scholarly journals Overview of MIGS

2020 ◽  
pp. 1-10
Author(s):  
Jing Wang ◽  
Keith Barton
Keyword(s):  
Side Effects ◽  
Invasive Surgery ◽  
Glaucoma Surgery ◽  
The Other ◽  
Filtering Surgery ◽  
Potential Utility ◽  
Early Glaucoma ◽  
Aqueous Shunt ◽  
Favourable Safety ◽  
Favourable Safety Profile

Abstract The term, minimally- or micro-invasive glaucoma surgery (MIGS), has entered common ophthalmic parlance and is playing an increasing role in the management of glaucoma patients. In common, the devices and procedures referred to are safer, less tissue invasive and associated with faster recovery than traditional filtering surgery, such as trabeculectomy or aqueous shunt implantation. MIGS can be categorized according to the tissue they target (or bypass): trabecular meshwork (TM) MIGS, subconjunctival MIGS, suprachoroidal MIGS and newer cycloablation procedures. A number of MIGS devices and techniques (e.g. TM MIGS) have relatively modest efficacy, but potential utility in a very large group of glaucoma patients with disease that is insufficiently severe to justify the invasiveness of conventional filtration surgery and the consequent intensity of postoperative care yet, burdened with medication and the attendant side effects and compliance issues thereof. On the other hand, subconjunctival MIGS devices, which are associated with bleb-related complications, can potentially achieve efficacy approaching that of traditional filtering surgery and are appropriate in selected individuals when larger IOP reductions are required, the exception being cases where glaucoma is very advanced. This book covers the techniques that are most commonly regarded as eligible to sit under the MIGS umbrella. Irrespective of the modest efficacy of many MIGS devices and techniques, the favourable safety profile lowers the threshold for early glaucoma surgery, especially when combined with cataract surgery, potentially delaying the requirement for more invasive surgery and associated risks.

scholarly journals Risks associated with oral deferiprone in the treatment of infratentorial superficial siderosis

2019 ◽  
Vol 267 (1) ◽  
pp. 239-243 ◽  
Author(s):  
Y. Sammaraiee ◽  
G. Banerjee ◽  
S. Farmer ◽  
B. Hylton ◽  
P. Cowley ◽  
...  
Keyword(s):  
Side Effects ◽  
Case Series ◽  
Iron Chelator ◽  
Superficial Siderosis ◽  
Neutropenic Sepsis ◽  
Favourable Safety ◽  
Favourable Safety Profile ◽  
Life Threatening ◽  
The Mean ◽  
Mean Time

Abstract Objective Deferiprone is an iron chelator that has recently been used to treat patients with infratentorial superficial siderosis (iSS). It is considered to have a generally favourable safety profile but concerns have been raised due to the risk of agranulocytosis. We aimed to evaluate the safety and tolerability of oral deferiprone as a treatment for patients with iSS. Methods We present a case series of 10 consecutive patients presenting with classical iSS treated with deferiprone. Results Ten patients were followed up for a mean period of 2.3 years (range 0.5–5.5 years). Four patients (40%) were withdrawn from treatment because of treatment-related side effects. The reasons for treatment discontinuation were neutropenic sepsis (n = 3) and fatigue (n = 1). In 2 out of the 3 cases of neutropenic sepsis, patients initially developed neutropenia without sepsis. The mean time to neutropenic sepsis following deferiprone was 1.2 years (range 0.3–2.5) with mean neutrophil count of 0.4 (range 0.3–0.5). Six patients (60%) reported no change in neurological function while on treatment, and four patients (40%) reported that their condition deteriorated. Conclusions Deferiprone was poorly tolerated, with 40% of patients withdrawing from treatment, most commonly due to neutropenic sepsis, after an average of 2 years on treatment. This study increases the number of reported cases of agranulocytosis in patients with iSS treated with deferiprone. Clinicians treating iSS patients with deferiprone should be aware that this drug has a potentially life-threatening side effect of neutropenic sepsis, and should ensure that appropriate haematological monitoring is in place.

scholarly journals Ibrexafungerp: A First-in-Class Oral Triterpenoid Glucan Synthase Inhibitor

