DOCSLIB.ORG

PRAC Minutes June 2019

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
PRAC Minutes June 2019 11 July 2019 EMA/PRAC/616893/2019 Inspections, Human Medicines Pharmacovigilance and Committees Division Pharmacovigilance Risk Assessment Committee (PRAC) Minutes of the meeting on 11-14 June 2019 Chair: Sabine Straus – Vice-Chair: Martin Huber Health and safety information In accordance with the Agency’s health and safety policy, delegates were briefed on health, safety and emergency information and procedures prior to the start of the meeting. Disclaimers Some of the information contained in the minutes is considered commercially confidential or sensitive and therefore not disclosed. With regard to intended therapeutic indications or procedure scope listed against products, it must be noted that these may not reflect the full wording proposed by applicants and may also change during the course of the review. Additional details on some of these procedures will be published in the PRAC meeting highlights once the procedures are finalised. Of note, the minutes are a working document primarily designed for PRAC members and the work the Committee undertakes. Note on access to documents Some documents mentioned in the minutes cannot be released at present following a request for access to documents within the framework of Regulation (EC) No 1049/2001 as they are subject to on- going procedures for which a final decision has not yet been adopted. They will become public when adopted or considered public according to the principles stated in the Agency policy on access to documents (EMA/127362/2006, Rev. 1). Official address Domenico Scarlattilaan 6 ● 1083 HS Amsterdam ● The Netherlands Address for visits and deliveries Refer to www.ema.europa.eu/how-to-find-us Send us a question Go to www.ema.europa.eu/contact Telephone +31 (0)88 781 6000 An agency of the European Union © European Medicines Agency, 2019. Reproduction is authorised provided the source is acknowledged. Table of contents 1. Introduction 14 1.1. Welcome and declarations of interest of members, alternates and experts .......... 14 1.2. Agenda of the meeting on 11-14 June 2019 ......................................................... 14 1.3. Minutes of the previous meeting on 13-16 May 2019 ........................................... 14 2. EU referral procedures for safety reasons: urgent EU procedures 14 2.1. Newly triggered procedures ................................................................................. 14 2.2. Ongoing procedures ............................................................................................. 14 2.3. Procedures for finalisation .................................................................................... 15 3. EU referral procedures for safety reasons: other EU referral procedures 15 3.1. Newly triggered procedures ................................................................................. 15 3.1.1. Leuprorelin (NAP) – EMEA/H/A-31/1486 ..................................................................... 15 3.2. Ongoing procedures ............................................................................................. 16 3.3. Procedures for finalisation .................................................................................... 16 3.4. Re-examination procedures .................................................................................. 16 3.5. Others .................................................................................................................. 16 4. Signals assessment and prioritisation 16 4.1. New signals detected from EU spontaneous reporting systems ............................ 16 4.2. New signals detected from other sources ............................................................. 16 4.3. Signals follow-up and prioritisation ...................................................................... 16 4.3.1. Dipeptidyl peptidase-4 (DPP-4) inhibitors: alogliptin – VIPIDIA (CAP) - EMEA/H/C/002182/SDA/011; linagliptin – TRAJENTA (CAP) - EMEA/H/C/002110/SDA/017; saxagliptin – ONGLYZA (CAP) - EMEA/H/C/001039/SDA/043; sitagliptin – JANUVIA (CAP) - EMEA/H/C/000722/SDA/038, RISTABEN (CAP) - EMEA/H/C/001234/SDA/016, TESAVEL (CAP) - EMEA/H/C/000910/SDA/032, XELEVIA (CAP) - EMEA/H/C/000762/SDA/037; vildagliptin – GALVUS (CAP) - EMEA/H/C/000771/SDA/047, JALRA (CAP) - EMEA/H/C/001048/SDA/031, XILIARX (CAP) - EMEA/H/C/001051/SDA/031; Glucagon-like peptide-1 (GLP-1) receptor agonists: albiglutide – EPERZAN; dulaglutide – TRULICITY (CAP) - EMEA/H/C/002825/SDA/012; exenatide – BYDUREON (CAP) - EMEA/H/C/002020/SDA/026, BYETTA (CAP) - EMEA/H/C/000698/SDA/046; liraglutide – SAXENDA (CAP) - EMEA/H/C/003780/SDA/018, VICTOZA (CAP) - EMEA/H/C/001026/SDA/037; lixisenatide – LYXUMIA (CAP) - EMEA/H/C/002445/SDA/015; semaglutide – OZEMPIC (CAP) – EMEA/H/C/004174/SDA/006 ....................................... 16 4.3.2. Loperamide (NAP) ................................................................................................... 17 4.3.3. Propylthiouracil (NAP) .............................................................................................. 18 4.3.4. Rivaroxaban - XARELTO (CAP) - EMEA/H/C/000944/SDA/045; NAPs .............................. 19 4.3.5. Secukinumab - COSENTYX (CAP) - EMEA/H/C/003729/SDA/006 .................................... 