DOCSLIB.ORG

Biologic and Oral Disease-Modifying Antirheumatic Drug Monotherapy in Rheumatoid Arthritis Paul Emery,1,2 Anthony Sebba,3 Tom W J Huizinga4

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Biologic and Oral Disease-Modifying Antirheumatic Drug Monotherapy in Rheumatoid Arthritis Paul Emery,1,2 Anthony Sebba,3 Tom W J Huizinga4 ARD Online First, published on August 5, 2013 as 10.1136/annrheumdis-2013-203485 Review Biologic and oral disease-modifying antirheumatic drug monotherapy in rheumatoid arthritis Paul Emery,1,2 Anthony Sebba,3 Tom W J Huizinga4 Handling editor Tore K Kvien ABSTRACT reasons for, and evidence supporting, the use of bio- ▸ Additional material is Clinical evidence demonstrates coadministration of logics or oral DMARDs (tofacitinib) as monother- published online only. To view tumour necrosis factor inhibitor (TNFi) agents and apy (box 1). References in retrieved articles were please visit the journal online methotrexate (MTX) is more efficacious than reviewed to identify trials in which biologics alone (http://dx.doi.org/10.1136/ administration of TNFi agents alone in patients with were administered. Additional search strategies to annrheumdis-2013-203485) rheumatoid arthritis, leading to the perception that identify potential reasons for use of biologics as 1 Leeds Institute of Rheumatic coadministration of MTX with all biologic agents or oral monotherapy were conducted. & Musculoskeletal Medicine, University of Leeds, Leeds, UK disease-modifying antirheumatic drugs is necessary for 2 fi NIHR Leeds Musculoskeletal maximum ef cacy. Real-life registry data reveal MTX IN COMBINATION THERAPY Biomedical Research Unit, approximately one-third of patients taking biologic The enhanced efficacy of TNFi agents used in com- Leeds Teaching Hospitals NHS agents use them as monotherapy. Additionally, an bination with MTX compared with TNFi mono- Trust United Kingdom, Leeds, analysis of healthcare claims data showed that when UK therapy is supported by data from randomized 3Department of Rheumatology, MTX was prescribed in conjunction with a biologic controlled trials (RCTs). Patients treated with inflixi- University of South Florida, agent, as many as 58% of patients did not collect the mab plus MTX had longer duration of response Tampa, Florida, USA MTX prescription. Given this discrepancy between 4 than those who received infliximab alone; 20% Department of Rheumatology, perception and real life, we conducted a review of the Leiden University Medical Paulus criteria were maintained for median 16.5 Center, Leiden, peer-reviewed literature and rheumatology medical versus 2.6 weeks (p=0.006).13 In the PREMIER The Netherlands congress abstracts to determine whether data support study, adalimumab in combination with MTX was biologic monotherapy as a treatment option for patients superior to adalimumab monotherapy; 62% of Correspondence to with rheumatoid arthritis. Our analysis suggests only for patients achieved ACR50 response on combination Professor Paul Emery, Leeds tocilizumab is there evidence that the efficacy of biologic Institute of Rheumatic & therapy compared with 41% on monotherapy Musculoskeletal Medicine, monotherapy is comparable with combination therapy with significantly less radiographic progression University of Leeds, Leeds LS7 with MTX. (p<0.001, both comparisons).14 In the Trial of 4SA, UK; [email protected] Etanercept and Methotrexate with Radiographic Received 18 February 2013 Patient Outcomes (TEMPO) study, higher response Revised 20 June 2013 INTRODUCTION rates were achieved with etanercept plus MTX than Accepted 9 July 2013 Methotrexate (MTX), administered alone or with etanercept monotherapy; ACR20, 86% vs 75%; another conventional disease-modifying antirheu- ACR50, 71% vs 54%; ACR70, 49% vs 27% and matic drug (DMARD), is the recommended first-line 28-joint Disease Activity Score (DAS28) remission, treatment for patients with rheumatoid arthritis 42% vs 22% (p<0.01, all comparisons); there