Comparison of a Once Daily Long-Acting Formulation of Propranolol with Conventional Propranolol Given Twice Daily in Patients with Mild to Moderate Hypertension

1979 ◽  
Vol 7 (3) ◽  
pp. 221-223 ◽  
Author(s):  
A P Douglas-Jones
Keyword(s):  
Clinical Response ◽  
Patient Compliance ◽  
Moderate Hypertension ◽  
Dosage Schedule ◽  
Once Daily ◽  
Significant Difference ◽  
Long Acting

The effect of conventional propranolol tablets given twice daily has been compared with an equivalent dosage of a long-acting formulation of propranolol ('Inderal’ LA)p given once daily in twenty-nine patients with mild to moderate hypertension. The study lasted 10 weeks. There was no significant difference in clinical response to the two treatments which were equally effective and well tolerated. A once daily dosage schedule should greatly aid patient compliance.

Antihypertensive Effect of Oxprenolol and Chlorthalidone in Fixed Combination, Given Once Daily

1979 ◽  
Vol 7 (6) ◽  
pp. 519-523 ◽  
Author(s):  
R Buoninconti ◽  
M Motolese ◽  
M Rubegni
Keyword(s):  
Clinical Response ◽  
Patient Compliance ◽  
Moderate Hypertension ◽  
Antihypertensive Effect ◽  
Fixed Combination ◽  
Once Daily ◽  
Patient Study ◽  
Treatment Regimes ◽  
Significant Difference ◽  
Single Blind

In a multicentre, single-blind, within-patient study, the effectiveness and tolerability of the fixed combination oxprenolol 80 mg + chlorthalidone 10 mg per tablet given once daily, compared to the well established b.i.d. schedule, has been investigated in forty out-patients with mild to moderate hypertension. After a two-weeks placebo wash-out, twenty patients were given 1 tablet b.i.d. of the fixed combination for 4 weeks and thereafter 2 tablets once-daily for a further 4 weeks; the remaining twenty patients were given the fixed combination in the reverse order. There was no significant difference in clinical response between the two treatment regimes, which were equally effective and well tolerated. However, patient compliance might be considerably improved with the once-daily dosage schedule of the fixed combination.

scholarly journals Prospective, randomized double blind comparative study of safety and efficacy of carvedilol versus atenolol in patients of mild to moderate hypertension

2017 ◽  
Vol 6 (7) ◽  
pp. 1678
Author(s):  
Swathi Ratnam R. ◽  
Usha Kiran P. ◽  
S. V. R. Rajasekhar ◽  
M. Prasad Naidu
Keyword(s):  
Blood Pressure ◽  
Moderate Hypertension ◽  
Treatment Phase ◽  
Study Groups ◽  
Response To Therapy ◽  
Double Blind ◽  
Once Daily ◽  
Significant Difference ◽  
The Mean ◽  
Atenolol Group

Background: Carvedilol is a new cardiovascular compound with the combined pharmacologic properties of nonselective ß-blockade and vasodilation. The Aim of the study was to compare the safety and antihypertensive efficacy of 25mg Carvedilol once daily with 50mg atenolol once daily in patients with mild to moderate essential hypertension.Methods: This was a single center study conducted in Rangaraya Medical College, Kakinada. 80 eligible patients with mild to moderate hypertension were randomized to receive 25mg Carvedilol once daily (40 patients) or 50mg atenolol (40 patients) in a double-blind 12-week treatment phase. At each visit 0, 4, 8 and 12 weeks of treatment, sitting Blood Pressure (BP) and heart rate were measured. The effect on BP reduction within the group is compared by paired “t”test and the effect on reduction of BP between two study groups compared by unpaired “t”test.Results: After 12 weeks of treatment, the mean reduction of SBP (Systolic Blood Pressure) with carvedilol is 22.33±8.31mmHg with no Significant difference (p >0.05) compared to atenolol group mean reduction in SBP of 21.37±10mm Hg. The mean reduction in DBP (Diastolic Blood Pressure) after completion of the study in carvedilol group is 6.75±4.82mm Hg with no Significant difference (p >0.05) compared to atenolol group mean reduction in DBP of 8.55±5.25mm Hg. No significant difference seen in the efficacy parameters of both the drugs. The incidence of adverse effects such as bradycardia, headache, nausea, vomiting, hypotension and rash is less with carvedilol.Conclusions: In patients with mild to moderate hypertension, there was no statistically significant difference between efficacy of carvedilol or atenolol with regard to the degree of reduction in BP or the percentage of patients achieving a response to therapy but carvedilol showed a better safety profile when compared to atenolol.

