N, Johnson M, Meric-Bernstam F, Yoh K, Garon EB, Heist RS, Spira A. O2-1 Datopotamab Deruxtecan (Dato-DXd; DS-1062), a TROP2 ADC, in patients with advanced NSCLC: Updated results of TROPION-PanTumor01 phase 1 study*. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.524] [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: 10/20/2022] Open
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12
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Meric-Bernstam F, Spira AI, Lisberg AE, Sands J, Yamamoto N, Johnson ML, Yoh K, Garon EB, Heist RS, Petrich A, Greenberg J, Tajima N, Kawasaki Y, Gu J, Kobayashi F, Lu Y, Guevara FM, Shimizu T. TROPION-PanTumor01: Dose analysis of the TROP2-directed antibody-drug conjugate (ADC) datopotamab deruxtecan (Dato-DXd, DS-1062) for the treatment (Tx) of advanced or metastatic non-small cell lung cancer (NSCLC). J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.9058] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
9058 Background: Datopotamab deruxtecan (Dato-DXd; DS-1062) is an ADC composed of a humanized anti-TROP2 IgG1 monoclonal antibody conjugated to a topoisomerase I inhibitor via a tetrapeptide-based cleavable linker. Methods: TROPION-PanTumor01 (NCT03401385) is a multicenter dose-escalation/expansion study evaluating Dato-DXd administered Q3W in patients (pts) with advanced NSCLC (since expanded to other tumor types, excluded from this analysis). Efficacy and safety were evaluated in 175 pts for dose analysis. Pharmacometric analyses (population pharmacokinetics [popPK] and exposure-response modeling) were conducted across doses to inform dose selection for further development. Results: At data cutoff (Sept 4, 2020), median follow-up was 7.4 mo (range, 0.10-21.7 mo). Select all-grade TEAEs were 1.5- to 2-fold higher in the 8 mg/kg vs 4 and 6 mg/kg cohorts: vomiting (34% vs 12% and 18%), anemia (28% vs 4% and 16%), diarrhea (20% vs 6% and 11%), and mucositis (29% vs 6% and 13%). Rates of grade ≥3 drug-related TEAEs and serious drug-related TEAEs were ≥2-fold higher with the 8 mg/kg dose (n = 80; 34% and 20%) relative to the 4 mg/kg (n = 50; 10% and 8%) and 6 mg/kg (n = 45; 16% and 9%) doses. Rates of drug-related interstitial lung disease (ILD), as determined by an independent adjudication committee, were higher in the 8 mg/kg cohort (15% vs 2% and 2% in the 4 and 6 mg/kg cohorts); 3 pts in the 8 mg/kg cohort experienced grade 5 ILD. Dose interruptions and reductions due to TEAEs increased with dose (4 mg/kg: 4% and 2%; 6 mg/kg: 20% and 9%; 8 mg/kg: 20% and 31%). More pts in the 8 mg/kg cohort discontinued Tx early due to AEs (15%) compared with those in the 4 mg/kg (4%) and 6 mg/kg (7%) cohorts. ORRs determined by blinded independent central review were similar: 8 mg/kg, 25% (20/80); 6 mg/kg, 21% (8/39); and 4 mg/kg, 23% (9/40). Preliminary median PFS (95% CI) was 5.4 mo (4.1-7.1 mo) in the 8 mg/kg cohort, 8.2 mo (1.5-11.8 mo) in the 6 mg/kg cohort, and 4.3 mo (2.0 mo-NE) in the 4 mg/kg cohort. PFS was limited by early censoring due to immature duration of follow-up, with the majority of pts having ≤3 mo of follow-up in the 4 (66%) and 6 mg/kg (67%) cohorts vs 8 mg/kg (46%) cohort. In pharmacometric analyses, tumor-size change from baseline and probability of complete response/partial response positively correlated with exposure (AUC) of Dato-DXd. Incidences of dose reduction and grade ≥2 stomatitis/mucositis were also positively correlated with exposure; projected probabilities in a virtual population bootstrapped from pts with NSCLC in the popPK data confirmed these trends. Updated results will be presented. Conclusions: A Dato-DXd dose of 6 mg/kg was selected for the randomized, phase 3, TROPION-Lung01 trial (NCT04656652) based on better tolerance and improved efficacy, including a trend toward increased PFS. Clinical trial information: NCT03401385.
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Affiliation(s)
| | | | | | | | - Noboru Yamamoto
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo, Japan
| | | | - Kiyotaka Yoh
- Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa-Shi, Chiba, Japan
| | | | | | | | | | | | | | | | | | | | | | - Toshio Shimizu
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo, Japan
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Bardia A, Juric D, Shimizu T, Tolcher A, Karim R, Spira A, Mukohara T, Lisberg A, Kogawa T, Krop I, Papadopoulos K, Hamilton E, Damodaran S, Greenberg J, Gu W, Kobayashi F, Guevara F, Jikoh T, Kawasaki Y, Meric-Bernstam F. LBA4 Datopotamab deruxtecan (Dato-DXd), a TROP2-directed antibody-drug conjugate (ADC), for triple-negative breast cancer (TNBC): Preliminary results from an ongoing phase I trial. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.03.213] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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14
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Spira A, Lisberg A, Sands J, Greenberg J, Phillips P, Guevara F, Tajima N, Kawasaki Y, Gu J, Kobayashi F, Yamamoto N, Johnson M, Meric-Bernstam F, Yoh K, Garon E, Heist R, Shimizu T. OA03.03 Datopotamab Deruxtecan (Dato-DXd; DS-1062), a TROP2 ADC, in Patients With Advanced NSCLC: Updated Results of TROPION-PanTumor01 Phase 1 Study. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.280] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Zahir H, Kobayashi F, Zamora C, Gajee R, Gordon MS, Babiker HM, Wang Q, Greenberg J, Wagner AJ. Evaluation of Potential Drug-Drug Interaction Risk of Pexidartinib With Substrates of Cytochrome P450 and P-Glycoprotein. J Clin Pharmacol 2020; 61:298-306. [PMID: 32918831 PMCID: PMC7891582 DOI: 10.1002/jcph.1734] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 04/30/2020] [Accepted: 08/17/2020] [Indexed: 02/02/2023]
Abstract
Pexidartinib is approved for treatment of adults with symptomatic tenosynovial giant cell tumor. In vitro data showed pexidartinib's potential to inhibit and induce cytochrome P450 (CYP) 3A, inhibit CYP2C9, CYP2C19 and P‐glycoprotein (P‐gp). Herein, 2 open‐label, single‐sequence, crossover studies evaluated the drug‐drug interaction potential of pexidartinib on CYP enzymes (CYP2C9, CYP2C19, and CYP3A) and P‐gp. Thirty‐two subjects received single oral doses of midazolam (CYP3A substrate) and tolbutamide (CYP2C9 substrate) alone and after single and multiple oral doses of pexidartinib. Twenty subjects received single oral doses of omeprazole (CYP2C19 substrate) and digoxin (P‐gp substrate) alone or with pexidartinib. Analysis of variance was conducted to determine the effect of pexidartinib on various substrates’ pharmacokinetics. No drug‐drug interaction was concluded if the 90% confidence interval of the ratio of test to reference was within the range 80% to 125%. Coadministration of single and multiple doses of pexidartinib resulted in 21% and 52% decreases, respectively, in the area under the plasma concentration–time curve from time zero to the last measurable time point (AUClast) of midazolam, whereas AUClast values of tolbutamide increased 15% and 36%, respectively. Omeprazole exposure decreased on concurrent administration with pexidartinib, the metabolite‐to‐parent ratio was similar following omeprazole administration alone vs coadministration with pexidartinib; pexidartinib did not affect CYP2C19‐mediated metabolism. Maximum plasma concentrations of digoxin slightly increased (32%) with pexidartinib coadministration; no significant effect on digoxin AUClast. These results indicate that pexidartinib is a moderate inducer of CYP3A and a weak inhibitor of CYP2C9 and does not significantly affect CYP2C19‐mediated metabolism or P‐gp transport.
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Affiliation(s)
- Hamim Zahir
- Daiichi Sankyo, Inc., Basking Ridge, New Jersey, USA
| | | | | | - Roohi Gajee
- Daiichi Sankyo, Inc., Basking Ridge, New Jersey, USA
| | | | - Hani M Babiker
- University of Arizona Cancer Center, Tucson, Arizona, USA
| | - Qiang Wang
- Daiichi Sankyo, Inc., Basking Ridge, New Jersey, USA
| | | | - Andrew J Wagner
- Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts, USA
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16
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Mendell J, Kobayashi F, Shimizu T. Randomized, Double-Blind, Single-Dose, Placebo-Controlled Crossover Study to Evaluate the Effects of Esaxerenone on QTc Interval in Healthy Subjects. Clin Pharmacol Drug Dev 2020; 9:709-718. [PMID: 32255542 DOI: 10.1002/cpdd.794] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 08/29/2019] [Accepted: 02/18/2020] [Indexed: 11/10/2022]
Abstract
This phase 1 single-center, single-dose, double-dummy, placebo-controlled, 4-period and 4-sequence crossover study assessed the potential of esaxerenone, a novel nonsteroidal mineralocorticoid receptor blocker used to treat hypertension, to affect cardiac repolarization. In this double-blind study, 55 subjects were randomized to single doses of 10 mg esaxerenone (therapeutic dose), 40 mg esaxerenone (supratherapeutic dose), 400 mg moxifloxacin, or placebo. Serial electrocardiograms and pharmacokinetics (PK) were obtained over 24 and 168 hours, respectively. The primary end point was Fridericia-corrected QT interval (QTcF). Secondary end points included safety and PK. Assay sensitivity was confirmed as the lower limit of 90% confidence interval (90%CIs) for placebo-corrected change from baseline QTcF (∆∆QTcF) for moxifloxacin was >5 milliseconds at the prespecified times; mean ∆∆QTcF was 12.5 milliseconds at 3 and 4 hours postdose. The upper 90%CI limits of ∆∆QTcF were ≤0 milliseconds at all times for both doses of esaxerenone. No concentration-QTc relationship was identified. Therefore, esaxerenone had no potential to inhibit cardiac repolarization. No deaths or serious adverse events (AEs) occurred; 1 subject discontinued the study because of a treatment-emergent AE unrelated to esaxerenone. This clinical evaluation showed that esaxerenone has no QTc prolongation potential.
