New drugs for hypertension – variations on old themes

1991 ◽  
Vol 29 (6) ◽  
pp. 21-22
Keyword(s):  
Calcium Antagonists ◽  
Plasma Lipids ◽  
Arterial Disease ◽  
New Drugs ◽  
Converting Enzyme ◽  
First Line ◽  
Treatment Of Hypertension ◽  
Adrenergic Blockers ◽  
The Impact

Alpha-adrenergic blockers, calcium antagonists and some angiotensin-converting enzyme (ACE) inhibitors are now promoted as first-line drugs for the treatment of hypertension, competing with the traditional choices of β-adrenergic blockers and diuretics. The older drugs have established long-term benefits, but have some theoretical disadvantages and sometimes unwanted effects. No trials have looked at the impact of these new drugs on cardiovascular disease; studies of their efficacy have examined only immediate outcome measures such as blood pressure, and their effects on other risk factors for arterial disease such as plasma lipids. Choosing a drug for the initial treatment of hypertension has therefore become more difficult. We discuss here a new α-blocker and three recently marketed calcium antagonists.

scholarly journals Review of Treatment Options for the Management of Advanced Stage Hodgkin Lymphoma

Cancers ◽  
2021 ◽  
Vol 13 (15) ◽  
pp. 3745
Author(s):  
Hélène Vellemans ◽  
Marc P. E. André
Keyword(s):  
Hodgkin Lymphoma ◽  
New Drugs ◽  
Western World ◽  
Tumor Control ◽  
Advanced Stage ◽  
Line Treatment ◽  
First Line ◽  
Remission Rates ◽  
The Impact ◽  
First Line Treatment

Hodgkin lymphoma (HL) is a lymphoid-type hematologic disease that is derived from B cells. The incidence of this lymphoid malignancy is around 2–3/100,000/year in the western world. Long-term remission rates are linked to a risk-adapted approach, which allows remission rates higher than 80%. The first-line treatment for advanced stage classical HL (cHL) widely used today is doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) or escalated bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPPesc) chemotherapy. Randomized studies comparing these two regimens and a recently performed meta-analysis have demonstrated consistently better disease control with BEACOPPesc. However, this treatment is not the standard of care, as there is an excess of acute hematological toxicities and therapy-related myeloid neoplasms. Moreover, there is a recurrent controversy concerning the impact on overall survival with this regimen. More recently, new drugs such as brentuximab vedotin and checkpoint inhibitors have become available and have been evaluated in combination with doxorubicin, vinblastine, and dacarbazine (AVD) for the first-line treatment of patients with advanced cHL with the objective of tumor control improvement. There are still major debates with respect to first-line treatment of advanced cHL. The use of positron emission tomography-adapted strategies has allowed a reduction in the toxicity of chemotherapy regimens. Incorporation of new drugs into the treatment algorithms requires confirmation.

scholarly journals The impact of antihypertensives on kidney disease

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 611 ◽  
Author(s):  
Diego F Marquez ◽  
Gema Ruiz-Hurtado ◽  
Luis Ruilope
Keyword(s):  
Blood Pressure ◽  
Kidney Disease ◽  
Angiotensin Receptor Blocker ◽  
Channel Blocker ◽  
Enzyme Inhibitor ◽  
New Drugs ◽  
Converting Enzyme ◽  
Angiotensin Receptor ◽  
Positive Data ◽  
The Impact

Arterial hypertension and chronic kidney disease (CKD) are intimately related. The control of blood pressure (BP) levels is strongly recommended in patients with CKD in order to protect the kidney against the accompanying elevation in global cardiovascular (CV) risk. Actually, the goal BP in patients with CKD involves attaining values <140/90 mmHg except if albuminuria is present. In this case, it is often recommended to attain values <130/80 mmHg, although some guidelines still recommend <140/90 mmHg. Strict BP control to values of systolic BP around 120 mmHg was recently shown to be safe in CKD according to data from the SPRINT trial, albeit more data confirming this benefit are required. Usually, combination therapy initiated with an angiotensin receptor blocker (ARB) or angiotensin-converting enzyme inhibitor (ACEi) and commonly followed by the addition of a calcium channel blocker and a diuretic is needed. Further studies are required as well as new drugs in particular after the positive data obtained from new oral anti-diabetic drugs.

