scholarly journals A survey on the experience of 136 Italian urologists in the treatment of erectile dysfunction with PDE5 inhibitors and recommendations for the use of Avanafil in the clinical practice

2016 ◽  
Vol 88 (2) ◽  
pp. 128 ◽  
Author(s):  
Vincenzo Mirone ◽  
Ferdinando Fusco ◽  
Fabio Parazzini ◽  
Alessandro Zucchi
Keyword(s):  
Erectile Dysfunction ◽  
Clinical Practice ◽  
Scientific Literature ◽  
Therapeutic Option ◽  
Tolerability Profile ◽  
High Efficacy ◽  
Pde5 Inhibitors ◽  
Good Tolerability ◽  
Duration Of Action ◽  
Different Characteristics

Introduction: PDE5 inhibitors are the firstline treatment for erectile dysfunction. Although all these drugs share the same mechanism of action, each agent could have different characteristics in terms of selectivity, pharmacokinetics and tolerability profile. Materials and Methods: This manuscript illustrates a project, undertaken by the Italian Society of Urology in order to obtain a “snapshot” of the experience of Italian urologists with the use of PDE5 inhibitors in the clinical practice. This project included a survey, targeting a sample of 136 Italian urologists experienced in the treatment of ED, and the organization of a conference of experts who, based on the findings of the survey, the scientific literature and the clinical experience, would define some recommendations for the use of PDE5 inhibitors in clinical practice with a particular focus on Avanafil, the most recent drug in this class. Results: The following recommendations on the use of Avanafil were issued: 1) In patients who are candidates for the use of Avanafil, it is advisable to use the 200-mg dose from the first administration; 2) When used at the highest dose (200 mg), Avanafil shows a favourable tolerability profile with an efficacy similar to that of other agents; 3) The patient should be instructed to take Avanafil on an empty stomach, i.e., 30-45 minutes before or 2 hours after a meal; 4) The efficacy window of Avanafil is between 30 minutes and 6 hours after dosing, which qualifies this molecule as a new drug with an intermediate duration of action; 5) Avanafil at a dose of 50-100 mg/day may be a therapeutic option in chronic rehabilitation. Conclusions: Among PDE5 inhibitors, Avanafil is a new agent with an intermediate duration of action, characterized by high efficacy and good tolerability even at the highest dose (200 mg).

Rheumatic diseases and coronavirus infection: levilimab use experience

2021 ◽  
pp. 7-12
Author(s):  
E. V. Kalinina ◽  
I. V. Lekareva ◽  
M. S. Zvonorenko ◽  
A. L. Emelianova ◽  
I. V. Kostryukova ◽  
...  
Keyword(s):  
Rheumatic Diseases ◽  
Risk Group ◽  
Therapeutic Option ◽  
High Efficacy ◽  
National Guidelines ◽  
Good Tolerability ◽  
Increased Risk ◽  
Coronavirus Infection ◽  
System Disorder ◽  
Receptor Inhibitor

Background. Rheumatic diseases (RD) of autoimmune origin are considered as an important risk factor for infectious processes due to characteristic native immune system disorder, as well as due to the adverse effect of immunosuppressants and glucocorticoids on the mechanisms of anti-infective protection.Aim. To highlight the problem of RD and concomitant viral infection which becomes critical in the era of COVID‑19.Results. According to the current national guidelines for the management of patients with COVID‑19, patients with RD represent an increased risk group for the adverse course of coronavirus infection. Presented article provides basic information on the use of interleukin‑6 (IL‑6) inhibitors in patients with COVID‑19 focusing on the benefit of this therapeutic option in those with prior RD. The article presents an analysis of two clinical cases demonstrating high efficacy and good tolerability of levilimab (Ilsira®) in the treatment of coronavirus pneumoniae in the setting of autoimmune diseases: polymyositis (PM) and rheumatoid arthritis (RA).Conclusion. Our own clinical experience confirms the feasibility of including an IL‑6 receptor inhibitor in the treatment regimen for coronavirus pneumonia in patients with RD characterized of immune inflammation.