2021 ◽  
Vol 7 (3) ◽  
pp. 163 ◽  
Author(s):  
Sabelle Jallow ◽  
Nelesh P. Govender
Keyword(s):  
Pathogenic Fungi ◽  
Candida Spp ◽  
Fungal Cell ◽  
Favourable Safety ◽  
Favourable Safety Profile ◽  
Synthase Inhibitor ◽  
Increased Activity ◽  
In Vitro Data

Ibrexafungerp (formerly SCY-078 or MK-3118) is a first-in-class triterpenoid antifungal or “fungerp” that inhibits biosynthesis of β-(1,3)-D-glucan in the fungal cell wall, a mechanism of action similar to that of echinocandins. Distinguishing characteristics of ibrexafungerp include oral bioavailability, a favourable safety profile, few drug–drug interactions, good tissue penetration, increased activity at low pH and activity against multi-drug resistant isolates including C. auris and C. glabrata. In vitro data has demonstrated broad and potent activity against Candida and Aspergillus species. Importantly, ibrexafungerp also has potent activity against azole-resistant isolates, including biofilm-forming Candida spp., and echinocandin-resistant isolates. It also has activity against the asci form of Pneumocystis spp., and other pathogenic fungi including some non-Candida yeasts and non-Aspergillus moulds. In vivo data have shown IBX to be effective for treatment of candidiasis and aspergillosis. Ibrexafungerp is effective for the treatment of acute vulvovaginal candidiasis in completed phase 3 clinical trials.

scholarly journals Possible Future Monoclonal Antibody (mAb)-Based Therapy against Arbovirus Infections

2013 ◽  
Vol 2013 ◽  
pp. 1-21 ◽  
Author(s):  
Giuseppe Sautto ◽  
Nicasio Mancini ◽  
Giacomo Gorini ◽  
Massimo Clementi ◽  
Roberto Burioni
Keyword(s):  
Monoclonal Antibody ◽  
Monoclonal Antibodies ◽  
Side Effects ◽  
Antiviral Activity ◽  
The Other ◽  
Viral Escape ◽  
Passive Immunotherapy ◽  
Medical Need

More than 150 arboviruses belonging to different families are known to infect humans, causing endemic infections as well as epidemic outbreaks. Effective vaccines to limit the occurrence of some of these infections have been licensed, while for the others several new immunogens are under development mostly for their improvements concerning safety and effectiveness profiles. On the other hand, specific and effective antiviral drugs are not yet available, posing an urgent medical need in particular for emergency cases. Neutralizing monoclonal antibodies (mAbs) have been demonstrated to be effective in the treatment of several infectious diseases as well as in preliminaryin vitroandin vivomodels of arbovirus-related infections. Given their specific antiviral activity as well-tolerated molecules with limited side effects, mAbs could represent a new therapeutic approach for the development of an effective treatment, as well as useful tools in the study of the host-virus interplay and in the development of more effective immunogens. However, before their use as candidate therapeutics, possible hurdles (e.g., Ab-dependent enhancement of infection, occurrence of viral escape variants) must be carefully evaluated. In this review are described the main arboviruses infecting humans and candidate mAbs to be possibly used in a future passive immunotherapy.

scholarly journals Einsatz von Secukinumab bei Patienten mit Psoriasis und Psoriasis-Arthritis – Ergebnisse einer nichtinterventionellen Studie unter Praxisbedingungen (SERENA-Studie)

2021 ◽  
pp. 1-3
Author(s):  
Michael Sticherling
Keyword(s):  
Observational Study ◽  
Real World ◽  
Human Monoclonal Antibody ◽  
Rapid Onset ◽  
Onset Of Action ◽  
The Real ◽  
Interleukin 17A ◽  
Favourable Safety ◽  
Favourable Safety Profile

