Inverse Agonism of SQ 29,548 and Ramatroban on Thromboxane A2 Receptor
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(12) United States Patent (10) Patent No.: US 9,498,481 B2 Rao Et Al
USOO9498481 B2 (12) United States Patent (10) Patent No.: US 9,498,481 B2 Rao et al. (45) Date of Patent: *Nov. 22, 2016 (54) CYCLOPROPYL MODULATORS OF P2Y12 WO WO95/26325 10, 1995 RECEPTOR WO WO99/O5142 2, 1999 WO WOOO/34283 6, 2000 WO WO O1/92262 12/2001 (71) Applicant: Apharaceuticals. Inc., La WO WO O1/922.63 12/2001 olla, CA (US) WO WO 2011/O17108 2, 2011 (72) Inventors: Tadimeti Rao, San Diego, CA (US); Chengzhi Zhang, San Diego, CA (US) OTHER PUBLICATIONS Drugs of the Future 32(10), 845-853 (2007).* (73) Assignee: Auspex Pharmaceuticals, Inc., LaJolla, Tantry et al. in Expert Opin. Invest. Drugs (2007) 16(2):225-229.* CA (US) Wallentin et al. in the New England Journal of Medicine, 361 (11), 1045-1057 (2009).* (*) Notice: Subject to any disclaimer, the term of this Husted et al. in The European Heart Journal 27, 1038-1047 (2006).* patent is extended or adjusted under 35 Auspex in www.businesswire.com/news/home/20081023005201/ U.S.C. 154(b) by Od en/Auspex-Pharmaceuticals-Announces-Positive-Results-Clinical M YW- (b) by ayS. Study (published: Oct. 23, 2008).* This patent is Subject to a terminal dis- Concert In www.concertpharma. com/news/ claimer ConcertPresentsPreclinicalResultsNAMS.htm (published: Sep. 25. 2008).* Concert2 in Expert Rev. Anti Infect. Ther. 6(6), 782 (2008).* (21) Appl. No.: 14/977,056 Springthorpe et al. in Bioorganic & Medicinal Chemistry Letters 17. 6013-6018 (2007).* (22) Filed: Dec. 21, 2015 Leis et al. in Current Organic Chemistry 2, 131-144 (1998).* Angiolillo et al., Pharmacology of emerging novel platelet inhibi (65) Prior Publication Data tors, American Heart Journal, 2008, 156(2) Supp. -
Prevention of Atherothrombotic Events in Patients with Diabetes Mellitus: from Antithrombotic Therapies to New-Generation Glucose-Lowering Drugs
CONSENSUS STATEMENT EXPERT CONSENSUS DOCUMENT Prevention of atherothrombotic events in patients with diabetes mellitus: from antithrombotic therapies to new-generation glucose-lowering drugs Giuseppe Patti1*, Ilaria Cavallari2, Felicita Andreotti3, Paolo Calabrò4, Plinio Cirillo5, Gentian Denas6, Mattia Galli3, Enrica Golia4, Ernesto Maddaloni 7, Rossella Marcucci8, Vito Maurizio Parato9,10, Vittorio Pengo6, Domenico Prisco8, Elisabetta Ricottini2, Giulia Renda11, Francesca Santilli12, Paola Simeone12 and Raffaele De Caterina11,13*, on behalf of the Working Group on Thrombosis of the Italian Society of Cardiology Abstract | Diabetes mellitus is an important risk factor for a first cardiovascular event and for worse outcomes after a cardiovascular event has occurred. This situation might be caused, at least in part, by the prothrombotic status observed in patients with diabetes. Therefore, contemporary antithrombotic strategies, including more potent agents or drug combinations, might provide greater clinical benefit in patients with diabetes than in those without diabetes. In this Consensus Statement, our Working Group explores the mechanisms of platelet and coagulation activity , the current debate on antiplatelet therapy in primary cardiovascular disease prevention, and the benefit of various antithrombotic approaches in secondary prevention of cardiovascular disease in patients with diabetes. While acknowledging that current data are often derived from underpowered, observational studies or subgroup analyses of larger trials, we propose -
Xử Trí Quá Liều Thuốc Chống Đông
