Will a once-weekly anticoagulant for the treatment and secondary prevention of thromboembolism improve adherence?

2009 ◽  
Vol 101 (03) ◽  
pp. 422-427 ◽  
Author(s):  
Louise Maillardet ◽  
Yshai Yavin ◽  
Alexander T. Cohen
Keyword(s):  
Secondary Prevention ◽  
Depressive Disorders ◽  
Term Treatment ◽  
Bisphosphonate Treatment ◽  
Weekly Administration ◽  
Once Daily ◽  
New Anticoagulants ◽  
Improved Outcomes ◽  
Long Term Treatment

SummaryOral anticoagulation, most commonly with warfarin once daily, has long been the main form of long-term treatment and secondary prevention of thromboembolism. The efficacy of warfarin has been established in clinical trials, but problems with unstable anticoagulation with international normalized ratios (INRs) outside the recommended range due to incorrect dosing, drug and food interactions, and with adherence and persistence have been reported in practice. Poor adherence and persistence are serious problems because they result in out-of-range INRs. Many new thromboembolic events, such as strokes, occur when INRs are out-of-range or after warfarin discontinuation. Among the new anticoagulants currently being investigated, some offer the possibility of more stable anticoagulation and weekly administration. Less frequent dosing schedules generally improve adherence. In many cases, such as bisphosphonate treatment for osteoporosis, and the long-term treatment of depressive disorders or multiple sclerosis, adherence to, and persistence with, weekly dosing is improved compared with daily dosing, and most patients prefer weekly dosing. The advent of novel anticoagulants such as idraparinux with its long half-life offers hope for improved adherence with anticoagulation, and ultimately improved outcomes.

scholarly journals Successful Long-term Treatment with Once-daily Injection of Low-dose Octreotide in an Aged Patient with Insulinoma

2005 ◽  
Vol 52 (5) ◽  
pp. 629-634 ◽  
Author(s):  
Takuyuki KATABAMI ◽  
Hiroyuki KATO ◽  
Naoko SHIRAI ◽  
Satoru NAITO ◽  
Nobuhiko SAITO
Keyword(s):  
Low Dose ◽  
Term Treatment ◽  
Daily Injection ◽  
Aged Patient ◽  
Once Daily ◽  
Long Term Treatment

Once-daily fondaparinux monotherapy without warfarin for long-term treatment of venous thromboembolism

2007 ◽  
Vol 98 (12) ◽  
pp. 1384-1386 ◽  
Author(s):  
Ranjith Shetty ◽  
Ali Seddighzadeh ◽  
Sudha Parasuraman ◽  
Neelima Vallurupalli ◽  
Marie Gerhard Herman ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Term Treatment ◽  
Once Daily ◽  
Long Term Treatment

Long-term treatment with finasteride induces apoptosis and pathological changes in female mice

2019 ◽  
Vol 38 (7) ◽  
pp. 762-774 ◽  
Author(s):  
AA Alkahtane ◽  
G Albasher ◽  
NK Al-Sultan ◽  
WS Alqahtani ◽  
S Alarifi ◽  
...  
Keyword(s):  
Serum Levels ◽  
Term Treatment ◽  
Androgenetic Alopecia ◽  
High Dose ◽  
Histopathological Analysis ◽  
Once Daily ◽  
Female Mice ◽  
Long Term Treatment ◽  
High Doses

Androgenetic alopecia is the most common type of alopecia, and it affects humans of both genders. Finasteride is a type II selective 5α-reductase inhibitor that is administered orally to treat androgenetic alopecia and benign prostatic hyperplasia in human males. However, its effect on the vital organs of females is unknown. This study was designed to investigate the effects of finasteride on the vital organs such as liver, kidney, and heart of female mice. To study the prospective effects of finasteride, female mice were orally administered two doses of finasteride (0.5 and 1.5 mg/kg) once daily for 35 days, and serum levels of various biochemical parameters and histopathology of various organs were examined. The results showed that serum levels of alkaline phosphatase were significantly increased by both high- and low-dose finasteride, whereas cholesterol was significantly increased by the high dose only. Creatine kinase was significantly increased by the high and low doses, whereas glucose was significantly decreased by both doses. Histopathological analysis and DNA damage assays showed that finasteride has adverse effects within both the short and the long periods in female mice. In addition, the proapoptotic genes Bax and caspase-3 were significantly increased by high dose finasteride, whereas the antiapoptotic gene Bcl-2 was significantly decreased by the low and high doses. In conclusion, finasteride is not currently approved for therapeutic use in females, and the findings in this study suggest caution in any future consideration of such use.