was (RA).12MTX plus tumour necrosis factor inhibitor also less radiographic progression (p<0.05).17 In (TNFi) agents is the usual treatment for patients the A Multicenter, Randomized, Double-Blind, with RA with insufficient response to MTX/ Placebo-controlledTrial of Golimumab, a Fully DMARDs (MTX-/DMARD-IR).12TNFi agents Human Anti-TNFa Monoclonal Antibody, plus MTX reduce disease activity, improve physical Administered Subcutaneously, in Subjects With function and attenuate radiographic progression in Active Rheumatoid Arthritis Despite Methotrexate – MTX/DMARD-IR patients.3 12 When administered Therapy (GO-FORWARD) study, ACR20 response with MTX, enhanced efficacy has been observed for was achieved by 56% of patients receiving golimu- TNFi agents infliximab, etanercept, adalimumab mab in combination with MTX, which was signifi- – and golimumab.13 18 The efficacy reported with cer- cantly higher than MTX monotherapy (33%, tolizumab in combination with MTX19 20 is higher p<0.001), and 44% receiving golimumab alone, than that reported in separate studies with certolizu- which was not significantly higher than MTX alone mab monotherapy.21 The non-TNFi agent rituxi- (p=0.059).16 ACR20 responses were reported in mab, which targets CD20+ B cells, may also be 58% of patients treated with certolizumab in com- more effective when combined with MTX.22 bination with MTX in the Rheumatoid Arthritis Despite the efficacy of TNFi agents plus conven- PreventIon of structural Damage 2 (RAPID 2) tional DMARDs and the limited approval of biolo- study19 and 46% of patients in the EFficAcy and gics (etanercept, adalimumab, certolizumab, Safety of cerTolizumab pegol – 4 Weekly dosAge in tocilizumab) as monotherapy, biologic monotherapy RheumatoiD arthritis (FAST4WARD) study who for managing RA is widespread in clinical prac- received certolizumab monotherapy.21 Similar – tice.23 29 results have been reported for rituximab; ACR50 To cite: Emery P, Sebba A, Review of the peer-reviewed published literature response rates were 41% with rituximab in combin- Huizinga TWJ. Ann Rheum – Dis Published Online First: (2005 2012) and rheumatology medical congress ation with MTX, which was higher than MTX [please include Day Month abstracts (European League Against Rheumatism alone (13%, p=0.005), whereas, the response with Year] doi:10.1136/ and American College of Rheumatology (ACR), rituximab monotherapy (33%) was not significantly annrheumdis-2013-203485 2009–2012) was conducted to determine potential higher than MTX (p=0.059).22 CopyrightEmery P, et Article al. Ann Rheum author Dis 2013; (or0 :1their–8. doi:10.1136/annrheumdis-2013-203485 employer) 2013. Produced by BMJ Publishing Group Ltd (& EULAR) under licence.1 Review versus discontinuation of MTX when initiating etanercept in Box 1 Search terms and strategies for identifying MTX-IR patients showed continuation resulted in better clinical clinical studies that support the use of biologic and radiographic outcomes at weeks 52 and 104 than discon- monotherapy in patients with rheumatoid arthritis tinuation.40 41 Data from a Dutch registry showed discontinu- ation of DMARDs was not associated with increased disease activity after 6 months.42 Search strategies: Alternatives to initiating DMARD monotherapy include ▸ Evidence supporting the use of biologics as monotherapy: step-up, parallel, or step-down regimens.43 The most effective [drug name] AND [rheumatoid arthritis] AND regimen is unknown and may be different for different patients. [monotherapies OR monotherapy]. ▸ Reasons for using biologics as monotherapy: [DMARD] OR [methotrexate] AND [intoleran*] AND [management] AND [rheumatoid arthritis]. CHARACTERISATION OF RA PATIENTS NOT TAKING MTX 23–28 44 29 45 Drug names: tocilizumab, infliximab, etanercept, adalimumab, Data from biologic registries and US claims databases anakinra, abatacept, rituximab, certolizumab, golimumab, indicate approximately 30% of patients taking biologics use tofacitinib