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Affiliation(s)
- Jeanne Mendell
- Daiichi Sankyo Pharma Development, Basking Ridge, New Jersey, USA
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17
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Kobayashi F, Sasaki Y, Fujii S, Orihara H, Nagaya T. Negative viscosity of liquid crystals in the presence of turbulence: Conductivity dependence, phase diagram, and self-oscillation. Phys Rev E 2020; 101:022702. [PMID: 32168609 DOI: 10.1103/physreve.101.022702] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 01/15/2020] [Indexed: 11/07/2022]
Abstract
Recently, we reported the discovery of enormous negative viscosity of a nematic liquid crystal in the presence of turbulence induced by ac electric fields, which enabled us to observe unique phenomena related to the negative viscosity, such as spontaneous shear flow, hysteresis in flow curves, and self-oscillation [Orihara et al., Phys. Rev. E 99, 012701 (2019)10.1103/PhysRevE.99.012701]. In the present paper, we report the rheological properties of another nematic liquid crystal, which is a homologue of the previous one. The properties of the present liquid crystal are strongly dependent on electrical conductivity. Three samples with different conductivities were prepared by changing the amount of an ionic dopant. It was found that the lowest-conductivity sample without dopant shows no negative viscosity whereas the other ion-doped samples exhibit negative viscosity with strong dependence on the frequency of the ac electric field, consistent with microscopic observations. Phase diagrams of the negative- and positive-viscosity states in the amplitude and frequency plane are constructed to show the conductivity effect. Furthermore, we propose a model to reproduce another type of self-oscillation found in the present study.
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Affiliation(s)
- Fumiaki Kobayashi
- Division of Applied Physics, Hokkaido University, Sapporo 060-8628, Japan
| | - Yuji Sasaki
- Division of Applied Physics, Hokkaido University, Sapporo 060-8628, Japan
| | - Shuji Fujii
- Division of Applied Physics, Hokkaido University, Sapporo 060-8628, Japan
| | - Hiroshi Orihara
- Division of Applied Physics, Hokkaido University, Sapporo 060-8628, Japan
| | - Tomoyuki Nagaya
- Division of Natural Sciences, Oita University, Oita 870-1192, Japan
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Limsakun T, Dishy V, Mendell J, Pizzagalli F, Pav J, Kochan J, Vandell AG, Rambaran C, Kobayashi F, Orihashi Y, Warren V, McPhillips P, Zhou J. Safety and Pharmacokinetics of DS-1040 Drug-Drug Interactions With Aspirin, Clopidogrel, and Enoxaparin. J Clin Pharmacol 2020; 60:691-701. [PMID: 32106339 DOI: 10.1002/jcph.1568] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 10/01/2019] [Accepted: 11/27/2019] [Indexed: 01/02/2023]
Abstract
DS-1040, a novel low-molecular-weight inhibitor of activated thrombin-activatable fibrinolysis inhibitor, is under development for the treatment of thromboembolic diseases including venous thromboembolism and acute ischemic stroke. Here we describe the results of 3 studies that evaluated the safety and tolerability of DS-1040 along with the effect on DS-1040 pharmacokinetic (PK) parameters, when dosed alone or when coadministered with aspirin (NCT02071004), clopidogrel (NCT02560688), or enoxaparin in healthy subjects. Concomitant administration of single-dose DS-1040 with multiple-dose aspirin, multiple-dose clopidogrel, or single-dose enoxaparin, consistent with clinically relevant dose regimens, was safe and well tolerated with no serious treatment-emergent adverse events (TEAEs), TEAEs leading to discontinuation, bleeding-related TEAEs, and no significant changes in coagulation parameters. DS-1040 did not prolong bleeding time when administered concomitantly with aspirin or clopidogrel. In the aspirin study, DS-1040 PK was evaluated following the concomitant administration with multiple-dose aspirin, where the plasma DS-1040 exposure (peak plasma concentration [Cmax ] and area under the concentration-time curve [AUCinf ]) was to be similar to the data previously published in the first-in-human study of DS-1040 in healthy subjects. The PK parameters of DS-1040 coadministered with clopidogrel were similar to those of DS-1040 alone, with small increases in geometric means for Cmax (7%) and AUClast (9%). When coadministered with enoxaparin, the PK parameters of DS-1040 were not affected (1.1% and 1.5% decreases in geometric means for Cmax and AUClast , respectively). Therefore, concomitant administration of DS-1040 and clopidogrel or enoxaparin did not demonstrate PK drug-drug interactions.
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Affiliation(s)
| | - Victor Dishy
- Daiichi Sankyo, Inc, Basking Ridge, New Jersey, USA
| | | | | | - Joseph Pav
- Daiichi Sankyo, Inc, Basking Ridge, New Jersey, USA
| | | | | | | | | | | | - Vance Warren
- Daiichi Sankyo, Inc, Basking Ridge, New Jersey, USA
| | - Penny McPhillips
- Daiichi Sankyo Development Ltd, Gerrards Cross, Buckinghamshire, UK
| | - Jin Zhou
- Daiichi Sankyo, Inc, Basking Ridge, New Jersey, USA
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Kobayashi F, Uehara O, Ito C, Furusawa M, Abiko Y, Muramatsu T. DNA methylation of GJA1, BMP2 and BMP4 in a human cementoblast cell line induced by lipopolysaccharide. Int Endod J 2020; 53:804-811. [PMID: 32011747 DOI: 10.1111/iej.13275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 06/06/2019] [Revised: 01/30/2020] [Accepted: 01/30/2020] [Indexed: 11/26/2022]
Abstract
AIM To examine DNA methylation of GJA1, BMP2 and BMP4 in human cementoblasts (HCEM) induced by lipopolysaccharide (LPS). METHODOLOGY HCEM were cultured in osteoinduction medium. After 24 h, Escherichia coli LPS (1 μg/mL) was added to the medium, which was changed every 2-3 days. Untreated samples were used as controls. Messenger RNA was extracted after 4 weeks, and quantitative real-time polymerase chain reaction (qRT-PCR) for GJA1, BMP2, BMP4 and DNMT1 was performed. Genomic DNA was extracted after 4 weeks, and quantitative methylation-specific polymerase chain reaction was carried out for GJA1, BMP2 and BMP4. To detect mineralization, alizarin red and alkaline phosphatase staining were performed. The cells were also treated with the DNA methyltransferase inhibitor 5-Aza-2'-deoxycytidine (5Aza) and examined. The significance of differences amongst groups was assessed using a two-way analysis of variance (ANOVA) followed by Bonferroni's multiple comparison test with P < 0.05 being significant. RESULTS Decreased expression of mRNA was seen in GJA1, BMP2 and BMP4 after 4 weeks (P < 0.05). DNA hypermethylation was detected in GJA1, BMP2 and BMP4 (P < 0.05). Alizarin red staining and alkaline phosphatase staining revealed decreased mineralization levels in HCEM stimulated with LPS. 5Aza abolished the effects of DNA methylation in HCEM stimulated with LPS. CONCLUSIONS These results suggest that long-term LPS stimulation induces DNA methylation of GJA1, BMP2 and BMP4 in HCEM.
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Affiliation(s)
- F Kobayashi
- Department of Endodontics, Tokyo Dental College, Tokyo, Japan
| | - O Uehara
- Division of Disease Control and Molecular Epidemiology, Department of Oral Growth and Development, Health Sciences University of Hokkaido, Tobetsu, Japan
| | - C Ito
- Oral Health Science Center, Tokyo Dental College, Tokyo, Japan
| | - M Furusawa
- Department of Endodontics, Tokyo Dental College, Tokyo, Japan
| | - Y Abiko
- Division of Oral Medicine and Pathology, Department of Human Biology and Pathophysiology, School of Dentistry, Health Sciences University of Hokkaido, Tobetsu, Japan
| | - T Muramatsu
- Department of Operative Dentistry, Cariology and Pulp Biology, Tokyo Dental College, Tokyo, Japan
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Zhou J, Limsakun T, Yin O, Warren V, Zamora C, Atiee G, Kochan J, Pav J, Kobayashi F, Vashi V, Dishy V. First-in-Human Study to Assess the Safety, Pharmacokinetics, and Pharmacodynamics of an Oral Formulation of DS-1040, an Inhibitor of the Activated Form of Thrombin-Activatable Fibrinolysis Inhibitor, in Healthy Subjects. J Clin Pharmacol 2019; 59:1669-1677. [PMID: 31243790 DOI: 10.1002/jcph.1474] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 04/05/2019] [Accepted: 06/05/2019] [Indexed: 11/07/2022]
Abstract
DS-1040, a low-molecular-weight imidazole derivative, inhibits the enzymatic activity of thrombin-activatable fibrinolysis inhibitor (TAFIa), enhancing endogenous tissue plasminogen activator-triggered fibrinolysis. This first-in-human, randomized, placebo-controlled, phase 1 study evaluated the safety, pharmacokinetics (PK), and pharmacodynamics (PD) of an oral formulation of DS-1040. Healthy adults (aged 20-45 years; N = 56) were randomized 3:1 to receive DS-1040 orally administered as single ascending doses (50, 100, 200, or 400 mg) or placebo, or DS-1040 multiple ascending doses (100 mg once daily, 200 mg once daily, or 150 mg twice daily) or placebo for 14 days. Safety, PK, and PD parameters were assessed. All doses of DS-1040 were well tolerated; no serious/severe adverse events (AEs) or discontinuations due to AEs occurred. DS-1040 had no effect on coagulation parameters, and no treatment-related trends in the bleeding time were observed. DS-1040 exposure (peak concentration and area under the concentration-time curve) increased in a dose-proportional manner across the single-dose range. With multiple doses, steady state was achieved by day 7 with minimal accumulation (mean accumulation ratio 1.15-1.25), and the PK was time-independent. After 72 hours, approximately 10% of the DS-1040 400-mg single dose was recovered in urine as intact parent drug. The mean terminal half-life ranged from 17.2 to 24.9 hours, which was similar to previous intravenous administration data. Dose-dependent inhibition of total TAFIa activity was observed following single and multiple doses of oral DS-1040. The safety and PK/PD profiles of oral DS-1040 in healthy subjects support further clinical development.