<b>Introduction:</b> Secukinumab, a fully human monoclonal antibody that directly inhibits interleukin-17A, has demonstrated robust efficacy in the treatment of moderate to severe psoriasis (PsO), psoriatic arthritis (PsA) and ankylosing spondylitis (AS), with a rapid onset of action, sustained long-term clinical responses and a consistently favourable safety profile across phase 3 trials. Here, we report the clinical data at enrolment from SERENA, designed to investigate the real-world use of secukinumab across all three indications. <b>Methods:</b> SERENA is an ongoing, longitudinal, observational study conducted at 438 sites across Europe in patients with moderate to severe plaque PsO, active PsA or active AS. Patients should have received at least 16 weeks of secukinumab treatment before enrolment in the study. <b>Results:</b> Overall 2800 patients were included in the safety set; patients with PsA (N = 541) were older than patients with PsO (N = 1799) and patients with AS (N =  460); patients with PsO had a higher mean body weight than patients with PsA and patients with AS; and patients with PsO and patients with AS were predominantly male. Time since diagnosis was longer in patients with PsO compared with patients with PsA and patients with AS, and about 40% of patients were either current or former smokers. The proportion of obese patients (body mass index ≥ 30 kg/m<sup>2</sup>) was similar across indications. Patients were treated with secukinumab for a mean duration of 1 year prior to enrolment (range 0.89–1.04). The percentages of patients with prior biologics exposure were 31.5% PsO, 59.7% PsA and 55% AS. The percentages of patients prescribed secukinumab monotherapy were 75% (n =  1349) in PsO, 48.2% (n = 261) in PsA and 48.9% (n = 225) in AS groups. <b>Conclusion:</b> Baseline demographics of the study population are consistent with existing literature. This large observational study across all secukinumab indications will provide valuable information on the long-term effectiveness and safety of secukinumab in the real-world setting.

scholarly journals Assessment of Live Candidate Vaccines for Paratuberculosis in Animal Models and Macrophages

2009 ◽  
Vol 78 (3) ◽  
pp. 1383-1389 ◽  
Author(s):  
Gabriella M. Scandurra ◽  
Geoffrey W. de Lisle ◽  
Sonia M. Cavaignac ◽  
May Young ◽  
R. Pamela Kawakami ◽  
...  
Keyword(s):  
Side Effects ◽  
Bacterial Load ◽  
Economic Effect ◽  
Cost Effective ◽  
The Other ◽  
Murine Models ◽  
Initial Screening ◽  
Vaccine Candidates ◽  
Allelic Exchange ◽  
Potential Vaccine

ABSTRACT Mycobacterium avium subsp. paratuberculosis (basonym M. paratuberculosis) is the causative agent of paratuberculosis, a chronic enteritis of ruminants. To control the considerable economic effect that paratuberculosis has on the livestock industry, a vaccine that induces protection with minimal side effects is required. We employed transposon mutagenesis and allelic exchange to develop three potential vaccine candidates, which were then tested for virulence with macrophages, mice, and goats. All three models identified the WAg906 mutant as being the most attenuated, but some differences in the levels of attenuation were evident among the models when testing the other strains. In a preliminary mouse vaccine experiment, limited protection was induced by WAg915, as evidenced by a reduced bacterial load in spleens and livers 12 weeks following intraperitoneal challenge with M. paratuberculosis K10. While we found macrophages and murine models to be rapid and cost-effective alternatives for the initial screening of M. paratuberculosis mutants for attenuation, it appears necessary to do the definitive assessment of attenuation with a ruminant model.

Beta-Blocker Attenuates Cardiotoxicity Related Anthracycline Usage

2021 ◽  
Vol 104 (8) ◽  
pp. 1389-1392
Keyword(s):  
Side Effects ◽  
Cancer Therapy ◽  
Mortality Rate ◽  
Cancer Patients ◽  
Beta Blocker ◽  
The Other ◽  
Large Numbers ◽  
Therapy Effectiveness ◽  
Chemotherapy Agents

To summarize the recent trials and studies of the role of beta-blocker on the treatment for cancer patients treated with anthracycline to decrease morbidity and mortality rate. Good management of cancer will result in large numbers of cancer survivors. On the other hand, cancer therapy also has side effects, one of which is cardiotoxicity. Cardiotoxicity could reduce therapy effectiveness, hence, increase disease progression and mortality rate. Anthracyclines is one of the chemotherapy agents with cardiotoxicity as a side effect. Beta-blocker has the ability to reduce cardiotoxicity due to anthracyclines usage. Keywords: Beta-blocker; Cardiotoxicity; Anthracyclines

A trial construction of high durability railway viaducts with local aggregates

2019 ◽  
Author(s):  
Kotaro Kawamura ◽  
Joe Takemura ◽  
Shigenobu Iguchi ◽  
Tsutomu Yoshida ◽  
Masashi Kobayashi
Keyword(s):  
Fly Ash ◽  
Side Effects ◽  
Portland Cement ◽  
Ordinary Portland Cement ◽  
The Other ◽  
Strength Concrete ◽  
High Durability ◽  
Sound Barrier ◽  
Early Strength ◽  
Structural Measure