them as monotherapy. However, this does not capture patients Search limits: PubMed, 2005–2012; Congress (EULAR and ACR) who fill prescriptions but do not take some or all of the abstracts, 2009–2011; phase 3/4 studies and comparator studies medication. only; English language. Monotherapy studies that included Patients not taking MTX are those who never initiate MTX— background methotrexate were excluded. MTX is contraindicated or declined—and those who initiate ACR, American College of Rheumatology; DMARD, MTX but subsequently discontinue (figure 1). Among patients disease-modifying antirheumatic drug; EULAR, European League who never initiate treatment with MTX are those with contrain- Against Rheumatism. dications to MTX such as patients who are pregnant or breast- feeding, are heavy alcohol users, have alcohol-induced or other chronic liver diseases or have immunodeficiency or pre-existing blood dyscrasias, known hypersensitivity to MTX or lung Direct and indirect effects potentially account for the disease.46 The ACR recommends MTX not be used in the pres- fi enhanced ef cacy of TNFi agents coadministered with MTX. ence of clinically important RA-associated pneumonitis or inter- MTX may independently reduce inflammation and radiographic 4–8 stitial lung disease of unknown cause, or in patients with active progression. MTX also may increase the bioavailability of bacterial, active tuberculosis or life-threatening fungal or active fl 30 31 32 TNFi agents (in iximab and adalimumab, though no dose herpes zoster infection.2 Additionally, some patients may decline fl adjustments are required). In iximab can induce formation of MTX because of the advice to abstain from alcohol consump- anti-infliximab antibodies that may lower circulating infliximab 33 tion; the combination is associated with increased risk for levels and reduce clinical effect. However, MTX coadministra- hepatotoxicity.46 tion can promote immune tolerance and increase
Load more

Recommended publications
  • Study Protocol
    PROTOCOL SYNOPSIS A Multicentre, Randomised, Double-blind, Placebo-controlled, Phase 3 Study Evaluating the Efficacy and Safety of Two Doses of Anifrolumab in Adult Subjects with Active Systemic Lupus Erythematosus International Coordinating Investigator Study site(s) and number of subjects planned Approximately 450 subjects are planned at approximately 173 sites. Study period Phase of development Estimated date of first subject enrolled Q2 2015 3 Estimated date of last subject completed Q2 2018 Study design This is a Phase 3, multicentre, multinational, randomised, double-blind, placebo-controlled study to evaluate the efficacy and safety of an intravenous treatment regimen of anifrolumab (150 mg or 300 mg) versus placebo in subjects with moderately to severely active, autoantibody-positive systemic lupus erythematosus (SLE) while receiving standard of care (SOC) treatment. The study will be performed in adult subjects aged 18 to 70 years of age. Approximately 450 subjects receiving SOC treatment will be randomised in a 1:2:2 ratio to receive a fixed intravenous dose of 150 mg anifrolumab, 300 mg anifrolumab, or placebo every 4 weeks (Q4W) for a total of 13 doses (Week 0 to Week 48), with the primary endpoint evaluated at the Week 52 visit. Investigational product will be administered as an intravenous (IV) infusion via an infusion pump over a minimum of 30 minutes, Q4W. Subjects must be taking either 1 or any combination of the following: oral corticosteroids (OCS), antimalarial, and/or immunosuppressants. Randomisation will be stratified using the following factors: SLE Disease Activity Index 2000 (SLEDAI-2K) score at screening (<10 points versus ≥10 points); Week 0 (Day 1) OCS dose 2(125) Revised Clinical Study Protocol Drug Substance Anifrolumab (MEDI-546) Study Code D3461C00005 Edition Number 5 Date 18 May 2016 (<10 mg/day versus ≥10 mg/day prednisone or equivalent); and results of a type 1 interferon (IFN) test (high versus low).