A Study of Once Daily Tenormin (Atenolol) in Hypertension: Some Implications in Patient Compliance

1976 ◽  
Vol 4 (5) ◽  
pp. 347-351 ◽  
Author(s):  
A M Harris ◽  
K V Woollard ◽  
J A Tweed
Keyword(s):  
Blood Pressure ◽  
Drug Therapy ◽  
Clinical Study ◽  
Side Effects ◽  
Patient Compliance ◽  
Pressure Control ◽  
Once Daily ◽  
Hypertensive Patients ◽  
Significant Difference ◽  
Pre Treatment

A clinical study is described in which hypertensive patients on no drug therapy were given atenolol in increasing doses from 50 mg twice daily to 200 mg twice daily until the diastolic blood pressure was 90 mm Hg or below. At this stage the drug was withdrawn until blood pressure readings had risen to pre-treatment levels. The same dose of atenolol was then re-introduced but now given once-a-day (in the morning) and was continued for four weeks. Of the eleven patients entering the study, one withdrew as his blood pressure was not controlled on a dose of 200 mg of atenolol twice daily, and another because on withdrawal of atenolol his blood pressure did not rise to pre-treatment levels. The remaining nine patients completed the study. There was a statistically significant fall in blood pressure on both atenolol regimes and there was no significant difference between the blood pressure control achieved on twice-a-day and once-a-day administration. Only one patient developed side-effects; this being an asthmatic who developed mild dyspnoea on atenolol which did not necessitate withdrawal of the drug. It is concluded that once-a-day administration of a given dose of atenolol is therapeutically equivalent to twice-a-day administration. The implications of this in terms of better patient compliance, and thus better prognosis, are discussed.

PHARMACOKINETICS AND PHARMACODYNAMICS OF BAMBUTEROL, A LONG-ACTING BRONCHODILATOR PRO-DRUG OF TERBUTALINE, IN YOUNG AND ELDERLY PATIENTS WITH ASTHMA

PEDIATRICS ◽  
1994 ◽  
Vol 94 (2) ◽  
pp. 264-264
Author(s):  
Alan Kamada
Keyword(s):  
Elderly Patients ◽  
Biochemical Changes ◽  
Pharmacokinetics And Pharmacodynamics ◽  
Once Daily ◽  
Significant Difference ◽  
Clinically Significant ◽  
Long Acting ◽  
Elderly Asthmatics

A significant difference in the disposition of bambuterol is present between young and elderly asthmatics. This observation and the necessity for dosage adjustments requires further study in elderly asthmatics. Biochemical changes were not considered clinically significant. Bambuterol appears to offer the possibility of once-daily therapy in asthmatics.

scholarly journals Revefenacin, a once-daily, long-acting muscarinic antagonist, for nebulized maintenance therapy in patients with chronic obstructive pulmonary disease

2021 ◽  
Author(s):  
Christopher Hvisdas
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Adverse Events ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Suitable Alternative ◽  
Once Daily ◽  
Muscarinic Antagonist ◽  
Significant Difference ◽  
Long Acting

