Safety and Efficacy of Acamprosate for the Treatment of Alcohol Dependence

Acamprosate (calcium acetylhomotaurine) is an amino acid modulator that has displayed efficacy in some clinical trials in reducing craving and promoting abstinence in alcohol dependent patients following detoxification. While acamprosate is safe and generally well-tolerated, not all studies have demonstrated clinical efficacy that is superior to placebo. In addition, the precise neurochemical mechanisms of action of acamprosate have still not yet been identified. In this review, we summarize current clinical data on the safety, efficacy, and pharmacokinetic properties of acamprosate, as well theories on its potential mechanism of action. We also discuss tolerability and patient preference issues and conclude with a discussion of the place of acamprosate in addiction medicine and therapy.

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Differences in PARP Inhibitors for the Treatment of Ovarian Cancer: Mechanisms of Action, Pharmacology, Safety, and Efficacy

International Journal of Molecular Sciences ◽

10.3390/ijms22084203 ◽

2021 ◽

Vol 22 (8) ◽

pp. 4203

Author(s):

Giorgio Valabrega ◽

Giulia Scotto ◽

Valentina Tuninetti ◽

Arianna Pani ◽

Francesco Scaglione

Keyword(s):

Ovarian Cancer ◽

Signal Transduction ◽

Dna Damage ◽

Chemical Structure ◽

Parp Inhibitors ◽

Mechanisms Of Action ◽

Point Of View ◽

Safety And Efficacy ◽

Damage Repair ◽

Pharmacokinetic Properties

Poly(ADP-ribose) polymerases (PARP) are proteins responsible for DNA damage detection and signal transduction. PARP inhibitors (PARPi) are able to interact with the binding site for PARP cofactor (NAD+) and trapping PARP on the DNA. In this way, they inhibit single-strand DNA damage repair. These drugs have been approved in recent years for the treatment of ovarian cancer. Although they share some similarities, from the point of view of the chemical structure and pharmacodynamic, pharmacokinetic properties, these drugs also have some substantial differences. These differences may underlie the different safety profiles and activity of PARPi.

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So Much Writing, So Little Science: A Review of 37 Years of Literature on Edetate Sodium Chelation Therapy

Annals of Pharmacotherapy ◽

10.1177/106002809302701217 ◽

1993 ◽

Vol 27 (12) ◽

pp. 1504-1509 ◽

Cited By ~ 31

Author(s):

Michael T. Grier ◽

David G. Meyers

Keyword(s):

Clinical Trials ◽

Clinical Practice ◽

Literature Search ◽

Chelation Therapy ◽

Case Reports ◽

Scientific Evidence ◽

Case Series ◽

Mechanisms Of Action ◽

Tetraacetic Acid ◽

Safety And Efficacy

OBJECTIVE: To determine the safety and efficacy of edetate sodium (ethylenediamine tetraacetic acid; EDTA) chelation therapy for atherosclerosis. METHODS: Literature search using MEDLINE, encompassing 1966 through May 1993. Further references were obtained from articles and books, and from citations obtained from the American Academy of Medical Preventics. RESULTS: 16 case reports or case series, 2 longitudinal studies, and 3 clinical trials were reviewed, along with testimonials cited in 19 books. CONCLUSIONS: Little valid scientific evidence is available. Although the postulated mechanisms of action for EDTA are biologically plausible and EDTA appears to be safe, it has not been proven effective. Indeed, the best evidence shows it to be ineffective. Therefore, EDTA chelation therapy should not be used in clinical practice to treat atherosclerosis.

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COVID-19 and Cardiovascular System. Part 3. COVID-19 Current Treatment Approaches: Evidence-Based Review

Russian Sklifosovsky Journal Emergency Medical Care ◽

10.23934/2223-9022-2021-10-3-438-451 ◽

2021 ◽

Vol 10 (3) ◽

pp. 438-451

Author(s):

M. K. Vasilchenko ◽

A. A. Ivannikov ◽

A. N. Yesaulenko ◽

Kh. G. Alidzhanova ◽

S. S. Petrikov

Keyword(s):

Clinical Trials ◽

Cardiovascular System ◽

Mechanism Of Action ◽

Treatment Strategy ◽

Large Scale ◽

Management Plan ◽

Current Treatment ◽

Evidence Based ◽

Potential Mechanism ◽

System Part

Unified management plan and treatment strategy for COVID-19 patients are yet to be discovered. Many trials on COVID-19 interventions have been registered or are ongoing. In this article the results of large-scale clinical trials on COVID-19 treatment are presented, the potential mechanism of action of some drugs is discussed, the features of the main pharmacological and non-pharmacological therapeutic options for COVID-19 patients are described.