    [Show full text]
  • Polymorphisms of the Multidrug Pump ABCG2: a Systematic Review of Their Effect on Protein Expression, Function, and Drug Pharmacokinetics
    1521-009X/46/12/1886–1899$35.00 https://doi.org/10.1124/dmd.118.083030 DRUG METABOLISM AND DISPOSITION Drug Metab Dispos 46:1886–1899, December 2018 Copyright ª 2018 by The American Society for Pharmacology and Experimental Therapeutics Minireview Polymorphisms of the Multidrug Pump ABCG2: A Systematic Review of Their Effect on Protein Expression, Function, and Drug Pharmacokinetics Niall Heyes, Parth Kapoor, and Ian D. Kerr School of Life Sciences, Queen’s Medical Centre, University of Nottingham, Nottingham, United Kingdom Received June 12, 2018; accepted September 20, 2018 Downloaded from ABSTRACT The widespread expression and polyspecificity of the multidrug to improve outcomes in cancer patients treated with tyrosine ABCG2 efflux transporter make it an important determinant of the kinase inhibitors, but the reasons for this are yet to be estab- pharmacokinetics of a variety of substrate drugs. Null ABCG2 lished, and this residue’s role in the mechanism of the protein is expression has been linked to the Junior blood group. Polymor- unexplored by current biochemical and structural approaches. phisms affecting the expression or function of ABCG2 may have Research into the less-common polymorphisms is confined to dmd.aspetjournals.org clinically important roles in drug disposition and efficacy. The in vitro studies, with several polymorphisms shown to decrease most well-studied single nucleotide polymorphism (SNP), Q141K resistance to anticancer agents such as SN-38 and mitoxantrone. (421C>A), is shown to decrease ABCG2 expression and activity, In this review, we present a systematic analysis of the effects of resulting in increased total drug exposure and decreased re- ABCG2 polymorphisms on ABCG2 function and drug pharmaco- sistance to various substrates.
    [Show full text]
  • IMPDH Inhibitors for Anti-Tumor Therapy in Tuberous Sclerosis Complex
    bioRxiv preprint doi: https://doi.org/10.1101/835199; this version posted November 11, 2019. The copyright holder for this preprint (which was not certified by peer review) is the author/funder. All rights reserved. No reuse allowed without permission. IMPDH inhibitors for anti-tumor therapy in tuberous sclerosis complex Alexander J. Valvezan1, *, Spencer K. Miller1, Molly C. McNamara1, Margaret E. Torrence1, John M. Asara2, Elizabeth P. Henske3, Brendan D. Manning1,* 1Department of Genetics and Complex Diseases, Harvard T.H. Chan School of Public Health, Boston, MA, USA 2Division of Signal Transduction, Beth Israel Deaconess Medical Center, and Department of Medicine, Harvard Medical School, Boston, MA, USA 3Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA *Correspondence to: [email protected] or [email protected] 665 Huntington Ave, SPH2-117 Boston, MA 02115 617 432-5614 Running title: Repurposing mizoribine for tuberous sclerosis complex tumors Keywords: mTORC1, IMPDH, mizoribine, mycophenolate, tuberous sclerosis complex Financial support: This research was supported by grants from the National Institutes of Health (P01CA120964 to J.M.A. E.P.H. and B.D.M., P30CA006516 to J.M.A., and R35CA197459 to B.D.M.) and a Rothberg Courage Award from the TS Alliance to B.D.M. Conflict of interest statement: B.D.M. is a shareholder and scientific advisory board member for Navitor Pharmaceuticals and LAM Therapeutics. Word count: 5,171 Number of figures: 6 main figures, 4 supplemental figures 1 bioRxiv preprint doi: https://doi.org/10.1101/835199; this version posted November 11, 2019.
    [Show full text]
  • Efficacy and Safety of Mizoribine by One Single Dose Administration for Patients with Rheumatoid Arthritis
    □ ORIGINAL ARTICLE □ Efficacy and Safety of Mizoribine by One Single Dose Administration for Patients with Rheumatoid Arthritis Kunihiro Ichinose 1, Tomoki Origuchi 2, Shin-ya Kawashiri 1, Naoki Iwamoto 1, Keita Fujikawa 1, Toshiyuki Aramaki 1, Makoto Kamachi 1, Kazuhiko Arima 1, Mami Tamai 1, Hideki Nakamura 1, Hiroaki Ida 1, Atsushi Kawakami 1, Toshiaki Tsukada 3, Yukitaka Ueki 4 and Katsumi Eguchi 1 Abstract Objective Mizoribine (MZR) is an immunosuppressant that inhibits nucleic acid metabolism and is a rela- tively safe disease-modifying anti-rheumatic drug (DMARD). We evaluated the efficacy and safety of one single dose per day for patients with rheumatoid arthritis (RA). Patients and Methods In this study 32 patients with RA received MZR therapy. We evaluated the average dose of MZR and prednisolone, response to treatment and peak plasma level of MZR. Results The average dose of MZR was 146.1±31.2 (range: 50-200) mg/day. The average dose of predniso- lone was 4.63±3.59 (range: 0-14) mg/day. The average plasma level of MZR, measured after 3 hours, was 2.20±0.49 μg/mL in the responder group and 1.59±0.82 μg/mL in the non-responder group (p=0.020). The treatment with MZR for 24 weeks was completed by 71.9% of patients and the proportion of patients who achieved a good and moderate response rate according to the European League Against Rheumatism (EU- LAR) criteria was 56.3% at 24 weeks. The plasma level of MZR which was greater than or equal to 2.12 μg/ mL was significantly correlated with the clinical response (p<0.01).