scholarly journals Safe use of meloxicam in clinical practice

2019 ◽  
pp. 46-50
Author(s):  
E. I. Sas ◽  
V. B. Grinevich
Keyword(s):  
Chronic Pain ◽  
Clinical Practice ◽  
Gastrointestinal Tract ◽  
High Efficiency ◽  
Controlled Trials ◽  
High Efficacy ◽  
Selective Inhibitors ◽  
Good Tolerability ◽  
Inflammatory Drugs ◽  
Inflammatory Changes

Non-steroidal anti-inflammatory drugs (NSAIDs) – means of treatment of acute and chronic pain associated primarily with inflammatory changes, so this group of drugs is widely used in neurology, rheumatology, traumatology, etc. The mechanism of action of the drugs is associated with the effect on cyclooxygenase-2 (COG-2) and blockade of proinflammatory prostaglandins (PG) synthesis, as well as the effect on COG-1 and suppression of cytoprotective PG synthesis, which determines the possibility of side effects from the gastrointestinal tract (GIT). Now application of NPVP is focused not so much on increase of efficiency, as on their big safety. Creation of COG-2-selective inhibitors (meloxicam) and COG-2-high selective inhibitors (coxybes) allowed to reduce significantly the risk of complications from gastrointestinal tract while maintaining high efficiency. Thus, the safety profile of meloxicam, mainly inhibiting COG-2, is estimated in a whole series of studies. In particular, two large prospective controlled trials - MELISSA and SELECT - proved that meloxicam is less toxic to gastrointestinal tract than traditional NSAIDs. Thus, a reasonable conclusion can be made about the high efficacy of meloxicam, which is not inferior to that of non-selective NSAIDs, with good tolerability and safety of the drug against gastrointestinal tract.

scholarly journals Patterns of treatment with PDE5 inhibitors in the clinical practice in Italy: longitudinal data from the Erectile Dysfunction Observational Study

2009 ◽  
Vol 11 (5) ◽  
pp. 629-637 ◽  
Author(s):  
Ferdinando Fusco ◽  
Riccardo Sicuteri ◽  
Andrea Rossi ◽  
Stathis Kontodimas ◽  
Jose Maria Haro ◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Clinical Practice ◽  
Observational Study ◽  
Longitudinal Data ◽  
Pde5 Inhibitors

scholarly journals RNAi inhibition of angiopoietin-like protein 3 (ANGPTL3) with ARO-ANG3 mimics the lipid and lipoprotein profile of familial combined hypolipidemia

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
G.F Watts ◽  
C Schwabe ◽  
R Scott ◽  
P Gladding ◽  
D Sullivan ◽  
...  
Keyword(s):  
Adverse Events ◽  
Dose Response ◽  
Minimal Change ◽  
Funding Source ◽  
Private Company ◽  
Good Tolerability ◽  
Duration Of Action ◽  
Mixed Dyslipidemia ◽  
Genetic Deficiency