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Affiliation(s)
- Jin Zhou
- Daiichi Sankyo, Inc, Basking Ridge, NJ, USA
| | | | | | | | | | | | | | - Joseph Pav
- Daiichi Sankyo, Inc, Basking Ridge, NJ, USA
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Sands JM, Shimizu T, Garon EB, Greenberg J, Guevara FM, Heist RS, Kobayashi F, Noguchi Y, Okajima D, Tajima N, Spira AI, Yamamoto N, Lisberg AE. First-in-human phase 1 study of DS-1062a in patients with advanced solid tumors. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.9051] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
9051 Background: DS-1062a is a trophoblast cell-surface antigen 2 (TROP2)-targeting antibody drug conjugate. TROP2 is highly expressed in epithelial cancers, including non-small cell lung cancer (NSCLC). Overexpression of TROP2 may be associated with poor survival in some solid tumors. Preclinical studies showed promising antitumor activity of DS-1062a in mouse models with TROP2-positive tumors. Preliminary results are reported in the dose escalation part of this phase 1 study. Methods: This is an ongoing phase 1 study of DS-1062a in patients (pts) with advanced solid tumors in the US and Japan (NCT03401385). Adult (age ≥20 years in Japan or ≥18 years in US) pts with measurable disease per RECIST v1.1 and sufficient tumor tissue sample for TROP2 measurement were eligible. Pts were excluded if they had multiple primary malignancies or untreated brain metastases. Endpoints included safety, pharmacokinetics, and efficacy. Results: As of November 16, 2018, 22 pts with advanced NSCLC were treated with DS-1062a at doses of 0.27-mg/kg (n = 4), 0.5-mg/kg (n = 5), 1.0-mg/kg (n = 7), and 2.0-mg/kg (n = 6). Overall, mean (standard deviation) treatment duration and cumulative dose were 7.8 (4.1) weeks and 181.8 (141.4) mg, respectively, with a median of 2 (range 1–6) cycles initiated. The majority (n = 18; 81.8%) of pts had ≥1 treatment-emergent adverse event (TEAE). The most common TEAE, fatigue (n = 9), was the only grade ≥3 treatment-related TEAE (n = 1; 2.0-mg/kg). Serious TEAEs, reported in 5 pts in the 0.27-mg/kg (n = 2), 0.5-mg/kg (n = 2), and 2.0-mg/kg (n = 1) cohorts, were not treatment-related. TEAEs leading to discontinuation occurred in 1 pt in the 0.27-mg/kg cohort (pleural effusion; not treatment-related). One pt died due to progressive disease. Peak concentration (Cmax) and area under the curve from time 0 to last measurable concentration (AUClast) increases were generally dose proportional. Of 18 tumor evaluable pts, 1 had a partial response (PR; 1.0-mg/kg), and 8 had stable disease (SD). Conclusions: DS-1062a was well tolerated at doses up to 2.0-mg/kg. An observable PR and multiple pts with SD warrant further evaluation of DS-1062a. The maximum tolerated dose has not been reached, and this study is ongoing. Clinical trial information: NCT03401385.
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Affiliation(s)
| | | | - Edward B. Garon
- David Geffen School of Medicine, University of California/TRIO-US Network, Los Angeles, CA
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Ishikura S, Nakabayashi T, Kobayashi F, Fukuma H, Shibamoto Y. EP-1145 Xerostomia and volume and CT number changes of parotid glands during IMRT for head and neck cancer. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31565-8] [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] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kitamoto Y, Kobayashi F, Suzuki T, Miyata Y, Kita H, Funaki K, Oi S. Investigation of the Lewis acidic behaviour of an oxygen-bridged planarized triphenylborane toward amines and the properties of their Lewis acid–base adducts. Dalton Trans 2019; 48:2118-2127. [PMID: 30667001 DOI: 10.1039/c8dt00128f] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Lewis acid behavior of an oxygen-bridged triphenylborane (1) to amines and the properties of Lewis acid–base adducts of 1 with amines have been investigated.
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Affiliation(s)
- Yuichi Kitamoto
- New Industry Creation Hatchery Center
- Tohoku University
- Sendai 980-8579
- Japan
| | - Fumiaki Kobayashi
- Advanced Technology Center
- Corporate R&D Headquarters
- Konica Minolta
- Inc
- Tokyo 192-8505
| | - Takatsugu Suzuki
- Advanced Technology Center
- Corporate R&D Headquarters
- Konica Minolta
- Inc
- Tokyo 192-8505
| | - Yasuo Miyata
- Advanced Technology Center
- Corporate R&D Headquarters
- Konica Minolta
- Inc
- Tokyo 192-8505
| | - Hiroshi Kita
- Advanced Technology Center
- Corporate R&D Headquarters
- Konica Minolta
- Inc
- Tokyo 192-8505
| | - Kenji Funaki
- Department of Biomolecular Engineering
- Graduate School of Engineering
- Tohoku University
- Sendai 980-8579
- Japan
| | - Shuichi Oi
- New Industry Creation Hatchery Center
- Tohoku University
- Sendai 980-8579
- Japan
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Orihara H, Harada Y, Kobayashi F, Sasaki Y, Fujii S, Satou Y, Goto Y, Nagaya T. Negative viscosity of a liquid crystal in the presence of turbulence. Phys Rev E 2019; 99:012701. [PMID: 30780349 DOI: 10.1103/physreve.99.012701] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Indexed: 06/09/2023]
Abstract
We report on the discovery of enormous negative viscosity in a nematic liquid crystal in the presence of turbulence induced by electric fields. As the negative viscosity in this system is so large, we are able to observe several phenomena originating from it. For example, we observe a spontaneous shear flow that rotates the upper disk of a rheometer, as well as the reversal of the rotational direction upon applying an external torque in the opposite direction. Hysteresis loops are also observed in the shear-stress-shear-rate curves, which is reminiscent of those seen for ferromagnetic and ferroelectric materials. The similarities between the phenomena observed for our system and ferroic materials are comprehensively demonstrated, although the two systems are fundamentally different in that the former is out of equilibrium. We elucidate the origin of the negative viscosity and propose a simple model that reproduces the phenomena observed in this active fluid.