    [Show full text]
  • SUPPLEMENTARY APPENDIX 4: Search Strategies Syntax Guide For
    SUPPLEMENTARY APPENDIX 4: Search Strategies Pubmed, Embase Perioperative Management - PubMed Search Strategy – March 6, 2016 Syntax Guide for PubMed [MH] = Medical Subject Heading, also [TW] = Includes all words and numbers in known as MeSH the title, abstract, other abstract, MeSH terms, MeSH Subheadings, Publication Types, Substance Names, Personal Name as Subject, Corporate Author, Secondary Source, Comment/Correction Notes, and Other Terms - typically non-MeSH subject terms (keywords)…assigned by an organization other than NLM [SH] = a Medical Subject Heading [TIAB] = Includes words in the title and subheading, e.g. drug therapy abstracts [MH:NOEXP] = a command to retrieve the results of the Medical Subject Heading specified, but not narrower Medical Subject Heading terms Boolean Operators OR = retrieves results that include at least AND = retrieves results that include all the one of the search terms search terms NOT = excludes the retrieval of terms from the search Perioperative Management PubMed Search Strategy – March 6, 2016 Search Query #1 ((((ARTHROPLASTY, REPLACEMENT, HIP[MH] OR HIP PROSTHES*[TW] OR HIP REPLACEMENT*[TIAB] OR HIP ARTHROPLAST*[TIAB] OR HIP TOTAL REPLACEMENT*[TIAB] OR FEMORAL HEAD PROSTHES*[TIAB]) OR (ARTHROPLASTY, REPLACEMENT, KNEE[MH] OR KNEE PROSTHES*[TW] OR KNEE REPLACEMENT*[TW] OR KNEE ARTHROPLAST*[TW] OR KNEE TOTAL REPLACEMENT*[TIAB]) OR (ARTHROPLAST*[TW] AND (HIP[TIAB] OR HIPS[TIAB] OR KNEE*[TIAB])) AND (("1980/01/01"[PDAT] : "2016/03/06"[PDAT]) AND ENGLISH[LANG])) NOT (((("ADOLESCENT"[MESH]) OR "CHILD"[MESH])
    [Show full text]
  • Treatment Or Prophylaxis Against Hepatitis B Virus Infection in Patients with Rheumatic Disease Undergoing Immunosuppressive Therapy: an Update
    Journal of Clinical Medicine Review Treatment or Prophylaxis against Hepatitis B Virus Infection in Patients with Rheumatic Disease Undergoing Immunosuppressive Therapy: An Update Cristina Stasi 1,2,* , Giacomo Tiengo 1, Sinan Sadalla 3 and Anna Linda Zignego 1 1 MASVE Interdepartmental Hepatology Center, Department of Experimental and Clinical Medicine, University of Florence and CRIA-MASVE Center for Research and Innovation, Careggi University Hospital, 50134 Florence, Italy; [email protected] (G.T.); [email protected]fi.it (A.L.Z.) 2 Epidemiology Unit, Regional Health Agency of Tuscany, 50141 Florence, Italy 3 Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy; [email protected] * Correspondence: [email protected] Abstract: Chronic hepatitis B virus (HBV) flares or reactivations are serious causes of morbidity or mortality in rheumatologic patients undergoing immunosuppressive therapy. The recent insights in the pathogenesis of rheumatic diseases led to the use of new immunosuppressive therapies indi- cated in case of failure, partial response, or intolerance of conventional synthetic disease-modifying anti-rheumatic drugs. Based on these premises, this review examines and discusses the main rheuma- tologic treatments that could require the initiation of prophylactic treatment or close monitoring of occult HBV infection in patients beginning antiviral therapy at the first signs of HBV reactivation, or antiviral treatment in chronic HBV-infected patients. We searched for relevant studies published in Citation: Stasi, C.; Tiengo, G.; the last five years. Studies suggested that the presence of HBV infection is common in rheumatic Sadalla, S.; Zignego, A.L. Treatment patients and HBV reactivation during these immunosuppressant treatments is quite frequent in these or Prophylaxis against Hepatitis B kinds of patients.