scholarly journals Longitudinal study of the impact of three major regulations on the Korean pharmaceutical industry in the last 30 years

2022 ◽  
Vol 20 (1) ◽  
Author(s):  
Seung In Um ◽  
Uy Dong Sohn ◽  
Sun-Young Jung ◽  
Seung-Hun You ◽  
Changone Kim ◽  
...  
Keyword(s):  
Pharmaceutical Industry ◽  
Patent System ◽  
Sustainable Growth ◽  
New Drugs ◽  
Regulatory Policies ◽  
Study Results ◽  
Short Period ◽  
Before And After ◽  
The Impact

Abstract Background The pharmaceutical industry is heavily regulated. Partly for this reason, new drugs generally take over 10 years from the product development stage to market entry. Although regulations affect the pharmaceutical industry over a long period, previous studies investigating the impact of new regulatory policies have usually focused on the short period before and after implementing that policy. Therefore, the purpose of this study is to examine whether and how significantly regulatory policies affect long-term innovation in the pharmaceutical industry in Korea. Methods This study focused on three significant regulatory policies: the introduction of the product patent system, changes in the Good Manufacturing Practice (GMP) system, and the Drug Expenditure Rationalization Plan (DERP). The study used interrupted time series (ITS) analysis to investigate the long-term impacts of the policies before and after implementation. Results Our results show that introducing the product patent system in 1987 significantly increased the number of Korean patent applications. The effect of the revised GMP policies was also statistically significant, both before and after implementation and between pre-emptive companies and non-pre-emptive ones. However, due to the companies' negotiations with the regulatory authorities or the regulatory system that links drug approval and price evaluation, the DERP did not significantly delay new drug registration in Korea. Conclusion This study showed that the policies of the product patent system, GMP policies, and DERP regulations have significantly encouraged pharmaceutical companies to strive to meet regulatory requirements and promote innovation in Korea. The study suggests that it is necessary for companies to pre-emptively respond to systemic changes in development and production strategies to deal with regulatory changes and achieve sustainable growth. Also, our study results indicate that since government policies motivate the innovative system of the pharmaceutical industry, governmental authorities, when formulating pharmaceutical policies, need to consider the impact on the long-term innovation of the industry.

Importance of Achieving a Complete Response in Multiple Myeloma, and the Impact of Novel Agents

2010 ◽  
Vol 28 (15) ◽  
pp. 2612-2624 ◽  
Author(s):  
Asher A. Chanan-Khan ◽  
Sergio Giralt
Keyword(s):  
Multiple Myeloma ◽  
Overall Survival ◽  
Prognostic Significance ◽  
Complete Response ◽  
Maximal Response ◽  
Prognostic Impact ◽  
Long Term Outcomes ◽  
First Line ◽  
The Impact

The goal of treatment for multiple myeloma (MM) is to improve patients' long-term outcomes. One important factor that has been associated with prolonged progression-free and overall survival is the quality of response to treatment, particularly achievement of a complete response (CR). There is extensive evidence from clinical studies in the transplant setting in first-line MM demonstrating that CR or maximal response post-transplant is significantly associated with prolonged progression-free and overall survival, with some studies demonstrating a similar association with postinduction response. Supportive evidence is also available from studies in the nontransplant and relapsed settings. With the introduction of bortezomib, thalidomide, and lenalidomide, higher rates of CR are being achieved in both first-line and relapsed MM compared with previous chemotherapeutic approaches, thereby potentially improving long-term outcomes. While standard CR by established response criteria has been shown to have differential prognostic impact compared with lesser responses, increasingly sensitive analytic techniques are now being explored to define more stringent degrees of CR or elimination of minimal residual disease (MRD), including multiparameter flow cytometry and polymerase chain reaction. Demonstrating eradication of MRD by these techniques has already been shown to predict for improved outcomes. Here, we review the prognostic significance of achieving CR in MM and highlight the importance of CR as an increasingly realizable goal at all stages of treatment. We discuss clinical management issues and provide recommendations relevant to practicing oncologists, such as the routine use of sensitive techniques for assessment of disease status to inform evidence-based decisions on optimal patient management.