<p>We are carrying out a construction project of new railroad viaducts. These new railroad viaducts are constructing using about 110,000 m<span>3</span> volume concrete. In this construction place, it is difficult for us to get low ASR-reactive aggregates and it is expected to be supplied with snowmelt water on the viaducts in winter. Then we tested ASR-reactive these local aggregates and found an effective mixed ratio of fly-ash is 20% of cement. On the other hand, various side effects were also expected by using fly-ash. For example, initial cracking due to contraction, early strength concrete, bleeding, etc. Therefore, we repeated various tests and examined and carried out a method that could ensure the same construction method and quality as when using ordinary Portland cement, even with fly-ash. Also, we adopted a structure that is unlikely to be affected by rainwater as a structural measure. For example, the entire adoption of a ramen type viaduct that has eliminated bearings, adoption of FRP sound barrier, etc. Then we made it possible to build highly durable railway viaducts by these various measures of materials and structures.</p>

scholarly journals Durvalumab in NSCLC: latest evidence and clinical potential

2018 ◽  
Vol 10 ◽  
pp. 175883591880415 ◽  
Author(s):  
Nerea Muñoz-Unceta ◽  
Isabel Burgueño ◽  
Elizabeth Jiménez ◽  
Luis Paz-Ares
Keyword(s):  
Cytotoxic T Lymphocyte ◽  
Checkpoint Inhibitors ◽  
Survival Rates ◽  
Progression Free Survival ◽  
Phase Iii ◽  
Significant Activity ◽  
Unresectable Stage ◽  
Favourable Safety ◽  
Favourable Safety Profile ◽  
Nsclc Patients

Advances in immunotherapy have led to radical improvements in outcomes, including overall survival, such as in non-small cell lung cancer (NSCLC) patients with metastatic disease treated with immune checkpoint inhibitors. More recently, promising results have been obtained in earlier disease settings, and combinations with other therapies are being actively investigated. Durvalumab, a monoclonal antibody directed against the programmed death ligand 1, has demonstrated significant activity in NSCLC, including increased progression-free survival rates after chemoradiation for unresectable stage III disease, with a favourable safety profile. Clinical trials, including phase III studies, are ongoing as monotherapy and in combination with chemotherapy, radiotherapy and other immunotherapies, such as the anti-cytotoxic T-lymphocyte antigen 4 drug tremelimumab, in diverse stages of the disease.

A Double-Blind Comparative Clinical Trial of Floctafenine and Four Other Analgesics Conducted in General Practice

1976 ◽  
Vol 4 (3) ◽  
pp. 179-182 ◽  
Author(s):  
D M Lomas ◽  
J Gay ◽  
R N Midha ◽  
D L Postlethwaite
Keyword(s):  
Clinical Trial ◽  
General Practice ◽  
Side Effects ◽  
Analgesic Effect ◽  
Rank Order ◽  
Controlled Trial ◽  
The Other ◽  
Double Blind ◽  
Comparative Clinical Trial

Three hundred and twelve patients suffering from painful conditions were admitted to a multicentre, double-blind controlled trial, conducted in general practice in which five analgesics—floctafenine (Idarac), paracetamol, aspirin, dihydrocodeine and pentazocine—were compared. Overall ratings of analgesic effect placed floctafenine first in rank order. Floctafenine was statistically significantly superior in effect to pentazocine but not to the other three agents as far as doctor ratings were concerned; and superior to both pentazocine and dihydrocodeine in the opinion of patients. Fewer patients experienced side-effects on floctafenine than on the other four analgesics and this difference between floctafenine and pentazocine, and floctafenine and dihydrocodeine was statistically significant.

The Other Face of the Moon: Side Effects, Interactions and Molecules of Concerns

2017 ◽  
pp. 141-176
Author(s):  
Chiara Di Lorenzo ◽  
Aymeric Dopter ◽  
Sarah Vecchio ◽  
Saskia Lüde ◽  
Francesca Colombo ◽  
...  
Keyword(s):  
Side Effects ◽  
The Other ◽  
The Moon
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