Abstract Disclaimer In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose This article reviews the efficacy and safety of revefenacin, the first once-daily, long-acting muscarinic antagonist, when delivered via a standard jet nebulizer in patients with chronic obstructive pulmonary disease (COPD). Summary Revefenacin 175 µg is indicated for the maintenance treatment of patients with moderate to very severe COPD. Preclinical studies showed that revefenacin is a potent and selective antagonist with similar affinity for the different subtypes of muscarinic receptor (M1-M5). Furthermore, prevention of methacholine- and acetylcholine-induced bronchoconstrictive effects was dose dependent and lasted longer than 24 hours, demonstrating a long duration of action. In phase 2 and 3 trials, treatment with revefenacin was demonstrated to result in statistical improvements in pulmonary function (≥100 mL, P < 0.05) vs placebo, including among patients with markers of more severe disease and those who received concomitant long-acting β-agonists or long-acting β-agonists together with inhaled corticosteroids. Revefenacin was also demonstrated to have efficacy similar to that of tiotropium. The clinical trial findings indicated no significant difference between revefenacin and tiotropium with regard to rates of adverse events. Overall, revefenacin was well tolerated, with COPD worsening/exacerbation, dyspnea, headache, and cough among the most common adverse events noted in the clinical trials. Conclusions Revefenacin treatment delivered via nebulization led to improvements in lung function in patients with COPD. It was also generally well tolerated with no major safety concerns. Revefenacin provides a viable treatment option for patients with COPD and may be a suitable alternative for those with conditions that may impair proper use of traditional handheld inhalers.

scholarly journals Short-Course Versus Long-Course Colistin for Treatment of Carbapenem-Resistant A.baumannii in Cancer Patient

Antibiotics ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 484
Author(s):  
Wasan Katip ◽  
Suriyon Uitrakul ◽  
Peninnah Oberdorfer
Keyword(s):  
Clinical Response ◽  
Cancer Patients ◽  
Therapy Group ◽  
University Hospital ◽  
P Value ◽  
Chiang Mai ◽  
Carbapenem Resistant ◽  
Short Course ◽  
Significant Difference ◽  
Long Course

Carbapenem-resistant Acinetobacter baumannii (CRAB) is one of the most commonly reported nosocomial infections in cancer patients and could be fatal because of suboptimal immune defenses in these patients. We aimed to compare clinical response, microbiological response, nephrotoxicity, and 30-day mortality between cancer patients who received short (<14 days) and long (≥14 days) courses of colistin for treatment of CRAB infection. A retrospective cohort study was conducted in cancer patients with CRAB infection who received short or long courses of colistin between 2015 to 2017 at Chiang Mai University Hospital (CMUH). A total of 128 patients met the inclusion criteria. The results of this study show that patients who received long course of colistin therapy had a higher rate of clinical response; adjusted odds ratio (OR) was 3.16 times in patients receiving long-course colistin therapy (95%CI, 1.37–7.28; p value = 0.007). Microbiological response in patients with long course was 4.65 times (adjusted OR) higher than short course therapy (95%CI, 1.72–12.54; p value = 0.002). Moreover, there was no significant difference in nephrotoxicity (adjusted OR, 0.91, 95%CI, 0.39–2.11; p value = 0.826) between the two durations of therapy. Thirty-day mortality in the long-course therapy group was 0.11 times (adjusted OR) compared to the short-course therapy group (95%CI, 0.03–0.38; p value = 0.001). Propensity score analyses also demonstrated similar results. In conclusion, cancer patients who received a long course of colistin therapy presented greater clinical and microbiological responses and lower 30-day mortality but similar nephrotoxicity as compared with those who a received short course. Therefore, a long course of colistin therapy should be considered for management of CRAB infection in cancer patients.

scholarly journals Asthma in elderly is characterized by increased sputum neutrophils, lower airway caliber variability and air trapping

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
F. Schleich ◽  
S. Graff ◽  
F. Guissard ◽  
M. Henket ◽  
V. Paulus ◽  
...  
Keyword(s):  
Bronchial Hyperresponsiveness ◽  
Forced Expiratory Volume ◽  
Lower Airway ◽  
Low Grade ◽  
Sputum Induction ◽  
Air Trapping ◽  
Cell Counts ◽  
Airway Caliber ◽  
Significant Difference ◽  
Long Acting