    [Show full text]
  • Immunosuppressant Ingredients, Immunostimulant Ingredients
    Immunosuppressant Ingredients, Immunostimulant Ingredients Immunosuppressant Ingredients Immunosuppressant ingredients are chemical and medicinal agents used for the suppression and regulation of immune responses. Pharmacologically speaking, these agents have varied mecha- nisms of action, such as regulation of inflammatory gene expression, suppression of lymphocyte signal transduction, neutralization of cytokine activity, and inhibition lymphocyte proliferation by agent-induced cytotoxicity. Common agents include glucocorticoids, alkylating agents, metabolic antagonists, calcineurin inhibitors, T-cell suppressive agents, and cytokine inhibitors. 5-Aminosalicylic Acid 25g / 500g [A0317] 5-Aminosalicylic acid (5-ASA) is commonly used as a gastrointestinal anti-inflammatory agent. It has in vitro and in vivo pharmacologic effects that decrease leukotriene production, scavenge for free radicals, and inhibits leukocyte chemotaxis et al. Azathioprine 5g / 25g [A2069] Azathioprine is a prodrug of 6-mercaptopurine (6-MP), which inhibits the synthesis of purine ribonucleotides and DNA/RNA. Cyclophosphamide Monohydrate 5g / 25g [C2236] Cyclophosphamide is an antitumor alkylating reagent involved in the cross-linking of tumor cell DNA. Cyclosporin A 100mg / 1g [C2408] Cyclosporin A is a cyclic polypeptide immunosuppressant. It inhibits the activity of T-lymphocytes, and the phosphatase activity of calcineurin. Dimethyl Fumarate 25g / 500g [F0069] Dimethyl fumarate has neuroprotective and immunomodulating effects. Fingolimod Hydrochloride 200mg / 1g [F1018] Fingolimod (FTY720) is an immunomodulatory agent. It is an agonist at sphingosine 1-phosphate (S1P) receptors, and inhibits lymphocyte emigra- tion from lymphoid organs. Iguratimod 25mg / 250mg [I0945] Iguratimod (T-614) is an agent with anti-inflammatory and immunomodulatory activities. Its activity functions by the inhibiting production of immune globulin and inflammatory cytokines such as TNF-α, IL-1β and IL-6, and used as a disease modifying anti-rheumatic drug (DMARD).
    [Show full text]
  • Customs Tariff - Schedule
    CUSTOMS TARIFF - SCHEDULE 99 - i Chapter 99 SPECIAL CLASSIFICATION PROVISIONS - COMMERCIAL Notes. 1. The provisions of this Chapter are not subject to the rule of specificity in General Interpretative Rule 3 (a). 2. Goods which may be classified under the provisions of Chapter 99, if also eligible for classification under the provisions of Chapter 98, shall be classified in Chapter 98. 3. Goods may be classified under a tariff item in this Chapter and be entitled to the Most-Favoured-Nation Tariff or a preferential tariff rate of customs duty under this Chapter that applies to those goods according to the tariff treatment applicable to their country of origin only after classification under a tariff item in Chapters 1 to 97 has been determined and the conditions of any Chapter 99 provision and any applicable regulations or orders in relation thereto have been met. 4. The words and expressions used in this Chapter have the same meaning as in Chapters 1 to 97. Issued January 1, 2019 99 - 1 CUSTOMS TARIFF - SCHEDULE Tariff Unit of MFN Applicable SS Description of Goods Item Meas. Tariff Preferential Tariffs 9901.00.00 Articles and materials for use in the manufacture or repair of the Free CCCT, LDCT, GPT, UST, following to be employed in commercial fishing or the commercial MT, MUST, CIAT, CT, harvesting of marine plants: CRT, IT, NT, SLT, PT, COLT, JT, PAT, HNT, Artificial bait; KRT, CEUT, UAT, CPTPT: Free Carapace measures; Cordage, fishing lines (including marlines), rope and twine, of a circumference not exceeding 38 mm; Devices for keeping nets open; Fish hooks; Fishing nets and netting; Jiggers; Line floats; Lobster traps; Lures; Marker buoys of any material excluding wood; Net floats; Scallop drag nets; Spat collectors and collector holders; Swivels.