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Acamprosate for the Treatment of Alcohol Dependence: A Review of Double-Blind, Placebo-Controlled Trials

CNS Spectrums ◽

10.1017/s1092852900012827 ◽

2000 ◽

Vol 5 (2) ◽

pp. 58-69 ◽

Cited By ~ 44

Author(s):

Barbara J. Mason ◽

Raymond L. Ownby

Keyword(s):

Clinical Trials ◽

Alcohol Dependence ◽

Latin American ◽

The United States ◽

Concomitant Treatment ◽

Controlled Clinical Trials ◽

Double Blind ◽

Safety And Efficacy ◽

Double Blind Placebo ◽

Alcohol Dependent

AbstractAcamprosate (calcium acetyl-homotaurine) is a synthetic compound that crosses the blood-brain barrier and has a chemical structure similar to that of the naturally occurring amino acid neuromediators, homotaurine and γ-aminobu-tyric acid (GABA). Acamprosate appears to act primarily by restoring normal N-methyl-D-aspartate (NMDA) receptor tone in the glutamate system, and has been shown to have a specific dose-dependent effect on decreasing voluntary alcohol intake in animals with no effects on food and water consumption. The safety and efficacy of acamprosate in alcohol-dependent outpatients is currently under evaluation in the United States. Acamprosate has been available by prescription since 1989 in France and more recently in most European and Latin American coutries as well as Australia, South Africa, and Hong Kong. More than 4 million people have been treated with acamprosate since it became commercially available.The purpose of this article is to review all available double-blind, placebo-controlled clinical trials evaluating the safety and efficacy of acamprosate treatment of alcohol dependence. This work encompasses 16 controlled clinical trials conducted across 11 European countries and involves more than 4,500 outpatients with alcohol dependence. Fourteen of 16 studies found alcohol-dependent patients treated with acamprosate had a significantly greater rate of treatment completion, time to first drink, abstinence rate, and/or cumulative abstinence duration than patients treated with placebo. Additionally, a multinational open-label study of acamprosate in 1,281 patients with alcohol dependence found acamprosate to be equally effective across four major psychosocial concomitant treatment programs in maintaining abstinence and reducing consumption during any periods of relapse. An absence of known strong predictors of response to acamprosate, in conjunction with a modest but consistent effect on prolonging abstinence, and an excellent safety profile, lend support to the use of acamprosate across a broad range of patients with alcohol dependence.

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Current and Future Therapies for Multiple Sclerosis

Scientifica ◽

10.1155/2013/249101 ◽

2013 ◽

Vol 2013 ◽

pp. 1-11 ◽

Cited By ~ 24

Author(s):

Alireza Minagar

Keyword(s):

Multiple Sclerosis ◽

Clinical Trials ◽

Glatiramer Acetate ◽

Side Effect ◽

Dimethyl Fumarate ◽

Mechanisms Of Action ◽

Natural Course ◽

Safety And Efficacy ◽

Comprehensive Review ◽

Incurable Disease

With the introduction of interferon-β1b in 1993 as the first FDA-approved treatment for multiple sclerosis, the era of treatment of this incurable disease began, and its natural course was permanently changed. Currently, seven different treatments for patients with multiple sclerosis with different mechanisms of action and dissimilar side effect profiles exist. These medications include interferon-β1a intramuscular (Avonex), interferon-β1a subcutaneous (Rebif), interferon-β1b subcutaneous (Betaseron/Extavia), glatiramer acetate (Copaxone), natalizumab (Tysabri), fingolimod (Gilenya), teriflunomide (Aubagio), and mitoxantrone (Novantrone). In addition, a large number of clinical trials are being conducted to assess the safety and efficacy of various experimental agents in patients with multiple sclerosis, including alemtuzumab, dimethyl fumarate, laquinimod, rituximab, daclizumab, and cladribine. In this paper, the author presents a concise and comprehensive review of present and potential treatments for this incurable disease.

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Safety and efficacy of four drug regimens in newly diagnosed multiple myeloma: Systematic review.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.e19537 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. e19537-e19537

Author(s):

Udhayvir Singh Grewal ◽

Rajshekhar Chakraborty ◽

Fazal I Raziq ◽

Afia Ashraf ◽

Ammara Majeed ◽

...