Abstract Background Elevated LDL-C and triglyceride rich lipoproteins (TRLs) are independent risk factors for cardiovascular disease (CVD). Genetic deficiency of angiopoietin-like protein 3 (ANGPTL3) is associated with reduced circulating levels of LDL-C, triglycerides (TGs), VLDL-C, HDL-C and reduced CVD risk, with no described adverse phenotype. ARO-ANG3 is a RNA interference drug designed to silence expression of ANGPTL3. Single doses of ARO-ANG3 have been shown to reduce ANGPTL3, TGs, VLDL-C and LDL-C in healthy volunteers (HVs, AHA 2019). We report the effects of multiple doses of ARO-ANG3 in HVs with a focus on the duration of action. Methods ARO-ANG3 was administered subcutaneously to HVs on days 1 and 29 at doses of 100, 200 or 300 mg (n=4 per group). Measured parameters included ANGPTL3, LDL-C, TGs, VLDL-C and HDL-C. Follow up is ongoing. Results All HVs have received both doses and follow-up is currently through week 16 (12 weeks after second dose). Mean nadir for ANGPTL3 levels occurred 2 weeks after the second dose (−83–93%) with minimal change for 200 and 300 mg but 16% recovery for 100 mg at week 16. Mean TGs and VLDL-C reached nadir earlier (3 wks, −61–65%) without apparent dose response and minimal change for any dose at wk 16. LDL-C nadir occurred 4–6 wks after the second dose (−45–54%), again with minimal evidence for dose response or change through wk 16. HDL-C was reduced 14–37% at wk 16. ARO-ANG3 was well tolerated without serious or severe adverse events or dropouts related to drug. The most common adverse events have been headache and upper respiratory infections. Conclusions Genetic deficiency of ANGPTL3 is a cause of familial combined hypolipemia and is associated with a decreased risk of CVD. Using RNAi to selectively suppress ANGPTL3 production reproduces these genetic effects with a duration of at least 12 weeks following a second dose and with good tolerability over 16 wks. ANGPTL3 inhibition results in lowering of LDL-C and TRLs which may confer protection against CVD in patients with atherogenic mixed dyslipidemia. Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Arrowhead Pharmaceuticals

scholarly journals The Palliative Outcome Scale (POS) applied to clinical practice and research: an integrative review

2016 ◽  
Vol 24 (0) ◽  
Author(s):  
Fernanda Capella Rugno ◽  
Marysia Mara Rodrigues do Prado De Carlo
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Clinical Practice ◽  
Scientific Literature ◽  
Service Organization ◽  
Units Of Analysis ◽  
Final Sample ◽  
Measuring Outcomes ◽  
Pc Method

ABSTRACT Objective: to identify and evaluate the evidence found in the international scientific literature on the application of the Palliative Outcome Scale (POS) in clinical practice and research in Palliative Care (PC). Method: integrative literature review, through the search of publications in journals indexed in PubMed / MEDLINE, LILACS, SciELO and CINAHL databases, between the years 1999 and 2014. Results: the final sample consisted of 11 articles. In the data analysis, the articles were classified into 2 units of analysis (studies using the POS as a resource in research and studies using the POS in clinical practice), in which the information was presented in the form of sub-themes related to publications of the selected studies, highlighting the synthesis of the results. Conclusion: POS emerged as an important tool for measuring outcomes to assess the quality of life of patients and families, of the quality of care provided and the PC service organization. The international scientific literature on the application of POS proved to be relevant to the advancement and consolidation of the field of knowledge related to PC.

The lung-gut axis and COVID-19

2021 ◽  
Vol 19 (1) ◽  
pp. 91-96
Author(s):  
V.P. Novikova ◽  
◽  
A.I. Khavkin ◽  
A.V. Polunina ◽  
A.V. Gorelov ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Gastrointestinal Tract ◽  
Scientific Literature ◽  
Intestinal Microbiome ◽  
Disease Course ◽  
Qualitative And Quantitative ◽  
Commensal Flora ◽  
Gastrointestinal Lesions ◽  
Coronavirus Infection ◽  
Quantitative Changes

This review summarizes relevant scientific literature analyzing the lung-gut axis and its association with coronavirus infection (COVID-19), lesions to the gastrointestinal tract caused by this infection, and state of the microbiome. Approximately 20%–50% of COVID-19 patients have such symptoms as nausea, vomiting, and diarrhea, as well as SARS-CoV-2 RNA detected in their feces. Therefore, investigation of the virus effect on the gastrointestinal tract and its commensal flora is important not only for research purposes, but for clinical practice, since patients with COVID-19 demonstrate both qualitative and quantitative changes in their microbiome. The latter may serve as a basis for the development of additional probiotic therapy for gastrointestinal lesions in COVID-19 patients. Despite the existing evidence, it is still necessary to clarify the effect of the intestinal microbiome on the pathogenesis of coronavirus infection and the disease course. Key words: COVID-19, coronavirus infection, microbiome, intestinal microbiota, SARS-CoV-2, probiotics, probiotic therapy

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