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Affiliation(s)
- Hiroshi Orihara
- Division of Applied Physics, Hokkaido University, Sapporo 060-8628, Japan
| | - Yuko Harada
- Division of Applied Physics, Hokkaido University, Sapporo 060-8628, Japan
| | - Fumiaki Kobayashi
- Division of Applied Physics, Hokkaido University, Sapporo 060-8628, Japan
| | - Yuji Sasaki
- Division of Applied Physics, Hokkaido University, Sapporo 060-8628, Japan
| | - Shuji Fujii
- Division of Applied Physics, Hokkaido University, Sapporo 060-8628, Japan
| | - Yuki Satou
- Division of Electrical and Electronic Engineering, Oita University, Oita 870-1192, Japan
| | - Yoshitomo Goto
- Beppu University Junior College, Beppu 874-8501, Japan
- Division of Materials Science and Production Engineering, Oita University, Oita 870-1192, Japan
| | - Tomoyuki Nagaya
- Division of Electrical and Electronic Engineering, Oita University, Oita 870-1192, Japan
- Division of Materials Science and Production Engineering, Oita University, Oita 870-1192, Japan
- Division of Natural Sciences, Oita University, Oita 870-1192, Japan
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Amano R, Salamon P, Yokokawa S, Kobayashi F, Sasaki Y, Fujii S, Buka Á, Araoka F, Orihara H. Tunable two-dimensional polarization grating using a self-organized micropixelated liquid crystal structure. RSC Adv 2018; 8:41472-41479. [PMID: 35559295 PMCID: PMC9092010 DOI: 10.1039/c8ra08557a] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 10/16/2018] [Accepted: 12/03/2018] [Indexed: 11/21/2022] Open
Abstract
Utilization of the self-organizing nature of soft materials is promising for fabricating micro- and nano-structures, which can be applied for optics. Because of the high birefringence, liquid crystals are especially suitable for optoelectronic applications such as beam steering and polarization conversion. On the other hand, most self-organized patterns in liquid crystals are one-dimensional and there are only a few examples of two dimensional systems. Here we study the light diffraction from a micro-pixelated pattern of a nematic liquid crystal which is formed by self-organization of topological defects. We demonstrate that the system works as a tunable two dimensional optical grating, which splits the incident laser beam and changes the polarization property. The intensity can be controlled by electrical voltages, which cause extinction of the zeroth-order beam. The polarization properties depend on the location of spots. The numerical calculation and the theoretical analysis not only support the experimental results but also unveil the uniqueness of the pixelated structure. A micro-pixelated pattern of a nematic liquid crystal formed by self-organization of topological defects is shown to work as a tunable two-dimensional optical grating.![]()
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Affiliation(s)
- Reo Amano
- Division of Applied Physics, Faculty of Engineering, Hokkaido University North 13 West 8, Kita-ku Sapporo Hokkaido 060-8628 Japan +81 (0)11 7066642
| | - Péter Salamon
- Institute for Solid State Physics and Optics, Wigner Research Centre for Physics, Hungarian Academy of Sciences H-1525 Budapest P. O. Box 49 Hungary.,RIKEN Center for Emergent Matter Science (CEMS) 2-1 Hirosawa Wako, Saitama 351-0198 Japan
| | - Shunsuke Yokokawa
- Division of Applied Physics, Faculty of Engineering, Hokkaido University North 13 West 8, Kita-ku Sapporo Hokkaido 060-8628 Japan +81 (0)11 7066642
| | - Fumiaki Kobayashi
- Division of Applied Physics, Faculty of Engineering, Hokkaido University North 13 West 8, Kita-ku Sapporo Hokkaido 060-8628 Japan +81 (0)11 7066642
| | - Yuji Sasaki
- Division of Applied Physics, Faculty of Engineering, Hokkaido University North 13 West 8, Kita-ku Sapporo Hokkaido 060-8628 Japan +81 (0)11 7066642
| | - Shuji Fujii
- Division of Applied Physics, Faculty of Engineering, Hokkaido University North 13 West 8, Kita-ku Sapporo Hokkaido 060-8628 Japan +81 (0)11 7066642
| | - Ágnes Buka
- Institute for Solid State Physics and Optics, Wigner Research Centre for Physics, Hungarian Academy of Sciences H-1525 Budapest P. O. Box 49 Hungary
| | - Fumito Araoka
- RIKEN Center for Emergent Matter Science (CEMS) 2-1 Hirosawa Wako, Saitama 351-0198 Japan
| | - Hiroshi Orihara
- Division of Applied Physics, Faculty of Engineering, Hokkaido University North 13 West 8, Kita-ku Sapporo Hokkaido 060-8628 Japan +81 (0)11 7066642
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Kato M, Furuie H, Shimizu T, Miyazaki A, Kobayashi F, Ishizuka H. Single- and multiple-dose escalation study to assess pharmacokinetics, pharmacodynamics and safety of oral esaxerenone in healthy Japanese subjects. Br J Clin Pharmacol 2018; 84:1821-1829. [PMID: 29688582 DOI: 10.1111/bcp.13616] [Citation(s) in RCA: 36] [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] [Received: 11/06/2017] [Revised: 03/23/2018] [Accepted: 04/04/2018] [Indexed: 11/28/2022] Open
Abstract
AIMS To characterize the pharmacokinetics, pharmacodynamics and safety of esaxerenone, a mineralocorticoid receptor antagonist, in healthy adult Japanese men. METHODS Double-blind, placebo-controlled, sequential, dose-escalation studies were conducted in subjects randomized to receive oral once-daily esaxerenone (ranges: 5-200 mg [single-dose]; 10-100 mg over 10 days [multiple-dose]) or placebo under fasting conditions. Plasma concentrations were analysed by liquid chromatograph-tandem mass spectrometry. Pharmacokinetic parameters were determined by noncompartment analysis. Plasma/urine levels of pharmacodynamic biomarkers for mineralocorticoid receptor activity were evaluated. RESULTS In total, 48/48 and 39/40 subjects completed the single- and multiple-dose studies, respectively. Exposures were generally dose-proportional. The tmax , t1/2 and CL/F remained unchanged, independent of dose; the respective ranges were 1.5-4.0 h, 22.3-25.1 h, and 4.0-5.2 l h-1 (multiple-dose study). Vz /F ranged from 136.5 to 283.7 l in the multiple-dose study, and exposure reached steady state by day 4. The mean observed accumulation ratio, by dose, ranged from 1.36-1.98. The urinary Na+ /K+ ratio increased after single-dose administration; however, its relationship to the doses tested remains unclear. Plasma renin activity, active renin concentration and aldosterone concentration increased dose-dependently. Although blood potassium levels increased dose-dependently in the multiple-dose study (reaching a maximum mean ± standard deviation of 4.63 ± 0.354 mmol l-1 in the 100-mg group), no safety/tolerability-related problems were detected in either study. CONCLUSIONS Exposure levels in healthy adults receiving esaxerenone were generally dose-proportional. Dose-dependent changes in plasma pharmacodynamic biomarkers for the mineralocorticoid receptor were identified during multiple-dose treatment and support the pharmacological activity of esaxerenone. No important safety concerns were identified.
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Sands JM, Shimizu T, Garon EB, Greenberg J, Heist RS, Kobayashi F, Noguchi Y, Okajima D, Spira AI, Yamamoto N, Yamashita T, Lisberg AE. First-in-human phase 1 study of DS-1062a in patients (pts) with advanced solid tumors (AST). J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.tps2605] [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: 11/20/2022] Open
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Nakazawa R, Azuma N, Suzuki M, Nakatani M, Nankou T, Furuyoshi S, Yasuda A, Takata S, Tani N, Kobayashi F. A New Treatment for Dialysis-Related Amyloidosis with β 2-Microglobulin Adsorbent Column. Int J Artif Organs 2018. [DOI: 10.1177/039139889301601207] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Dialysis-related amyloidosis (DRA) is characterized by the presence of β 2-microglobulin (β 2-m) in the plasma. In order to eliminate β 2-m from the circulating blood, the β 2-m selective adsorbent for direct hemoperfusion (DHP) was developed. A DHP column (BM-01), containing 350 ml of the adsorbent, was subjected to clinical trials. The column was connected with a PAN (AN69) membrane dialyzer in series and used 3 times a week for 1 week (11 patients), 4 weeks (5 patients), 6 months (1 patient) and 12 months (2 patients). The percent reduction (%) of β 2-m was for 16 patients (for 1 or 4 weeks), more than 65, and for 3 patients (for more than 6 months), 76.5 ± 4.9, 73.5 ± 5.7, 72.2 ± 6.2. At the end of each session, β 2-m plasma levels were found to be below 10 mg/L, with 3.4 mg/L being the lowest. The total amounts of β 2-m removed were 172.5 ± 22.3, 257.0 ± 75.6, 157.6 ± 32.2 and 429.8 mg/session at max. Two out of these three patients had a favorable effect on joint symptoms and ocular fundus. It can be concluded that this selective adsorption therapy may delay the progression of DRA, and is worth considering for wide application.
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Affiliation(s)
| | - N. Azuma
- Tokatsu Clinic Hospital, Matsudo
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29
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Shindo K, Sato T, Satake A, Kurita N, Tsuchiya M, Ichinose Y, Hata T, Koh K, Yamashiro N, Kobayashi F, Nagasaka T, Takiyama Y. Skin vasomotor regulation in patients with multiple system atrophy. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2588] [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: 11/24/2022]
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Sako R, Kobayashi F, Aida N, Furusawa M, Muramatsu T. Response of porcine epithelial rests of Malassez to stimulation by interleukin-6. Int Endod J 2017; 51:431-437. [PMID: 28898425 DOI: 10.1111/iej.12862] [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: 06/15/2017] [Accepted: 09/07/2017] [Indexed: 11/28/2022]
Abstract
AIM To investigate the proliferation and migration of epithelial cell rests of Malassez (ERM) after stimulation with IL-6. METHODOLOGY Porcine-derived ERM were seeded on Dulbecco's modified Eagle's Medium, and IL-6 (100 pg mL-1 ) was incorporated into the culture medium. The WST-1 assay was performed to evaluate cell proliferation, and absorption was measured at 450 nm. A wound-healing assay and immunofluorescence assay for integrin α3 were conducted to investigate migration. The Kruskal-Wallis test and the Mann-Whitney U-test with Bonferroni correction were used to analyse data of WST-1 and wound-healing assays. RESULTS Cell proliferation following the stimulation by IL-6 increased over time, with a significant increase being observed at 6 h (P < 0.05), but not in a concentration-dependent manner. Cell proliferation was significantly greater in IL-6-treated ERM than in nontreated ERM (P < 0.05). The results of the wound-healing assay revealed earlier closure in IL-6-treated ERM (P < 0.05). In the immunofluorescence assay, integrin α3 was detected at the edge of cell processes adjacent to the wound area. A neutralized antibody abrogated the effects of the IL-6 stimulation in cell proliferation and migration. CONCLUSION IL-6 promoted the proliferation and migration of porcine ERM in vitro.