Abstract Background Elderly asthmatics represent an important group that is often excluded from clinical studies. In this study we wanted to present characteristics of asthmatics older than 70 years old as compared to younger patients. Methods We conducted a retrospective analysis on a series of 758 asthmatics subdivided in three groups: lower than 40, between 40 and 70 and older than 70. All the patients who had a successful sputum induction were included in the study. Results Older patients had a higher Body Mass Index, had less active smokers and were more often treated with Long Acting anti-Muscarinic Agents. We found a significant increase in sputum neutrophil counts with ageing. There was no significant difference in blood inflammatory cell counts whatever the age group. Forced expiratory volume in one second (FEV1) and FEV1/FVC values were significantly lower in elderly who had lower bronchial hyperresponsiveness and signs of air trapping. We found a lower occurrence of the allergic component in advanced ages. Asthmatics older than 70 years old had later onset of the disease and a significant longer disease duration. Conclusion Our study highlights that asthmatics older than 70 years old have higher bronchial neutrophilic inflammation, a poorer lung function, signs of air trapping and lower airway variability. The role of immunosenescence inducing chronic low-grade inflammation in this asthma subtype remains to be elucidated.

scholarly journals Efficacy and Safety of Aidi Injection Combined with Transcatheter Arterial Chemoembolization on Primary Hepatic Carcinoma: A Systematic Review and Meta-Analysis

2018 ◽  
Vol 2018 ◽  
pp. 1-14
Author(s):  
Weihao Chen ◽  
Yurong Wang ◽  
Qiuer Liang ◽  
Yunfei Cai ◽  
Xudong Chen ◽  
...  
Keyword(s):  
Clinical Response ◽  
Transcatheter Arterial Chemoembolization ◽  
Response Rate ◽  
Clinical Response Rate ◽  
Efficacy And Safety ◽  
Hepatic Carcinoma ◽  
Primary Hepatic Carcinoma ◽  
Significant Difference ◽  
Aidi Injection ◽  
Arterial Chemoembolization

Objectives. To evaluate the efficacy and safety of Aidi injection (ADI) combined with transcatheter arterial chemoembolization (TACE) for primary hepatic carcinoma (PHCC). Methods. We conducted a literature search in EMBASE, PubMed, CENTRAL, MEDLINE, CNKI, Wanfang, and VIP databases from the earliest possible year to April 2018. Randomized controlled trials (RCTs) involving ADI combined with TACE versus TACE alone for patients with PHCC were included. The Cochrane Risk of Bias tool was applied for quality assessment. Results. 22 studies involving 1611 participants were included. The clinical response rate (RR = 1.28, 95% CI: 1.17-1.40; P < 0.00001), KPS score (RR = 1.78, 95% CI: 1.59-2.00; P < 0.00001), survival rate (RR = 1.27, 95% CI: 1.16-1.39; P < 0.00001), immune function (MD = 1.24, 95% CI: 0.98-1.51; P < 0.00001), and adverse effects (RR = 0.62, 95% CI: 0.57-0.68; P < 0.00001) of ADI plus TACE showed significant difference when compared with TACE alone. Conclusions. ADI combined with TACE in the treatment of PHCC improved the clinical response rate and safety compared to TACE alone. However, due to poor methodological quality of many of the included RCTs, more rigorously designed and large-scale RCTs are warranted to examine this beneficial effect in the future.