scholarly journals Sterilizing Activity of Novel TMC207- and PA-824-Containing Regimens in a Murine Model of Tuberculosis

2011 ◽  
Vol 55 (12) ◽  
pp. 5485-5492 ◽  
Author(s):  
Rokeya Tasneen ◽  
Si-Yang Li ◽  
Charles A. Peloquin ◽  
Dinesh Taylor ◽  
Kathy N. Williams ◽  
...  
Keyword(s):  
Murine Model ◽  
Building Blocks ◽  
Drug Combinations ◽  
New Drugs ◽  
Drug Resistant ◽  
First Line ◽  
Duration Of Treatment ◽  
Resistant Tuberculosis ◽  
Novel Drug

ABSTRACTTo truly transform the landscape of tuberculosis treatment, novel regimens containing at least 2 new drugs are needed to simplify the treatment of both drug-susceptible and drug-resistant forms of tuberculosis. As part of an ongoing effort to evaluate novel drug combinations for treatment-shortening potential in a murine model, we performed two long-term, relapse-based experiments. In the first experiment, TMC207 plus pyrazinamide, alone or in combination with any third drug, proved superior to the first-line regimen including rifampin, pyrazinamide, and isoniazid. On the basis of CFU counts at 1 month, clofazimine proved to be the best third drug combined with TMC207 and pyrazinamide, whereas the addition of PA-824 was modestly antagonistic. Relapse results were inconclusive due to the low rate of relapse in all test groups. In the second experiment evaluating 3-drug combinations composed of TMC207, pyrazinamide, PA-824, moxifloxacin, and rifapentine, TMC207 plus pyrazinamide plus either rifapentine or moxifloxacin was the most effective, curing 100% and 67% of the mice treated, respectively, in 2 months of treatment. Four months of the first-line regimen did not cure any mice, whereas the combination of TMC207, PA-824, and moxifloxacin cured 50% of the mice treated. The results reveal new building blocks for novel regimens with the potential to shorten the duration of treatment for both drug-susceptible and drug-resistant tuberculosis, including the combination of TMC207, pyrazinamide, PA-824, and a potent fluoroquinolone.

scholarly journals Implications of a Soy-Based Diet for Animal Models

2021 ◽  
Vol 22 (2) ◽  
pp. 774
Author(s):  
Justine Dhot ◽  
Valentine Prat ◽  
Marine Ferron ◽  
Virginie Aillerie ◽  
Angélique Erraud ◽  
...  
Keyword(s):  
Animal Models ◽  
Diastolic Dysfunction ◽  
Low Cost ◽  
New Drugs ◽  
Male Rats ◽  
Absolute Requirement ◽  
Diet Versus ◽  
Bias Attention ◽  
The Impact

The use of animal models in fundamental or pre-clinical research remains an absolute requirement for understanding human pathologies and developing new drugs. In order to transpose these results into clinical practice, many parameters must be taken into account to limit bias. Attention has recently been focused on the sex, age or even strain of each animal, but the impact of diet has been largely neglected. Soy, which is commonly used in the diet in varying quantities can affect their physiology. In order to assess whether the presence of soy can impact the obtained results, we studied the impact of a soy-based diet versus a soy-free diet, on diastolic function in a rat model based on transgenic overexpression of the β3-adrenergic receptors in the endothelium and characterized by the appearance of diastolic dysfunction with age. Our results show that the onset of diastolic dysfunction is only observed in transgenic male rats fed with a soy-free diet in the long term. Our study highlights the importance of the diet’s choice in the study design process, especially regarding the proportion of soy, to correctly interpret the outcome as low-cost diets are more likely to be highly concentrated in soy.

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