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Affiliation(s)
- R Sako
- Department of Endodontics, Tokyo Dental College, Tokyo, Japan
| | - F Kobayashi
- Department of Endodontics, Tokyo Dental College, Tokyo, Japan
| | - N Aida
- Department of Endodontics, Tokyo Dental College, Tokyo, Japan
| | - M Furusawa
- Department of Endodontics, Tokyo Dental College, Tokyo, Japan
| | - T Muramatsu
- Department of Operative Dentistry, Cariology and Pulp Biology, Tokyo Dental College, Tokyo, Japan
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Tajima N, Martinez A, Kobayashi F, He L, Dewland P. A phase 1 study comparing the proposed biosimilar BS-503a with bevacizumab in healthy male volunteers. Pharmacol Res Perspect 2017; 5:e00286. [PMID: 28357118 PMCID: PMC5368956 DOI: 10.1002/prp2.286] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [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: 11/18/2016] [Accepted: 11/24/2016] [Indexed: 11/11/2022] Open
Abstract
This is a randomized, double-blind, single-dose, parallel group phase 1 study to assess pharmacokinetic similarity, safety, and tolerability of BS-503a, a proposed bevacizumab biosimilar. A total of 114 male healthy subjects were randomized (1:1) to receive a single 3 mg/kg intravenous dose of either BS-503a or bevacizumab (Avastin®). Pharmacokinetic (PK) blood samples were collected up to Day 78, and serum drug concentrations were measured using a validated enzyme-linked immunosorbent assay. Pharmacokinetic similarity was evaluated using area under the serum concentration-time curve from zero to infinity (AUC inf) as a primary PK parameter, and maximum serum concentration (Cmax) and area under the serum concentration-time curve from zero to the last measurable time (AUC last) as secondary PK parameters. The 90% confidence intervals (CIs) of geometric mean ratio of AUC inf ranged 0.980-1.105, which met the predefined criteria of 0.80-1.25. The 90% CIs of geometric mean ratios for Cmax and AUC last were 1.009-1.125 and 0.982-1.096, respectively, falling into the same criteria. At least one drug-related treatment emergent adverse event occurred in 18 and 21 subjects treated with BS-503a and bevacizumab, respectively. The most common adverse events were headache, epistaxis, and rhinorrhea. Most adverse events were mild or moderate; however, one drug-related serious adverse event of duodenal ulcer perforation was reported by a subject 47 days after treatment of BS-503a. In conclusion, BS-503a was demonstrated to have highly similar PK to bevacizumab and adverse events observed were consistent with those observed for bevacizumab.
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Affiliation(s)
- Naoyuki Tajima
- Daiichi Sankyo Co., Ltd.1‐2‐58 HiromachiShinagawa‐kuTokyo140‐8710Japan
| | - Alberto Martinez
- Daiichi Sankyo Development Ltd.Chiltern Place, Chalfont ParkGerrards CrossSL9 0BGUnited Kingdom
| | - Fumiaki Kobayashi
- Daiichi Sankyo Co., Ltd.1‐2‐58 HiromachiShinagawa‐kuTokyo140‐8710Japan
| | - Ling He
- Daiichi Sankyo Pharma Development399 Thornall StreetEdisonNew Jersey08837
| | - Peter Dewland
- Daiichi Sankyo Development Ltd.Chiltern Place, Chalfont ParkGerrards CrossSL9 0BGUnited Kingdom
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Kobayashi F, Odake S, Miura T, Akuzawa R. Pasteurization and changes of casein and free amino acid contents of bovine milk by low-pressure CO2 microbubbles. Lebensm Wiss Technol 2016. [DOI: 10.1016/j.lwt.2016.03.042] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Iwamura M, Kobayashi F, Nozaki K. Effect of Substituents at the 4,7-Positions on the Structural Change Dynamics of Cu(I) Bis(phenanthroline) Complexes in the MLCT Excited State. CHEM LETT 2016. [DOI: 10.1246/cl.151018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Munetaka Iwamura
- Graduate School of Science and Engineering, University of Toyama
- Department of Chemistry, Faculty of Science, University of Toyama
| | | | - Koichi Nozaki
- Graduate School of Science and Engineering, University of Toyama
- Department of Chemistry, Faculty of Science, University of Toyama
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Shimada K, Kario K, Kushiro T, Teramukai S, Ishikawa Y, Kobayashi F, Saito I. Differences between clinic blood pressure and morning home blood pressure, as shown by Bland-Altman plots, in a large observational study (HONEST study). Hypertens Res 2015; 38:876-82. [PMID: 26246021 PMCID: PMC4675842 DOI: 10.1038/hr.2015.88] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2014] [Revised: 05/01/2015] [Accepted: 05/12/2015] [Indexed: 12/11/2022]
Abstract
When interpreting home blood pressure (BP) measurements in hypertensive patients, differences between clinic and home BP should be noted. To investigate the differences between clinic and morning home BP in hypertensive patients, we analyzed clinic systolic BP (CSBP) and morning home systolic BP (MHSBP) data from the large-scale observational HONEST (Home BP measurement with Olmesartan Naive patients to Establish Standard Target blood pressure) study (n=21 340), using BP measurements obtained before starting olmesartan administration. We generated Bland-Altman plots, with the horizontal axis representing mean CSBP and MHSBP ([CSBP+MHSBP]/2) and the vertical axis representing the difference between CSBP and MHSBP (CSBP-MHSBP). We also did simulation experiments to explore factors affecting the results of the Bland-Altman plots. The difference between CSBP and MHSBP increased as the mean of the two values increased, and when the mean of CSBP and MHSBP was close to 140 mm Hg, the difference was theoretically 0 in average, although large interindividual BP variability existed in this BP range. Results were unaffected by factors such as previous antihypertensive treatment, age and concomitant diabetes or chronic kidney disease. Bland-Altman plots generated from simulated data of normal distribution showed that the slope of the regression line sloped upward, consistent with the results of the HONEST study, when the interindividual BP variability of MHSBP was less than that of CSBP. In conclusion, differences between mean CSBP and MHSBP may be caused by large interindividual variability in CSBP. Therefore, the differences between MHSBP and CSBP may vary between patient groups, which should be noted in the management of hypertension.
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Affiliation(s)
| | - Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Japan
| | | | - Satoshi Teramukai
- Department of Biostatistics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
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Aida N, Ushikubo T, Kobayashi F, Sako R, Suehara M, Furusawa M, Muramatsu T. Actin stabilization induces apoptosis in cultured porcine epithelial cell rests of Malassez. Int Endod J 2015; 49:663-9. [PMID: 26118334 DOI: 10.1111/iej.12494] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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: 03/27/2015] [Accepted: 06/23/2015] [Indexed: 11/29/2022]
Abstract
AIM To test whether actin stabilization by jasplakinolide induces inhibition of cell viability and apoptosis in epithelial cell rests of Malassez (ERM). METHODOLOGY ERM derived from porcine were spread in a 96-well dish (5 × 10(4) /well) using Dulbecco's modified Eagle's medium. The actin-specific stabilization reagent, jasplakinolide, was incorporated into the culture medium and incubated for 24 h. To evaluate cell viability, the WST-1 assay was carried out and absorption (450 nm) was measured. To detect apoptotic cells, monoclonal antibody to single-strand DNA (ssDNA) was used and absorption (405 nm) was measured. Actin stabilization and apoptosis induced by jasplakinolide were morphologically investigated by staining with Alexa Fluor 568 phalloidin and observed under a fluorescent microscope. As a negative control, DMSO was used instead of jasplakinolide. Differences between the jasplakinolide-treated group and the control group were analysed statistically using the Student's t-test. RESULTS Cell viability decreased in a concentration-dependent manner, and cell viability in the jasplakinolide-treated ERM was lower than that in nontreated ERM (n = 16, P < 0.01). Apoptotic cells in the jasplakinolide-treated ERM were more frequently detected compared to that in nontreated ERM (n = 16, P < 0.01). Morphologically, shrinkage, irregular forms and fragmentation of nuclei suggesting apoptotic bodies were observed in jasplakinolide-treated ERM, whilst actin filaments were extended in non-treated ERM. CONCLUSION Actin stabilization by jasplakinolide inhibited cell viability and induced apoptosis in epithelial cell rests of Malassez.
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Affiliation(s)
- N Aida
- Department of Endodontics and Clinical Cariology, Tokyo Dental College, Tokyo, Japan
| | - T Ushikubo
- Department of Endodontics and Clinical Cariology, Tokyo Dental College, Tokyo, Japan
| | - F Kobayashi
- Department of Endodontics and Clinical Cariology, Tokyo Dental College, Tokyo, Japan
| | - R Sako
- Department of Endodontics and Clinical Cariology, Tokyo Dental College, Tokyo, Japan
| | - M Suehara
- Department of Endodontics and Clinical Cariology, Tokyo Dental College, Tokyo, Japan
| | - M Furusawa
- Department of Endodontics and Clinical Cariology, Tokyo Dental College, Tokyo, Japan
| | - T Muramatsu
- Department of Endodontics and Clinical Cariology, Tokyo Dental College, Tokyo, Japan
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Imai E, Ito S, Haneda M, Harada A, Kobayashi F, Yamasaki T, Makino H, Chan JCN. Effects of blood pressure on renal and cardiovascular outcomes in Asian patients with type 2 diabetes and overt nephropathy: a post hoc analysis (ORIENT-blood pressure). Nephrol Dial Transplant 2015; 31:447-54. [PMID: 26152402 PMCID: PMC4762397 DOI: 10.1093/ndt/gfv272] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [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: 01/03/2015] [Accepted: 06/09/2015] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Blood pressure (BP) control may have different effects on cardiovascular (CV) and renal outcomes in diabetes. We examined the impact of systolic BP (SBP) on renal and CV outcomes in a post hoc analysis in the Olmesartan Reducing Incidence of Endstage Renal Disease in Diabetic Nephropathy Trial. METHODS We stratified mean follow-up SBP into three categories (≤130, 131-140 and >140 mmHg) and used a Cox regression model to estimate the hazard ratio (HR, 95% confidence interval) for the outcomes. The composite renal outcome was doubling of serum creatinine, end-stage renal disease and all-cause death. The composite CV outcome included CV death, nonfatal stroke, nonfatal myocardial infarction, hospitalization for unstable angina or heart failure, revascularization and lower extremity amputation. We also compared the slope of estimated glomerular filtration rate (eGFR) in all three groups. RESULTS After a mean follow-up period of 3.2 years, the follow-up SBP was linearly associated with risk of renal outcomes in all 566 patients. In patients with heavy proteinuria (≥1 g/gCr), a follow-up SBP > 130 mmHg was associated with an HR of 2.33 (1.62-3.36) for renal outcomes with referent to SBP ≤ 130 mmHg. In patients without history of CV disease, a follow-up SBP > 140 mmHg was associated with an HR of 2.04 (1.23-3.40) for CV outcomes with referent to SBP < 140 mmHg. The median (interquartile range) slopes of eGFR were -3.27 (-6.90, -1.63), -4.53 (-8.08, -2.29) and -7.13 (-10.90, -3.99) dL/mg/year in patients with SBP ≤ 130, 131-140 and > 140 mmHg, respectively (P = 0.008 between ≤130 and 131-140, P < 0.001 between ≤ 130 and > 140 mmHg). CONCLUSION In Asian type 2 diabetic patients with chronic kidney disease and heavy proteinuria, reduction of SBP ≤ 130 mmHg was associated with greater renoprotection than cardioprotection. However, our results emphasize the need to individualize BP targets in type 2 diabetes.