XỬ TRÍ QUÁ LIỀU THUỐC CHỐNG ĐÔNG TS. Trần thị Kiều My Bộ môn Huyết học Đại học Y Hà nội Khoa Huyết học Bệnh viện Bạch mai TS. Trần thị Kiều My Coagulation cascade TIÊU SỢI HUYẾT THUỐC CHỐNG ĐÔNG VÀ CHỐNG HUYẾT KHỐI • Thuốc chống ngưng tập tiểu cầu • Thuốc chống các yếu tố đông máu huyết tương • Thuốc tiêu sợi huyết và huyết khối Thuốc chống ngưng tập tiểu cầu Đường sử Xét nghiệm theo dõi dụng Nhóm thuốc ức chế Glycoprotein IIb/IIIa: TM VerifyNow Abciximab, ROTEM Tirofiban SLTC, Hb, Hct, APTT, Clotting time Eptifibatide, ACT, aPTT, TT, and PT Nhóm ức chế receptor ADP /P2Y12 Uống NTTC, phân tích chức +thienopyridines năng TC bằng PFA, Clopidogrel ROTEM Prasugrel VerifyNow Ticlopidine +nucleotide/nucleoside analogs Cangrelor Elinogrel, TM Ticagrelor TM+uống ƯC ADP Uống Nhóm Prostaglandin analogue (PGI2): Uống NTTC, phân tích chức Beraprost, năng TC bằng PFA, ROTEM Iloprost (Illomedin), Xịt hoặc truyền VerifyNow TM Prostacyclin,Treprostinil Nhóm ức chế COX: Uống NTTC, phân tích Acetylsalicylicacid/Aspirin#Aloxiprin,Carbasalate, chức năng TC bằng calcium, Indobufen, Triflusal PFA, ROTEM VerifyNow Nhóm ức chế Thromboxane: Uống NTTC, phân tích chức +thromboxane synthase inhibitors năng TC bằng PFA, Dipyridamole (+Aspirin), Picotamide ROTEM +receptor antagonist : Terutroban† VerifyNow Nhóm ức chế Phosphodiesterase: Uống NTTC, phân tích chức Cilostazol, Dipyridamole, Triflusal năng TC bằng PFA, ROTEM VerifyNow Nhóm khác: Uống NTTC, phân tích chức Cloricromen, Ditazole, Vorapaxar năng TC bằng PFA, ROTEM VerifyNow Dược động học một số thuốc -
Endogenous Biosynthesis of Prostacyclin and Thromboxane and Platelet Function During Chronic Administration of Aspirin in Man
Endogenous biosynthesis of prostacyclin and thromboxane and platelet function during chronic administration of aspirin in man. G A FitzGerald, … , J A Lawson, A R Brash J Clin Invest. 1983;71(3):676-688. https://doi.org/10.1172/JCI110814. Research Article To assess the pharmacologic effects of aspirin on endogenous prostacyclin and thromboxane biosynthesis, 2,3-dinor-6- keto PGF1 alpha (PGI-M) and 2,3-dinor-thromboxane B2 (Tx-M) were measured in urine by mass spectrometry during continuing administration of aspirin. To define the relationship of aspirin intake to endogenous prostacyclin biosynthesis, sequential urines were initially collected in individuals prior to, during, and subsequent to administration of aspirin. Despite inter- and intra-individual variations, PGI-M excretion was significantly reduced by aspirin. However, full mass spectral identification confirmed continuing prostacyclin biosynthesis during aspirin therapy. Recovery of prostacyclin biosynthesis was incomplete 5 d after drug administration was discontinued. To relate aspirin intake to indices of thromboxane biosynthesis and platelet function, volunteers received 20 mg aspirin daily followed by 2,600 mg aspirin daily, each dose for 7 d in sequential weeks. Increasing aspirin dosage inhibited Tx-M excretion from 70 to 98% of pretreatment control values; platelet TxB2 formation from 4.9 to 0.5% and further inhibited platelet function. An extended study was performed to relate aspirin intake to both thromboxane and prostacyclin generation over a wide range of doses. Aspirin, in the range of 20 to 325 mg/d, resulted in a dose-dependent decline in both Tx-M and PGI-M excretion. At doses of 325-2,600 mg/d Tx-M excretion ranged from 5 to 3% of control values while PGI-M remained at 37-23% of control. -
Challenging the FDA Black Box Warning for High Aspirin Dose with Ticagrelor in Patients with Diabetes James J