A double-blind comparison of once-daily metoprolol controlled-release and atenolol in the treatment of Chinese patients with mild to moderate hypertension

1995 ◽  
Vol 9 (3) ◽  
pp. 401-406 ◽  
Author(s):  
Ming-Fong Chen ◽  
Chi-Yu Yang ◽  
Wen-Jone Chen ◽  
Chii-Ming Lee ◽  
Chau-Chung Wu ◽  
...  
Keyword(s):  
Controlled Release ◽  
Moderate Hypertension ◽  
Chinese Patients ◽  
Double Blind ◽  
Once Daily ◽  
Blind Comparison

Phase 3 comparison of high-dose once-daily (QD) thoracic radiotherapy (TRT) with standard twice-daily (BID) TRT in limited stage small cell lung cancer (LSCLC): CALGB 30610 (Alliance)/RTOG 0538.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 8505-8505
Author(s):  
Jeffrey A Bogart ◽  
Xiaofei F. Wang ◽  
Gregory A. Masters ◽  
Junheng Gao ◽  
Ritsuko Komaki ◽  
...  
Keyword(s):  
Regional Lymph Node ◽  
Performance Status ◽  
Lymph Node Involvement ◽  
High Dose ◽  
Phase 3 ◽  
Ecog Performance Status ◽  
Once Daily ◽  
Concomitant Boost ◽  
Significant Difference ◽  
Grade 3

8505 Background: Although level 1 evidence is lacking, the majority of patients (pts) with LSCLC are treated with a high dose QD TRT regimen in clinical practice. CALGB 30610/RTOG 0538 was designed to determine if administering high dose TRT would improve overall survival (OS), compared with standard 45 Gy BID TRT, in LSCLC pts treated with chemoradiotherapy. Methods: Eligible pts had LSCLC, ECOG performance status (PS) 0-2 and regional lymph node involvement excluding contralateral hilar or supraclavicular nodes. This phase 3 trial was conducted in 2 stages. In the first stage, pts were randomized 1:1:1 to 45 Gy BID over 3 weeks, 70 Gy QD over 7 weeks, or 61.2 Gy concomitant boost (CB) over 5 weeks. For the second stage, the study planned discontinuation of one high dose arm based on interim toxicity analysis with patients then randomized 1:1 in the two remaining arms. TRT was given starting with either the 1st or 2nd (of 4 total) chemotherapy cycles. The primary endpoint was OS measured from date of randomization. Results: The trial opened 03/15/2008 and closed 12/01/2019 upon completing accrual, with the CB arm discontinued 3/11/2013 after interim analysis. This analysis includes 638 pts randomized to 45 Gy BID TRT (n = 313) or 70 Gy QD TRT (n = 325). Median age was 63 years (range 37-81), the majority of pts were Caucasian (86%), female (52%), and with ECOG PS 0-1 (95%). After median follow-up of 2.84 years (IQR:1.35 -5.61) for surviving pts, QD compared to BID did not result in a significant difference in OS (HR 0.94, 95% CI: 0.76-1.2, p = 0.9). Median, 2- and 4-year OS for QD were 30.5 months (95% CI: 24.4-39.6), 56% (95% CI: 0.51-0.62), and 39% (95% CI: 0.33-0.45), and for BID 28.7 months (95% CI: 26.2-35.5), 59% (95% CI: 0.53-0.65), and 35% (95% CI: 0.29-0.42). QD also did not result in a significant difference in PFS (HR 0.96, 95% CI: 0.78-1.18, p = 0.94). Most grade 3+ hematologic and non-hematologic adverse events (AEs) were similar between cohorts. Rates of grade 3+ febrile neutropenia, dyspnea, esophageal pain and dysphagia for QD were 12.6%,7%, 11.6% and 11.3%, and for BID 13.6%, 4%, 11.2 % and 9.5%. Grade 5 AEs were reported in 3.7% and 1.7% of the QD and BID cohorts, respectively. Results will be updated at presentation. Conclusions: High dose QD TRT to 70 Gy did not significantly improve OS compared with standard 45 Gy BID TRT. Nevertheless, favorable outcomes on the QD arm provide the most robust evidence available supporting high dose once-daily TRT as an acceptable option in LSCLC. Outcomes from this study, the largest conducted in LSCLC to date, will help guide TRT decisions for this patient population. Support: U10CA180821, U10CA180882; Clinical trial information: NCT00632853.

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