    [Show full text]
  • Federal Register / Vol. 60, No. 80 / Wednesday, April 26, 1995 / Notices DIX to the HTSUS—Continued
    20558 Federal Register / Vol. 60, No. 80 / Wednesday, April 26, 1995 / Notices DEPARMENT OF THE TREASURY Services, U.S. Customs Service, 1301 TABLE 1.ÐPHARMACEUTICAL APPEN- Constitution Avenue NW, Washington, DIX TO THE HTSUSÐContinued Customs Service D.C. 20229 at (202) 927±1060. CAS No. Pharmaceutical [T.D. 95±33] Dated: April 14, 1995. 52±78±8 ..................... NORETHANDROLONE. A. W. Tennant, 52±86±8 ..................... HALOPERIDOL. Pharmaceutical Tables 1 and 3 of the Director, Office of Laboratories and Scientific 52±88±0 ..................... ATROPINE METHONITRATE. HTSUS 52±90±4 ..................... CYSTEINE. Services. 53±03±2 ..................... PREDNISONE. 53±06±5 ..................... CORTISONE. AGENCY: Customs Service, Department TABLE 1.ÐPHARMACEUTICAL 53±10±1 ..................... HYDROXYDIONE SODIUM SUCCI- of the Treasury. NATE. APPENDIX TO THE HTSUS 53±16±7 ..................... ESTRONE. ACTION: Listing of the products found in 53±18±9 ..................... BIETASERPINE. Table 1 and Table 3 of the CAS No. Pharmaceutical 53±19±0 ..................... MITOTANE. 53±31±6 ..................... MEDIBAZINE. Pharmaceutical Appendix to the N/A ............................. ACTAGARDIN. 53±33±8 ..................... PARAMETHASONE. Harmonized Tariff Schedule of the N/A ............................. ARDACIN. 53±34±9 ..................... FLUPREDNISOLONE. N/A ............................. BICIROMAB. 53±39±4 ..................... OXANDROLONE. United States of America in Chemical N/A ............................. CELUCLORAL. 53±43±0
    [Show full text]
  • PRODUCT INFORMATION Mizoribine Item No
    PRODUCT INFORMATION Mizoribine Item No. 23128 CAS Registry No.: 50924-49-7 Formal Name: 5-hydroxy-1-β-D-ribofuranosyl-1H- imidazole-4-carboxamide N Synonym: NSC 289637 MF: C H N O O N NH 9 13 3 6 HO 2 FW: 259.2 ≥95% O Purity: OH UV/Vis.: λmax: 242, 285 nm HO OH Supplied as: A crystalline solid Storage: -20°C Stability: ≥2 years Information represents the product specifications. Batch specific analytical results are provided on each certificate of analysis. Laboratory Procedures Mizoribine is supplied as a crystalline solid. A stock solution may be made by dissolving the mizoribine in the solvent of choice. Mizoribine is soluble in the organic solvent DMSO, which should be purged with an inert gas. Description Mizoribine is an imidazole nucleoside with immunosuppressive properties.1 It inhibits T cell proliferation in response to various mitogenic stimuli by 10-100% when used at concentrations ranging from 1 to 50 µg/mL. Mizoribine inhibits proliferation of stimulated T cells (IC50 = 5 µg/ml), which can be reversed by guanosine.2 It also inhibits guanine nucleotide formation in T cells, reducing GTP pools by 40-60% when used at a concentration of 5 µg/ml. Mizoribine inhibits replication of hepatitis C virus (HCV) RNA 3 in vitro (IC50 = 100 µM). It suppresses glomerulosclerosis, urinary albumin excretion, interstitial fibrotic lesions, and macrophage infiltration into glomeruli and the interstitium in a rat model of type 2 diabetes when used at doses of 5 or 10 mg/kg.4 Mizoribine also reduces MCP-1, osteopontin (OPN), and TGF-β1 mRNA expression in the kidney in the same model.