PERSPECTIVES IN DIABETES Challenging the FDA Black Box Warning for High Aspirin Dose With Ticagrelor in Patients With Diabetes James J. DiNicolantonio and Victor L. Serebruany – Ticagrelor, a novel reversible antiplatelet agent, has a Food and ASA 300 325 mg (53.6%) in the U.S. compared with the Drug Administration (FDA) black box warning to avoid mainte- rest of the world (1.7%) was the only factor to explain nance doses of aspirin (ASA) .100 mg/daily. This restriction is (out of 37 variables explored) the regional interaction based on the hypothesis that ASA doses .100 mg somehow de- that ticagrelor was less effective and potentially more creased ticagrelor’s benefit in the Platelet Inhibition and Patient harmful than clopidogrel (2). However, this interaction Outcomes (PLATO) U.S. cohort. However, these data are highly was not significant, is highly postrandomized, comes postrandomized, come from a very small subgroup in PLATO from a very small subgroup of PLATO, and makes no (57% of patients in the U.S. site), and make no biological sense. biological sense (3). Moreover, the ticagrelor-ASA interaction was not significant by any multivariate Cox regression analyses. The Complete Re- sponse Review for ticagrelor indicates that for U.S. PLATO patients, an ASA dose .300 mg was not a significant interaction TICAGRELOR-ASA HYPOTHESIS for vascular outcomes. In the ticagrelor-ASA .300 mg cohort, all- The claimed ticagrelor-ASA interaction states that ticagrelor cause and vascular mortality were not significantly increased fi – P plus low-dose ASA is bene cial, whereas increasing doses (hazard ratio [HR] 1.27 [95% CI 0.84 1.93], = 0.262 and 1.39 of ASA in combination with ticagrelor produces adverse [0.87–2.2], P = 0.170), respectively. -
GTH 2021 State of the Art—Cardiac Surgery: the Perioperative Management of Heparin-Induced Thrombocytopenia in Cardiac Surgery
Review Article 59 GTH 2021 State of the Art—Cardiac Surgery: The Perioperative Management of Heparin-Induced Thrombocytopenia in Cardiac Surgery Laura Ranta1 Emmanuelle Scala1 1 Department of Anesthesiology, Cardiothoracic and Vascular Address for correspondence Emmanuelle Scala, MD, Centre Anesthesia, Lausanne University Hospital (CHUV), Lausanne, Hospitalier Universitaire Vaudois, Rue du Bugnon 46, BH 05/300, 1011 Switzerland Lausanne, Suisse, Switzerland (e-mail: [email protected]). Hämostaseologie 2021;41:59–62. Abstract Heparin-induced thrombocytopenia (HIT) is a severe, immune-mediated, adverse drug Keywords reaction that paradoxically induces a prothrombotic state. Particularly in the setting of ► Heparin-induced cardiac surgery, where full anticoagulation is required during cardiopulmonary bypass, thrombocytopenia the management of HIT can be highly challenging, and requires a multidisciplinary ► cardiac surgery approach. In this short review, the different perioperative strategies to run cardiopul- ► state of the art monary bypass will be summarized. Introduction genicity of the antibodies and is diagnostic for HIT. The administration of heparin to a patient with circulating Heparin-induced thrombocytopenia (HIT) is a severe, im- pathogenic HITabs puts the patient at immediate risk of mune-mediated, adverse drug reaction that paradoxically severe thrombotic complications. induces a prothrombotic state.1,2 Particularly in the setting The time course of HIT can be divided into four distinct of cardiac surgery, where full anticoagulation is required phases.6 Acute HIT is characterized by thrombocytopenia during cardiopulmonary bypass (CPB), the management of and/or thrombosis, the presence of HITabs, and confirma- HIT can be highly challenging, and requires a multidisciplin- tion of their platelet activating capacity by a functional ary approach. -
Antithrombotic Treatment After Stroke Due to Intracerebral Haemorrhage (Review)