Keyword(s):

Systematic Review ◽

Multiple Myeloma ◽

Clinical Trials ◽

Phase I ◽

Mechanisms Of Action ◽

Newly Diagnosed ◽

Safety And Efficacy ◽

Drug Regimens ◽

Ongoing Phase

e19537 Background: To improve outcomes, multiple agents with varied mechanisms of action targeting different multiple myeloma (MM) clones are needed. Methods: Systematic review of ongoing phase I-III clinical trials in newly diagnosed multiple myeloma (NDMM) was performed, (PRISMA guidelines) using 5 databases. Results: 8 trials n = 1,990 patients included (Table 1). We evaluated the efficacy of following four drug combinations Isatuximab (Isa), bortezomib (V), lenalidomide (R)dexamethasone (d) (Isa-VRd) Daratumumab (Dara) plus V, Melphalan (M) and Prednisone (P) (Dara-VMP) vs VMP Dara-VRd vs VRd Carfilzomib (K), Cyclophosphamide (C), R, Dexamethasone (KCRD) vs an immunomodulatory agent containing triplet (CTD/CRD) Dara with Ixazomib (I), R,d (Dara- IRd) Dara, Cyclophosphamide (Cy), V,d (Dara-CyBord) Elotuzumab (Elo) VRd Dara with K,R,d (Dara- KRd) For transplant-eligible patients, Dara-VRd demonstrated the best treatment response (VGPR = 100%, CR rate = 63% and 15 months PFS = 94%). Dara-VMP (ORR = 90.9%,VGPR+ = 72.9%, mPFS at 27. 8 m = NR) and Isa+VRd (ORR = 93%, VGPR = 71.43%, 7.5 m PFS = 100%) were associated with improvement in OR in transplant ineligible patients. Dara-KRd showed excellent efficacy (ORR = 100%, ≥VGPR = 86%) with 100% 6 m PFS. Conclusions: Four-drug regimens have improved efficacy (higher ORR, deeper response, higher proportion of MRD negativity and higher ≥VGPR responses) compared to three-drug regimens in NDMM, with a comparable incidence of toxicities. Longer follow-up is needed. [Table: see text]

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Antimicrobial Peptides: Diversity, Mechanism of Action and Strategies to Improve the Activity and Biocompatibility In Vivo

Biomolecules ◽

10.3390/biom8010004 ◽

2018 ◽

Vol 8 (1) ◽

pp. 4 ◽

Cited By ~ 190

Author(s):

Prashant Kumar ◽

Jayachandran Kizhakkedathu ◽

Suzana Straus

Keyword(s):

Clinical Trials ◽

Antibiotic Resistance ◽

Antimicrobial Peptides ◽

Mechanism Of Action ◽

Mechanisms Of Action ◽

Great Promise ◽

Chemical Modifications ◽

Protease Cleavage ◽

The Us

Antibiotic resistance is projected as one of the greatest threats to human health in the future and hence alternatives are being explored to combat resistance. Antimicrobial peptides (AMPs) have shown great promise, because use of AMPs leads bacteria to develop no or low resistance. In this review, we discuss the diversity, history and the various mechanisms of action of AMPs. Although many AMPs have reached clinical trials, to date not many have been approved by the US Food and Drug Administration (FDA) due to issues with toxicity, protease cleavage and short half-life. Some of the recent strategies developed to improve the activity and biocompatibility of AMPs, such as chemical modifications and the use of delivery systems, are also reviewed in this article.

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The following abstracts were presented as posters at the 2014 NEI Psychopharmacology Congress

CNS Spectrums ◽

10.1017/s1092852914000765 ◽

2015 ◽

Vol 20 (1) ◽

pp. 61-92 ◽

Cited By ~ 4

Keyword(s):

Eating Disorder ◽

Binge Eating ◽

Mechanism Of Action ◽

Binge Eating Disorder ◽

Potential Mechanism ◽

Lisdexamfetamine Dimesylate ◽

Safety And Efficacy ◽

Randomized Controlled ◽

Efficacy Trials ◽

Scientific Poster

Congratulations to the scientific poster winners of the 2014 NEI Psychopharmacology Congress!1stPLACE: Randomized controlled safety and efficacy trials of lisdexamfetamine dimesylate for adults with moderate to severe binge eating disorder (page 14)2ndPLACE: CNS Pharmacology of Dextromethorphan (DM): New insights on potential mechanism of action and therapeutic applications (page 30)

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