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Affiliation(s)
- Enyu Imai
- Nakayamadera Imai Clinic, Takarazuka, Japan Department of Nephrology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Sadayoshi Ito
- Division of Nephrology, Endocrinology, and Vascular Medicine, Department of Clinical Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masakazu Haneda
- Second Department of Medicine, Asahikawa University of Medical Science, Asahikawa, Japan
| | | | | | | | - Hirofumi Makino
- Department of Medicine and Clinical Science, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Juliana C N Chan
- Department of Medicine and Therapeutics, Prince of Wales Hospital, Hong Kong Institute of Diabetes and Obesity, Chinese University of Hong Kong, Shatin, Hong Kong SAR, China Department of Medicine and Therapeutics, Prince of Wales Hospital, Li Ka Shing Institute of Health Science, Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
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Sasaki Y, Hoshikawa H, Seto T, Kobayashi F, Jampani VSR, Herminghaus S, Bahr C, Orihara H. Direct visualization of spatiotemporal structure of self-assembled colloidal particles in electrohydrodynamic flow of a nematic liquid crystal. Langmuir 2015; 31:3815-3819. [PMID: 25774695 DOI: 10.1021/acs.langmuir.5b00450] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Characterization of spatiotemporal dynamics is of vital importance to soft matter systems far from equilibrium. Using a confocal laser scanning microscopy, we directly reveal three-dimensional motion of surface-modified particles in the electrohydrodynamic convection of a nematic liquid crystal. Particularly, visualizing a caterpillar-like motion of a self-assembled colloidal chain demonstrates the mechanism of the persistent transport enabled by the elastic, electric, and hydrodynamic contributions. We also precisely show how the particles' trajectory is spatially modified by simply changing the surface boundary condition.
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Affiliation(s)
- Yuji Sasaki
- †Division of Applied Physics, Faculty of Engineering, Hokkaido University, North 13 West 8, Kita-ku, Sapporo, Hokkaido 060-8628, Japan
| | - Hikaru Hoshikawa
- †Division of Applied Physics, Faculty of Engineering, Hokkaido University, North 13 West 8, Kita-ku, Sapporo, Hokkaido 060-8628, Japan
| | - Takafumi Seto
- †Division of Applied Physics, Faculty of Engineering, Hokkaido University, North 13 West 8, Kita-ku, Sapporo, Hokkaido 060-8628, Japan
| | - Fumiaki Kobayashi
- †Division of Applied Physics, Faculty of Engineering, Hokkaido University, North 13 West 8, Kita-ku, Sapporo, Hokkaido 060-8628, Japan
| | - V S R Jampani
- ‡Max Planck Institute for Dynamics and Self-Organization (MPIDS), 37077 Göttingen, Germany
| | - Stephan Herminghaus
- ‡Max Planck Institute for Dynamics and Self-Organization (MPIDS), 37077 Göttingen, Germany
| | - Christian Bahr
- ‡Max Planck Institute for Dynamics and Self-Organization (MPIDS), 37077 Göttingen, Germany
| | - Hiroshi Orihara
- †Division of Applied Physics, Faculty of Engineering, Hokkaido University, North 13 West 8, Kita-ku, Sapporo, Hokkaido 060-8628, Japan
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Kobayashi F, Yamamoto M, Kitamura K, Asuka K, Kinoshita H, Matsunaga S, Abe SI. Desmin and Vimentin Expression during Embryonic Development of Tensor Veli Palatini Muscle in Mice. J HARD TISSUE BIOL 2015. [DOI: 10.2485/jhtb.24.134] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
| | | | | | - Kishi Asuka
- Division of Oral Anatomy, Department of Morphological Biology, Ohu University School of Dentistry
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Kanada-En’yo Y, Kobayashi F, Suhara T, Yoshida Y. Cluster features of stable and unstable nuclei in the p-shell region. EPJ Web of Conferences 2015. [DOI: 10.1051/epjconf/20158800023] [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: 11/15/2022] Open
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Affiliation(s)
| | - Fumiaki Kobayashi
- Japan Atomic Energy Research Institute, Tokai-mura, Naka-gun, Ibaraki 319-1195, Japan
| | - Toru Ogawa
- Japan Atomic Energy Research Institute, Tokai-mura, Naka-gun, Ibaraki 319-1195, Japan
| | - Kazuo Minato
- Japan Atomic Energy Research Institute, Tokai-mura, Naka-gun, Ibaraki 319-1195, Japan
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Kario K, Saito I, Kushiro T, Teramukai S, Ishikawa Y, Mori Y, Kobayashi F, Shimada K. Home blood pressure and cardiovascular outcomes in patients during antihypertensive therapy: primary results of HONEST, a large-scale prospective, real-world observational study. Hypertension 2014; 64:989-96. [PMID: 25156169 DOI: 10.1161/hypertensionaha.114.04262] [Citation(s) in RCA: 117] [Impact Index Per Article: 11.7] [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: 11/16/2022]
Abstract
UNLABELLED This study aimed to investigate the relationship between on-treatment morning home blood pressure (HBP) and incidence of cardiovascular events using data from the Home Blood Pressure Measurement With Olmesartan Naive Patients to Establish Standard Target Blood Pressure (HONEST) study, a prospective observational study of 21 591 outpatients with essential hypertension (mean age, 64.9 years; women, 50.6%) enrolled between 2009 and 2010 at clinics and hospitals in Japan. They received olmesartan-based treatment throughout. The primary end point was major cardiovascular events. After a mean follow-up period of 2.02 years, cardiovascular events occurred in 280 patients (incidence, 6.46/1000 patient-years). The risk for the primary end point was significantly higher in patients with on-treatment morning HBP ≥145 to <155 mm Hg (hazard ratio [HR], 1.83; 95% confidence interval [CI], 1.12-2.99) and ≥155 mm Hg (HR, 5.03; 95% CI, 3.05-8.31) than <125 mm Hg and with on-treatment clinic blood pressure ≥150 to <160 mm Hg (HR, 1.69; 95% CI, 1.10-2.60) and ≥160 mm Hg (HR, 4.38; 95% CI, 2.84-6.75) than <130 mm Hg. Morning HBP associated with minimum risk was 124 mm Hg by spline regression analysis. Cardiovascular risk was increased in patients with morning HBP ≥145 mm Hg and clinic blood pressure <130 mm Hg (HR, 2.47; 95% CI, 1.20-5.08) compared with morning HBP <125 mm Hg and clinic blood pressure <130 mm Hg. In conclusion, it is essential to control morning HBP to <145 mm Hg, even in patients with controlled clinic blood pressure. CLINICAL TRIAL REGISTRATION URL http://www.umin.ac.jp/ctr/index.htm. UMIN Clinical Trials Registry, trial No. UMIN000002567.
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Affiliation(s)
- Kazuomi Kario
- From the Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Japan (K.K.); Keio University, Yokohama, Japan (I.S.); The Life Planning Center Foundation, Tokyo, Japan (T.K.); Department of Biostatistics, Graduate School of Medical Science Kyoto Prefectural University of Medicine, Kyoto, Japan (S.T.); Daiichi Sankyo Co, Ltd, Tokyo, Japan (Y.I., Y.M., F.K.); and Shin-Oyama City Hospital, Oyama, Japan (K.S.).
| | - Ikuo Saito
- From the Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Japan (K.K.); Keio University, Yokohama, Japan (I.S.); The Life Planning Center Foundation, Tokyo, Japan (T.K.); Department of Biostatistics, Graduate School of Medical Science Kyoto Prefectural University of Medicine, Kyoto, Japan (S.T.); Daiichi Sankyo Co, Ltd, Tokyo, Japan (Y.I., Y.M., F.K.); and Shin-Oyama City Hospital, Oyama, Japan (K.S.)
| | - Toshio Kushiro
- From the Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Japan (K.K.); Keio University, Yokohama, Japan (I.S.); The Life Planning Center Foundation, Tokyo, Japan (T.K.); Department of Biostatistics, Graduate School of Medical Science Kyoto Prefectural University of Medicine, Kyoto, Japan (S.T.); Daiichi Sankyo Co, Ltd, Tokyo, Japan (Y.I., Y.M., F.K.); and Shin-Oyama City Hospital, Oyama, Japan (K.S.)
| | - Satoshi Teramukai
- From the Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Japan (K.K.); Keio University, Yokohama, Japan (I.S.); The Life Planning Center Foundation, Tokyo, Japan (T.K.); Department of Biostatistics, Graduate School of Medical Science Kyoto Prefectural University of Medicine, Kyoto, Japan (S.T.); Daiichi Sankyo Co, Ltd, Tokyo, Japan (Y.I., Y.M., F.K.); and Shin-Oyama City Hospital, Oyama, Japan (K.S.)