Bisphosphonate-induced osteonecrosis of the ear canal: our experience and a review of the literature

2018 ◽  
Vol 132 (4) ◽  
pp. 372-374 ◽  
Author(s):  
L McCadden ◽  
C G Leonard ◽  
W J Primrose
Keyword(s):  
Side Effects ◽  
Acid Treatment ◽  
Osteonecrosis Of The Jaw ◽  
Term Treatment ◽  
External Ear ◽  
Bisphosphonate Treatment ◽  
Review Of The Literature ◽  
Ear Canal ◽  
Long Term Treatment

AbstractBackground:Oesophageal disorders and osteonecrosis of the jaw are recognised complications of the commonly prescribed medication bisphosphonate. Despite these diagnoses being seen comparatively frequently within the ENT clinic, osteonecrosis of the external ear is a less well reported complication.Methods:The current literature is reviewed and our experience with six cases of bisphosphonate-related ear canal osteonecrosis is presented.Results:Six cases were identified as suffering from ear canal osteonecrosis as a result of bisphosphonate treatment. One of our cases suffered bilateral ear canal osteonecrosis after only 20 months of oral alendronic acid treatment. Management ranged from bisphosphonate cessation and topical treatment, to surgical debridement in the operating theatre.Conclusion:Bisphosphonate-related ear canal osteonecrosis is undoubtedly under-diagnosed. For such a commonly prescribed medication, the risks and side effects of bisphosphonate should be better known and long-term treatment should be avoided if possible.

Low-molecular-weight heparin in the acute and long-term treatment of deep vein thrombosis

2003 ◽  
Vol 89 (04) ◽  
pp. 674-680 ◽  
Author(s):  
Milena Gebska ◽  
Zbigniew Kadziola ◽  
Neelam Saba ◽  
Pilar Carrasco ◽  
Vijay Kakkar ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Term Treatment ◽  
Low Molecular Weight ◽  
Once Daily ◽  
Vein Thrombosis ◽  
Long Term Treatment ◽  
Group A ◽  
Group B ◽  
Deep Vein

SummaryLow molecular weight heparins (LMWHs) are frequently used during acute treatment of deep vein thrombosis, but their utility for long-term treatment needs to be defined.In this multi-centre trial, 378 patients with acute deep vein thrombosis were randomised to intravenous unfractionated heparin (group A), once daily subcutaneous LMWH (bemiparin) for one week (group B) or once daily bemiparin in a therapeutic dose for one week followed by a maintenance dose for 12 weeks (group C).Fifty-two per cent of patients in group A, 72% of group B and 72% of group C showed venographic reduction in thrombus size assessed objectively on day 14; 20% greater improvement in group B and C indicates not only non-inferiority of bemiparin (p = 0.00003) but also superiority (p = 0.004) compared to UFH. Day 84 venographic or Doppler sonographic recanalisation of the affected veins was demonstrated in 75.3%, 79.8% and 81.5% in groups A, B and C respectively. Mortality, recurrent thromboembolic events and bleeding were similar in the three groups.Both bemiparin regimens were more effective than UFH in reducing thrombus size during the acute phase of treatment. The efficacy in terms of recurrence of venous thromboembolism and safety of Bemiparin is similar to UFH. Bemiparin is also an effective alternative to warfarin for long-term treatment.

Near-Infrared Imaging Reveals Site- and Age-Specific Localization of Bisphosphonate Delivery and Retention in Model of Osteogenesis Imperfecta

2009 ◽  
Author(s):  
Kenneth M. Kozloff ◽  
Leo I. Volakis ◽  
Joan C. Marini ◽  
Michelle S. Caird
Keyword(s):  
Osteogenesis Imperfecta ◽  
Near Infrared ◽  
Bending Strength ◽  
Infrared Imaging ◽  
Term Treatment ◽  
Bisphosphonate Treatment ◽  
Long Term Treatment ◽  
Prevention Of Osteoporosis

Bisphosphonate use has expanded beyond traditional applications, such as the prevention of osteoporosis, into non-traditional pediatric low bone mass diseases including osteogenesis imperfecta (OI) [1]. Despite enthusiasm, some questions remain on the overall effectiveness and implications of long-term treatment. In the Brtl/+ mouse model for OI, bisphosphonate treatment improves bone size, but bending strength fails to increase to proportionate levels and bones remain brittle [2]. Complications associated with long-term bisphosphonate treatment have been noted in other systems [3,4] leading to a need for critical information describing local drug-cell interactions responsible for these observations. The purpose of this study was to validate a fluorescent bisphosphonate analog, far-red fluorescent pamidronate (FRFP) [5] as a biomarker of bisphosphonate deposition and retention in vivo to monitor local drug concentration in a site-specific manner.

Course of NTX changes under continuous bisphosphonate treatment in cases of NTX over-reduction due to long-term treatment with bisphosphonates

2011 ◽  
Vol 16 (1) ◽  
pp. 71-76 ◽  
Author(s):  
Kousuke Iba ◽  
Koichi Sasaki ◽  
Takuro Wada ◽  
Toshihiko Yamashita ◽  
Junichi Takada
Keyword(s):  
Term Treatment ◽  
Bisphosphonate Treatment ◽  
Long Term Treatment
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