    [Show full text]
  • Anti-Tumor Potential of IMP Dehydrogenase Inhibitors: a Century-Long Story
    Review Anti-Tumor Potential of IMP Dehydrogenase Inhibitors: A Century-Long Story Rand Naffouje 1, Punita Grover 1, Hongyang Yu 2,3, Arun Sendilnathan 1, Kara Wolfe 1,4, Nazanin Majd 5, Eric P. Smith 6, Koh Takeuchi 7, Toshiya Senda 2,3, Satoshi Kofuji 8 and Atsuo T. Sasaki 1,4,9,10,* 1 Division of Hematology and Oncology, Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA; [email protected] (P.G.); [email protected] (A.S.); [email protected] (K.W.); [email protected] (A.T.S.) 2 Structural Biology Research Center, Institute of Materials Structure Science, High Energy Accelerator Research Organization (KEK), Tokyo 135-0063, Japan; [email protected] (H.Y.); [email protected] (T.S.) 3 Department of Accelerator Science, School of High Energy Accelerator Science, SOKENDAI (the Graduate University for Advanced Studies), 1-1 Oho, Tsukuba, Ibaraki 305-0801, Japan 4 Department of Cancer Biology, University of Cincinnati College of Medicine, OH 45267, USA 5 Department of Neuro-oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030, USA; [email protected] 6 Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA; [email protected] 7 Molecular Profiling Research Center for Drug Discovery, National Institute of Advanced Science and Technology, 2-3-26 Aomi, Koto, Tokyo 135-0063, Japan; [email protected] 8 Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan; [email protected] 9 Department of Neurosurgery, Brain Tumor Center at UC Gardner Neuroscience Institute, Cincinnati, OH 45267, USA 10 Institute for Advanced Biosciences, Keio University, Tsuruoka, Yamagata 997-0052, Japan * Correspondence: [email protected] Received: 9 August 2019; Accepted: 2 September 2019; Published: 11 September 2019 Abstract: The purine nucleotides ATP and GTP are essential precursors to DNA and RNA synthesis and fundamental for energy metabolism.
    [Show full text]
  • United States Patent (19) 11 Patent Number: 5,916,910 Lai (45) Date of Patent: Jun
    USOO591.6910A United States Patent (19) 11 Patent Number: 5,916,910 Lai (45) Date of Patent: Jun. 29, 1999 54 CONJUGATES OF DITHIOCARBAMATES Middleton et al., “Increased nitric oxide synthesis in ulcer WITH PHARMACOLOGICALLY ACTIVE ative colitis” Lancet, 341:465-466 (1993). AGENTS AND USES THEREFORE Miller et al., “Nitric Oxide Release in Response to Gut Injury Scand. J. Gastroenterol., 264:11-16 (1993). 75 Inventor: Ching-San Lai, Encinitas, Calif. Mitchell et al., “Selectivity of nonsteroidal antiinflamatory drugs as inhibitors of constitutive and inducible cyclooxy 73 Assignee: Medinox, Inc., San Diego, Calif. genase” Proc. Natl. Acad. Sci. USA, 90:11693–11697 (1993). 21 Appl. No.: 08/869,158 Myers et al., “Adrimaycin: The Role of Lipid Peroxidation in Cardiac Toxicity and Tumor Response' Science, 22 Filed: Jun. 4, 1997 197:165-167 (1977). 51) Int. Cl. ...................... C07D 207/04; CO7D 207/30; Onoe et al., “Il-13 and Il-4 Inhibit Bone Resorption by A61K 31/27; A61K 31/40 Suppressing Cyclooxygenase-2-Dependent ProStaglandin 52 U.S. Cl. .......................... 514/423: 514/514; 548/564; Synthesis in Osteoblasts' J. Immunol., 156:758–764 548/573; 558/235 (1996). 58 Field of Search ..................................... 514/514, 423; Reisinger et al., “Inhibition of HIV progression by dithio 548/565,573; 558/235 carb” Lancet, 335:679–682 (1990). Schreck et al., “Dithiocarbamates as Potent Inhibitors of 56) References Cited Nuclear Factor KB Activation in Intact Cells' J. Exp. Med., 175:1181–1194 (1992). U.S. PATENT DOCUMENTS Slater et al., “Expression of cyclooxygenase types 1 and 2 in 4,160,452 7/1979 Theeuwes ..............................
    [Show full text]