Cochrane Database of Systematic Reviews Antithrombotic treatment after stroke due to intracerebral haemorrhage (Review) Perry LA, Berge E, Bowditch J, Forfang E, Rønning OM, Hankey GJ, Villanueva E, Al-Shahi Salman R Perry LA, Berge E, Bowditch J, Forfang E, Rønning OM, Hankey GJ, Villanueva E, Al-Shahi Salman R. Antithrombotic treatment after stroke due to intracerebral haemorrhage. Cochrane Database of Systematic Reviews 2017, Issue 5. Art. No.: CD012144. DOI: 10.1002/14651858.CD012144.pub2. www.cochranelibrary.com Antithrombotic treatment after stroke due to intracerebral haemorrhage (Review) Copyright © 2017 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. TABLE OF CONTENTS HEADER....................................... 1 ABSTRACT ...................................... 1 PLAINLANGUAGESUMMARY . 2 SUMMARY OF FINDINGS FOR THE MAIN COMPARISON . ..... 3 BACKGROUND .................................... 5 OBJECTIVES ..................................... 5 METHODS ...................................... 6 RESULTS....................................... 8 Figure1. ..................................... 9 Figure2. ..................................... 11 Figure3. ..................................... 12 DISCUSSION ..................................... 14 AUTHORS’CONCLUSIONS . 15 ACKNOWLEDGEMENTS . 15 REFERENCES ..................................... 15 CHARACTERISTICSOFSTUDIES . 18 DATAANDANALYSES. 31 Analysis 1.2. Comparison 1 Short-term antithrombotic treatment, Outcome 2 Death. 31 Analysis 1.6. Comparison 1 Short-term antithrombotic -
Effect of Prostanoids on Human Platelet Function: an Overview
International Journal of Molecular Sciences Review Effect of Prostanoids on Human Platelet Function: An Overview Steffen Braune, Jan-Heiner Küpper and Friedrich Jung * Institute of Biotechnology, Molecular Cell Biology, Brandenburg University of Technology, 01968 Senftenberg, Germany; steff[email protected] (S.B.); [email protected] (J.-H.K.) * Correspondence: [email protected] Received: 23 October 2020; Accepted: 23 November 2020; Published: 27 November 2020 Abstract: Prostanoids are bioactive lipid mediators and take part in many physiological and pathophysiological processes in practically every organ, tissue and cell, including the vascular, renal, gastrointestinal and reproductive systems. In this review, we focus on their influence on platelets, which are key elements in thrombosis and hemostasis. The function of platelets is influenced by mediators in the blood and the vascular wall. Activated platelets aggregate and release bioactive substances, thereby activating further neighbored platelets, which finally can lead to the formation of thrombi. Prostanoids regulate the function of blood platelets by both activating or inhibiting and so are involved in hemostasis. Each prostanoid has a unique activity profile and, thus, a specific profile of action. This article reviews the effects of the following prostanoids: prostaglandin-D2 (PGD2), prostaglandin-E1, -E2 and E3 (PGE1, PGE2, PGE3), prostaglandin F2α (PGF2α), prostacyclin (PGI2) and thromboxane-A2 (TXA2) on platelet activation and aggregation via their respective receptors. Keywords: prostacyclin; thromboxane; prostaglandin; platelets 1. Introduction Hemostasis is a complex process that requires the interplay of multiple physiological pathways. Cellular and molecular mechanisms interact to stop bleedings of injured blood vessels or to seal denuded sub-endothelium with localized clot formation (Figure1). -
Modifications to the Harmonized Tariff Schedule of the United States To