| | - Yusuke Ishikawa
- From the Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Japan (K.K.); Keio University, Yokohama, Japan (I.S.); The Life Planning Center Foundation, Tokyo, Japan (T.K.); Department of Biostatistics, Graduate School of Medical Science Kyoto Prefectural University of Medicine, Kyoto, Japan (S.T.); Daiichi Sankyo Co, Ltd, Tokyo, Japan (Y.I., Y.M., F.K.); and Shin-Oyama City Hospital, Oyama, Japan (K.S.)
| | - Yoshihiro Mori
- From the Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Japan (K.K.); Keio University, Yokohama, Japan (I.S.); The Life Planning Center Foundation, Tokyo, Japan (T.K.); Department of Biostatistics, Graduate School of Medical Science Kyoto Prefectural University of Medicine, Kyoto, Japan (S.T.); Daiichi Sankyo Co, Ltd, Tokyo, Japan (Y.I., Y.M., F.K.); and Shin-Oyama City Hospital, Oyama, Japan (K.S.)
| | - Fumiaki Kobayashi
- From the Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Japan (K.K.); Keio University, Yokohama, Japan (I.S.); The Life Planning Center Foundation, Tokyo, Japan (T.K.); Department of Biostatistics, Graduate School of Medical Science Kyoto Prefectural University of Medicine, Kyoto, Japan (S.T.); Daiichi Sankyo Co, Ltd, Tokyo, Japan (Y.I., Y.M., F.K.); and Shin-Oyama City Hospital, Oyama, Japan (K.S.)
| | - Kazuyuki Shimada
- From the Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Japan (K.K.); Keio University, Yokohama, Japan (I.S.); The Life Planning Center Foundation, Tokyo, Japan (T.K.); Department of Biostatistics, Graduate School of Medical Science Kyoto Prefectural University of Medicine, Kyoto, Japan (S.T.); Daiichi Sankyo Co, Ltd, Tokyo, Japan (Y.I., Y.M., F.K.); and Shin-Oyama City Hospital, Oyama, Japan (K.S.)
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Kario K, Saito I, Kushiro T, Teramukai S, Ishikawa Y, Kobayashi F, Shimada K. Effects of olmesartan-based treatment on masked, white-coat, poorly controlled, and well-controlled hypertension: HONEST study. J Clin Hypertens (Greenwich) 2014; 16:442-50. [PMID: 24766515 PMCID: PMC4237560 DOI: 10.1111/jch.12323] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [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: 11/11/2013] [Revised: 02/26/2014] [Accepted: 03/05/2014] [Indexed: 11/28/2022]
Abstract
The authors examined the effects of olmesartan‐based treatment on clinic systolic blood pressure (CSBP) and morning home systolic blood pressure (HSBP) in 21,340 patients with masked hypertension (MH), white‐coat hypertension (WCH), poorly controlled hypertension (PCH), and well‐controlled hypertension (CH) using data from the Home Blood Pressure Measurement With Olmesartan Naive Patients to Establish Standard Target Blood Pressure (HONEST) study. MH, WCH, PCH, and CH were defined using CSBP 140 mm Hg and MHSBP 135 mm Hg as cutoff values at baseline. At 16 weeks, the MH, WCH, PCH, and CH groups had changes in CSBP by −1.0, −15.2, −23.1, and 1.8 mm Hg, and changes in morning HSBP by −12.5, 1.0, −20.3, and 2.0 mm Hg, respectively. In conclusion, in “real‐world” clinical practice, olmesartan‐based treatment decreased high morning HBP or CBP without excessive decreases in normal morning HBP or CBP according to patients' BP status.
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Affiliation(s)
- Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University, School of Medicine, Tochigi, Japan
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Kobayashi F, Kuroki M. A new proportion measure of the treatment effect captured by candidate surrogate endpoints. Stat Med 2014; 33:3338-53. [PMID: 24782344 DOI: 10.1002/sim.6180] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [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: 08/14/2013] [Revised: 03/05/2014] [Accepted: 03/27/2014] [Indexed: 11/10/2022]
Abstract
The use of surrogate endpoints is expected to play an important role in the development of new drugs, as they can be used to reduce the sample size and/or duration of randomized clinical trials. Biostatistical researchers and practitioners have proposed various surrogacy measures; however, (i) most of these surrogacy measures often fall outside the range [0,1] without any assumptions, (ii) these surrogacy measures do not provide a cut-off value for judging a surrogacy level of candidate surrogate endpoints, and (iii) most surrogacy measures are highly variable; thus, the confidence intervals are often unacceptably wide. In order to solve problems (i) and (ii), we propose a new surrogacy measure, a proportion of the treatment effect captured by candidate surrogate endpoints (PCS), on the basis of the decomposition of the treatment effect into parts captured and non-captured by the candidate surrogate endpoints. In order to solve problem (iii), we propose an estimation method based on the half-range mode method with the bootstrap distribution of the estimated surrogacy measures. Finally, through numerical experiments and two empirical examples, we show that the PCS with the proposed estimation method overcomes these difficulties. The results of this paper contribute to the reliable evaluation of how much of the treatment effect is captured by candidate surrogate endpoints.
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Affiliation(s)
- Fumiaki Kobayashi
- Daiichi Sankyo Co., Ltd., Tokyo, Japan; The Graduate University for Advanced Studies, Tokyo, Japan
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Imai E, Haneda M, Yamasaki T, Kobayashi F, Harada A, Ito S, Chan JCN, Makino H. Effects of dual blockade of the renin-angiotensin system on renal and cardiovascular outcomes in type 2 diabetes with overt nephropathy and hypertension in the ORIENT: a post-hoc analysis (ORIENT-Hypertension). Hypertens Res 2013; 36:1051-9. [PMID: 24026038 PMCID: PMC3853587 DOI: 10.1038/hr.2013.86] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2012] [Revised: 03/15/2013] [Accepted: 04/24/2013] [Indexed: 01/13/2023]
Abstract
Combination therapy with angiotensin II receptor blockers and angiotensin-converting enzyme inhibitors (ACEIs) requires further evaluation in patients with diabetic nephropathy and hypertension. In a post hoc analysis of the Olmesartan Reducing Incidence of Endstage renal disease in diabetic Nephropathy Trial with hypertension, we examined the effects of olmesartan on renal and cardiovascular outcomes in the presence or absence of an ACEI. Among 563 patients randomized to receive either olmesartan (n = 280) or placebo (n = 283), 73.5% (n = 414) received a concomitant ACEI. Compared with placebo, olmesartan significantly reduced proteinuria in both the ACEI-treated and non-ACEI-treated groups. The respective changes in the urinary protein creatinine ratio in the olmesartan-treated and placebo-treated groups were -32.6% and +21.1% without an ACEI (P = 0.001) and -17.0% and +2.2% with an ACEI (P = 0.028). In the olmesartan group, 115 patients developed primary renal outcomes (41.1%) compared with 129 (45.6%) in the placebo group (hazard ratio (HR): 0.97, P = 0.787). The respective HRs in the ACEI-treated and non-ACEI-treated groups were 1.02 (P = 0.891) and 0.84 (P = 0.450). 40 olmesartan-treated patients (14.3%) and 53 placebo-treated patients (18.7%) developed secondary cardiovascular outcomes (HR: 0.65, P = 0.042). The respective HRs in the ACEI-treated and non-ACEI-treated groups were 0.69 (P = 0.129) and 0.51 (P = 0.129). Olmesartan was well tolerated. Dual blockade treatment caused more hyperkalemia than monotherapy. In patients with diabetic nephropathy and hypertension, olmesartan significantly reduced proteinuria, independent of ACEI treatment and cardiovascular outcome but failed to show additional renal benefit compared with ACEI treatment alone. The cardiovascular benefit of dual treatment requires further evaluation.
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Affiliation(s)
- Enyu Imai
- Nakayamadera Imai Clinic, Takarazuka, Japan
| | - Masakazu Haneda
- Second Department of Medicine, Asahikawa University of Medical Science, Asahikawa, Japan
| | - Tetsu Yamasaki
- Business Intelligence Division, Daiichi Sankyo, Tokyo, Japan
| | | | - Atsushi Harada
- Business Intelligence Division, Daiichi Sankyo, Tokyo, Japan
| | - Sadayoshi Ito
- Division of Nephrology, Endocrinology, and Vascular Medicine, Department of Clinical Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Juliana CN Chan
- Department of Medicine and Therapeutics, Hong Kong Institute of Diabetes and Obesity and Li Ka Shing Institute of Health Science, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR, China
| | - Hirofumi Makino
- Department of Medicine, Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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Shoda T, Futamura K, Kobayashi F, Saito H, Matsumoto K, Matsuda A. Cell type-dependent effects of corticosteroid on periostin production by primary human tissue cells. Allergy 2013; 68:1467-70. [PMID: 24118000 DOI: 10.1111/all.12240] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2013] [Indexed: 01/24/2023]
Abstract
Overproduction of periostin, an IL-13-inducible matricellular protein, despite corticosteroid treatment is thought to be involved in the chronicity of allergic inflammation seen in corticosteroid-refractory tissue fibrosis. Therefore, we hypothesized that some tissue cells must produce periostin in a corticosteroid-insensitive manner. Here, we show that IL-4 and IL-13 each induced comparable levels of periostin production by primary normal human fibroblasts and microvascular endothelial cells derived from lung and skin. Dexamethasone, a corticosteroid, completely inhibited IL-4/13-induced, but did not affect TGF-β-induced, periostin production by fibroblasts. In contrast, dexamethasone synergistically enhanced IL-4/13-induced periostin production by microvascular endothelial cells. TGF-β did not induce periostin production by microvascular endothelial cells. Our novel findings suggest that IL-4/13-induced microvascular endothelium-derived and/or TGF-β-induced fibroblast-derived periostin might play a pivotal role in corticosteroid-refractory tissue fibrosis, leading to chronic allergic inflammation in the lung and/or skin.
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Affiliation(s)
- T. Shoda
- Department of Health and Psychosocial Medicine; Aichi Medical University School of Medicine; Aichi
- Department of Allergy and Immunology; National Research Institute for Child Health and Development; Tokyo Japan
| | - K. Futamura
- Department of Allergy and Immunology; National Research Institute for Child Health and Development; Tokyo Japan
| | - F. Kobayashi
- Department of Health and Psychosocial Medicine; Aichi Medical University School of Medicine; Aichi
| | - H. Saito
- Department of Allergy and Immunology; National Research Institute for Child Health and Development; Tokyo Japan
| | - K. Matsumoto
- Department of Allergy and Immunology; National Research Institute for Child Health and Development; Tokyo Japan
| | - A. Matsuda
- Department of Allergy and Immunology; National Research Institute for Child Health and Development; Tokyo Japan
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Imai E, Haneda M, Chan JCN, Yamasaki T, Kobayashi F, Ito S, Makino H. Reduction and residual proteinuria are therapeutic targets in type 2 diabetes with overt nephropathy: a post hoc analysis (ORIENT-proteinuria). Nephrol Dial Transplant 2013; 28:2526-34. [PMID: 24013685 DOI: 10.1093/ndt/gft249] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Proteinuria is a major predictor for progression of renal disease, including diabetic nephropathy. In a post hoc analysis of the ORIENT, a double-blinded randomized trial of 566 type 2 diabetic patients with nephropathy, we examined the risk association of composite renal outcome [end-stage renal disease, ESRD, doubling of serum creatinine (SCr) and death] with baseline, change and residual urinary protein/creatinine ratio (UPCR). METHODS We estimated the hazard ratios (HRs) with 95% confidence interval (CI) of composite renal outcome with baseline UPCR (low <1.0 g/gCr; moderate ≥ 1.0 g/gCr, <3.0 g/gCr and high ≥ 3.0 g/gCr) as well as percentage reduction of UPCR (Δ) (worsening: <0%; moderate: ≥ 0%, <30% and high ≥ 30%) and residual UPCR at 24 weeks (remission <1.0 g/gCr; moderate ≥ 1.0 g/gCr, <3.0 g/gCr and heavy ≥ 3.0 g/gCr). RESULTS Compared with the low group with baseline UPCR < 1.0 g/gCr, the respective HRs with 95% CI in the moderate and high UPCR groups were 3.02 (1.76-5.19) and 9.24 (5.43-15.73). Compared with patients with a worsening UPCR (<0%) at 24 weeks, the HR was 0.54 (0.39-0.74) in those with ≥ 0%, <30% ΔUPCR and 0.43 (0.31-0.61) in those with ≥ 30% ΔUPCR. Compared with the remission at 24 weeks, the HR was 2.12 (1.28-3.49) in moderate residual proteinuria and 4.59 (2.74-7.69) in heavy residual proteinuria. Compared with patients with residual UPCR ≥ 1.0 g/gCr and ΔUPCR <30%, the HR in those with ΔUPCR ≥ 30% and residual UPCR<1.0 g/gCr was 0.38 (0.22-0.64). CONCLUSIONS In patients with type 2 diabetes and overt nephropathy, over 30% reduction of UPCR compared with baseline and/or residual UPCR<1.0 g/gCr at 24 weeks predicted renoprotection. These values may be used as targets to guide anti-proteinuric and renoprotective therapy in diabetic nephropathy. TRIAL REGISTRATION ClinicalTrials.gov NCT00141453.
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Affiliation(s)
- Enyu Imai
- Nakayamadera Imai Clinic, Takarazuka, Hyogo, Japan
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Kario K, Saito I, Kushiro T, Teramukai S, Mori Y, Hiramatsu K, Kobayashi F, Shimada K. Enhanced blood pressure-lowering effect of olmesartan in hypertensive patients with chronic kidney disease-associated sympathetic hyperactivity: HONEST study. J Clin Hypertens (Greenwich) 2013; 15:555-61. [PMID: 23889717 PMCID: PMC3884768 DOI: 10.1111/jch.12132] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [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: 03/04/2013] [Revised: 04/09/2013] [Accepted: 04/12/2013] [Indexed: 01/12/2023]
Abstract
To investigate the blood pressure (BP)–lowering effect of olmesartan in relation to chronic kidney disease (CKD)–associated sympathetic nerve activity, a subanalysis was performed using data from the first 16 weeks of the Home BP Measurement With Olmesartan‐Naive Patients to Establish Standard Target Blood Pressure (HONEST) study, a prospective observational study of hypertensive patients. Essential hypertensive patients who took no antihypertensive agent at baseline were classified based on baseline morning home systolic BP (MHSBP) in quartiles. In each class, patients were further classified based on baseline morning home pulse rate (MHPR). A subgroup analysis in patients with/without chronic kidney disease (CKD) was performed. A total of 5458 patients (mean age, 63.0 years; 51.6% women) were included. In the 4th quartile of baseline MHSBP (≥165 mm Hg), patients with MHPR ≥70 beats per minute had a greater BP reduction (by 3.2 mm Hg) than those with MHPR <70 beats per minute after 16 weeks of olmesartan‐based treatment (P=.0005). An even greater BP reduction (by 6.6 mm Hg) was observed in patients with CKD than in patients without CKD in this group (P=.0084). Olmesartan was more effective in hypertensive patients with high MHSBP and MHPR ≥70 beats per minute, especially in patients with CKD. Olmesartan may have enhanced BP‐lowering effects by improving renal ischemia in hypertensive CKD patients with potential increased sympathetic nerve activity.
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Affiliation(s)
- Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Japan.
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Mori Y, Nishikawa Y, Kobayashi F, Hiramatsu K. Clinical status and outcome of Japanese heart failure patients with reduced or preserved ejection fraction treated with carvedilol. Int Heart J 2013; 54:15-22. [PMID: 23428919 DOI: 10.1536/ihj.54.15] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [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: 11/18/2022]
Abstract
The effect of beta-blockers in treating Japanese heart failure (HF) patients with preserved left ventricular (LV) ejection fraction (EF) is unclear. This prospective observational study enrolled 1,682 Japanese HF patients who received carvedilol for the first time. Patients were followed for a mean of 1.6 years. The 1,492 patients with baseline LVEF measurements were allocated to the following groups: reduced EF (LVEF < 40%; n = 724), borderline EF (LVEF 4050%; n = 355), and preserved EF (LVEF ≥ 50%; n = 413). Baseline characteristics, New York Heart Association (NYHA) class, change in B-type natriuretic peptide (BNP) level, and long-term outcome were compared among the groups. Patients with preserved EF were more likely to be older, female, and have ischemic etiology and hypertension than patients with reduced EF. Carvedilol maintenance dosage was lower in patients with preserved EF (7.9 mg/day versus 6.6 mg/ day). NYHA class and BNP level were lower in patients with preserved EF at baseline but improved to the same level in all groups at 6 months. After adjusting for baseline characteristics, the hazard ratio for death or hospitalization due to cardiovascular disease in patients with preserved EF versus those with reduced EF was 1.031 (P = 0.847). This study elucidated the characteristics of HF patients given carvedilol in "real world" clinical settings. A comparative controlled study is necessary to elucidate whether the improvements in NYHA and BNP as well as the outcome profile observed in patients with preserved EF were caused by the favorable effects of carvedilol.
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Affiliation(s)
- Yoshihiro Mori
- Department of Post-Marketing Studies Management, Daiichi Sankyo Co., Ltd., Tokyo, Japan
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Yamagishi K, Iso H, Kokubo Y, Saito I, Yatsuya H, Ishihara J, Inoue M, Tsugane S, Sobue T, Hanaoka T, Ogata J, Baba S, Mannami T, Okayama A, K. Y, Miyakawa K, Saito F, Koizumi A, Sano Y, Hashimoto I, Ikuta T, Tanaba Y, Miyajima Y, Suzuki N, Nagasawa S, Furusugi Y, Nagai N, Sanada H, Hatayama Y, Kobayashi F, Uchino H, Shirai Y, Kondo T, Sasaki R, Watanabe Y, Miyagawa Y, Kobayashi Y, Machida M, Kishimoto Y, Takara E, Fukuyama T, Kinjo M, Irei M, Sakiyama H, Imoto K, Yazawa H, Seo T, Seiko A, Ito F, Shoji F, Saito R, Murata A, Minato K, Motegi K, Fujieda T, Abe T, Katagiri M, Suzuki M, Matsui K, Doi M, Terao A, Ishikawa Y, Tagami T, Doi H, Urata M, Okamoto N, Ide F, Sueta H, Sakiyama H, Onga N, Takaesu H, Uehara M, Horii F, Asano I, Yamaguchi H, Aoki K, Maruyama S, Ichii M, Takano M, Matsushima S, Natsukawa S, Akabane M, Konishi M, Okada K, Honda Y, Sakurai KYS, Tsuchiya N, Sugimura H, Tsubono Y, Kabuto M, Tominaga S, Iida M, Ajiki W, Ioka A, Sato S, Yasuda N, Nakamura K, Kono S, Suzuki K, Takashima Y, Yoshida M, Maruyama E, Yamaguchi M, Matsumura Y, Sasaki S, Watanabe S, Kadowaki T, Noda M, Mizoue T, Kawaguchi Y, Shimizu H. Dietary intake of saturated fatty acids and incident stroke and coronary heart disease in Japanese communities: the JPHC Study. Eur Heart J 2013; 34:1225-32. [DOI: 10.1093/eurheartj/eht043] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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