U.S. International Trade Commission COMMISSIONERS Shara L. Aranoff, Chairman Daniel R. Pearson, Vice Chairman Deanna Tanner Okun Charlotte R. Lane Irving A. Williamson Dean A. Pinkert Address all communications to Secretary to the Commission United States International Trade Commission Washington, DC 20436 U.S. International Trade Commission Washington, DC 20436 www.usitc.gov Modifications to the Harmonized Tariff Schedule of the United States to Implement the Dominican Republic- Central America-United States Free Trade Agreement With Respect to Costa Rica Publication 4038 December 2008 (This page is intentionally blank) Pursuant to the letter of request from the United States Trade Representative of December 18, 2008, set forth in the Appendix hereto, and pursuant to section 1207(a) of the Omnibus Trade and Competitiveness Act, the Commission is publishing the following modifications to the Harmonized Tariff Schedule of the United States (HTS) to implement the Dominican Republic- Central America-United States Free Trade Agreement, as approved in the Dominican Republic-Central America- United States Free Trade Agreement Implementation Act, with respect to Costa Rica. (This page is intentionally blank) Annex I Effective with respect to goods that are entered, or withdrawn from warehouse for consumption, on or after January 1, 2009, the Harmonized Tariff Schedule of the United States (HTS) is modified as provided herein, with bracketed matter included to assist in the understanding of proclaimed modifications. The following supersedes matter now in the HTS. (1). General note 4 is modified as follows: (a). by deleting from subdivision (a) the following country from the enumeration of independent beneficiary developing countries: Costa Rica (b). -
Activation of the Murine EP3 Receptor for PGE2 Inhibits Camp Production and Promotes Platelet Aggregation
Activation of the murine EP3 receptor for PGE2 inhibits cAMP production and promotes platelet aggregation Jean-Etienne Fabre, … , Thomas M. Coffman, Beverly H. Koller J Clin Invest. 2001;107(5):603-610. https://doi.org/10.1172/JCI10881. Article The importance of arachidonic acid metabolites (termed eicosanoids), particularly those derived from the COX-1 and COX-2 pathways (termed prostanoids), in platelet homeostasis has long been recognized. Thromboxane is a potent agonist, whereas prostacyclin is an inhibitor of platelet aggregation. In contrast, the effect of prostaglandin E2 (PGE2) on platelet aggregation varies significantly depending on its concentration. Low concentrations of PGE2 enhance platelet aggregation, whereas high PGE2 levels inhibit aggregation. The mechanism for this dual action of PGE2 is not clear. This study shows that among the four PGE2 receptors (EP1–EP4), activation of EP3 is sufficient to mediate the proaggregatory actions of low PGE2 concentration. In contrast, the prostacyclin receptor (IP) mediates the inhibitory effect of higher PGE2 concentrations. Furthermore, the relative activation of these two receptors, EP3 and IP, regulates the intracellular level of cAMP and in this way conditions the response of the platelet to aggregating agents. Consistent with these findings, loss of the EP3 receptor in a model of venous inflammation protects against formation of intravascular clots. Our results suggest that local production of PGE2 during an inflammatory process can modulate ensuing platelet responses. Find the latest version: https://jci.me/10881/pdf Activation of the murine EP3 receptor for PGE2 inhibits cAMP production and promotes platelet aggregation Jean-Etienne Fabre,1 MyTrang Nguyen,1 Krairek Athirakul,2 Kenneth Coggins,1 John D. -
Prostacyclin Therapies for the Treatment of Pulmonary Arterial Hypertension
Eur Respir J 2008; 31: 891–901 DOI: 10.1183/09031936.00097107 CopyrightßERS Journals Ltd 2008 SERIES ‘‘PULMONARY HYPERTENSION: BASIC CONCEPTS FOR PRACTICAL MANAGEMENT’’ Edited by M.M. Hoeper and A.T. Dinh-Xuan Number 2 in this Series Prostacyclin therapies for the treatment of pulmonary arterial hypertension M. Gomberg-Maitland* and H. Olschewski# ABSTRACT: Prostacyclin and its analogues (prostanoids) are potent vasodilators and possess AFFILIATIONS antithrombotic, antiproliferative and anti-inflammatory properties. Pulmonary hypertension (PH) *Dept of Cardiology, University of Chicago Hospitals, Chicago, IL, USA. is associated with vasoconstriction, thrombosis and proliferation, and the lack of endogenous #Dept of Pulmonology, Medical prostacyclin may considerably contribute to this condition. This supports a strong rationale for University Graz, Graz, Austria. prostanoid use as therapy for this disease. The first experiences of prostanoid therapy in PH patients were published in 1980. CORRESPONDENCE H. Olschewski Epoprostenol, a synthetic analogue of prostacyclin, and the chemically stable analogues Dept of Pulmonology iloprost, beraprost and treprostinil were tested in randomised controlled trials. The biological Medical University Graz actions are mainly mediated by activation of specific receptors of the target cells; however, new Auenbruggerplatz 20 data suggest effects on additional intracellular pathways. In the USA and some European Graz 8010 Austria countries, intravenous infusion of epoprostenol and treprostinil, as well as subcutaneous infusion Fax: 43 3163853578 of treprostinil and inhalation of iloprost, have been approved for therapy of pulmonary arterial E-mail: horst.olschewski@ hypertension. Iloprost infusion and beraprost tablets have been approved in few other countries. meduni-graz.at Ongoing clinical studies investigate oral treprostinil, inhaled treprostinil and the combination of Received: inhaled iloprost and sildenafil in pulmonary arterial hypertension. -
Pharmaceutical Appendix to the Tariff Schedule 2
Harmonized Tariff Schedule of the United States (2007) (Rev. 2) Annotated for Statistical Reporting Purposes PHARMACEUTICAL APPENDIX TO THE HARMONIZED TARIFF SCHEDULE Harmonized Tariff Schedule of the United States (2007) (Rev. 2) Annotated for Statistical Reporting Purposes PHARMACEUTICAL APPENDIX TO THE TARIFF SCHEDULE 2 Table 1. This table enumerates products described by International Non-proprietary Names (INN) which shall be entered free of duty under general note 13 to the tariff schedule. The Chemical Abstracts Service (CAS) registry numbers also set forth in this table are included to assist in the identification of the products concerned. For purposes of the tariff schedule, any references to a product enumerated in this table includes such product by whatever name known. ABACAVIR 136470-78-5 ACIDUM LIDADRONICUM 63132-38-7 ABAFUNGIN 129639-79-8 ACIDUM SALCAPROZICUM 183990-46-7 ABAMECTIN 65195-55-3 ACIDUM SALCLOBUZICUM 387825-03-8 ABANOQUIL 90402-40-7 ACIFRAN 72420-38-3 ABAPERIDONUM 183849-43-6 ACIPIMOX 51037-30-0 ABARELIX 183552-38-7 ACITAZANOLAST 114607-46-4 ABATACEPTUM 332348-12-6 ACITEMATE 101197-99-3 ABCIXIMAB 143653-53-6 ACITRETIN 55079-83-9 ABECARNIL 111841-85-1 ACIVICIN 42228-92-2 ABETIMUSUM 167362-48-3 ACLANTATE 39633-62-0 ABIRATERONE 154229-19-3 ACLARUBICIN 57576-44-0 ABITESARTAN 137882-98-5 ACLATONIUM NAPADISILATE 55077-30-0 ABLUKAST 96566-25-5 ACODAZOLE 79152-85-5 ABRINEURINUM 178535-93-8 ACOLBIFENUM 182167-02-8 ABUNIDAZOLE 91017-58-2 ACONIAZIDE 13410-86-1 ACADESINE 2627-69-2 ACOTIAMIDUM 185106-16-5 ACAMPROSATE 77337-76-9