20 4.3.6. Sulfasalazine (NAP) .................................................................................................. 20 Pharmacovigilance Risk Assessment Committee (PRAC) EMA/PRAC/616893/2019 Page 2/105 4.3.7. Temozolomide - TEMODAL (CAP) - EMEA/H/C/000229/SDA/042; TEMOMEDAC (CAP), TEMOZOLOMIDE ACCORD (CAP), TEMOZOLOMIDE HEXAL (CAP), TEMOZOLOMIDE SANDOZ (CAP), TEMOZOLOMIDE SUN (CAP), TEMOZOLOMIDE TEVA (CAP); NAP ......................... 21 4.3.8. Topiramate (NAP) .................................................................................................... 22 5. Risk management plans (RMPs) 22 5.1. Medicines in the pre-authorisation phase ............................................................. 22 5.1.1. Cefiderocol - EMEA/H/C/004829 ................................................................................ 22 5.1.2. Emapalumab - EMEA/H/C/004386, Orphan ................................................................. 23 5.1.3. Fostamatinib - EMEA/H/C/005012 .............................................................................. 23 5.1.4. Netarsudil - EMEA/H/C/004583 ................................................................................. 23 5.1.5. Omadacycline tosilate - EMEA/H/C/004715 ................................................................. 23 5.1.6. Quizartinib - EMEA/H/C/004468, Orphan .................................................................... 23 5.1.7. Replication-competent live recombinant vesicular stomatitis virus (rVSVΔG-ZEBOV-GP, live attenuated) expressing the envelope glycoprotein of the Ebolavirus-Zaire Kikwit strain - EMEA/H/C/004554 ................................................................................................... 23 5.2. Medicines in the post-authorisation phase – PRAC-led procedures ....................... 23 5.3. Medicines in the post-authorisation phase – CHMP-led procedures ...................... 23 6. Periodic safety update reports (PSURs) 23 6.1. PSUR single assessment (PSUSA) procedures including centrally authorised products (CAPs) only ............................................................................................ 23 6.1.1. Aclidinium bromide, formoterol fumarate dihydrate - BRIMICA GENUAIR (CAP); DUAKLIR GENUAIR (CAP) - PSUSA/00010307/201811 ............................................................... 24 6.1.2. Aflibercept - EYLEA (CAP) - PSUSA/00010020/201811 ................................................. 24 6.1.3. Atezolizumab - TECENTRIQ (CAP) - PSUSA/00010644/201811 ...................................... 25 6.1.4. Cabozantinib - CABOMETYX (CAP); COMETRIQ (CAP) - PSUSA/00010180/201811 (with RMP) ...................................................................................................................... 26 6.1.5. Darifenacin - EMSELEX (CAP) - PSUSA/00000933/201810 ............................................ 27 6.1.6. Erenumab - AIMOVIG (CAP) - PSUSA/00010699/201811 .............................................. 27 6.1.7. Etelcalcetide - PARSABIV (CAP) - PSUSA/00010533/201811 ......................................... 28 6.1.8. Ibrutinib - IMBRUVICA (CAP) - PSUSA/00010301/201811 ............................................. 29 6.1.9. Metformin, saxagliptin - KOMBOGLYZE (CAP) - PSUSA/00002686/201811 ...................... 30 6.1.10. Nusinersen - SPINRAZA (CAP) - PSUSA/00010595/201811 ........................................... 31 6.1.11. Osimertinib - TAGRISSO (CAP) - PSUSA/00010472/201811 .......................................... 31 6.1.12. Pentosan polysulfate sodium - ELMIRON (CAP) - PSUSA/00010614/201812 .................... 32 6.1.13. Sofosbuvir - SOVALDI (CAP) - PSUSA/00010134/201812 ............................................. 33 6.1.14. Tolvaptan - JINARC (CAP) - PSUSA/00010395/201811 ................................................. 34 6.2. PSUR single assessment (PSUSA) procedures including centrally authorised products (CAPs) and nationally authorised products (NAPs) ................................ 35 6.2.1. Eslicarbazepine acetate - ZEBINIX (CAP); NAP - PSUSA/00001267/201810 .................... 35 6.2.2. Methotrexate - JYLAMVO (CAP), NORDIMET (CAP); NAP - PSUSA/00002014/201810 ....... 36 Pharmacovigilance Risk Assessment Committee (PRAC) EMA/PRAC/616893/2019 Page 3/105 6.2.3. Sevelamer
Load more

Recommended publications
  • Vernakalant Versus Ibutilide for Immediate Conversion of Recent-Onset Atrial Fibrillation Vogiatzis I, Papavasiliou E, Dapcevitch I, Pittas S, Koulouris E
    HIPPOKRATIA 2017, 21, 2: 67-73 RESEARCH ARTICLE Vernakalant versus ibutilide for immediate conversion of recent-onset atrial fibrillation Vogiatzis I, Papavasiliou E, Dapcevitch I, Pittas S, Koulouris E Department of Cardiology, General Hospital of Veroia, Veroia, Greece Abstract Background: The pharmacological cardioversion of recent-onset atrial fibrillation (AF) is a challenge for the clinician. The aim of the study was to compare the efficacy, the safety, and the overall cost of intravenous (iv) administration of vernakalant, which is a relatively new atrial-selective antiarrhythmic agent, versus ibutilide, in cardioversion of recent- onset AF. Methods: We enrolled in this study 78 patients (56 men, 22 women; mean age 63.72 ± 6.67 years) who presented with recent-onset AF. Cardioversion was attempted in 36 patients (group A: 24 men, 12 women; mean age 62.44 ± 7.24 years) by iv administration of vernakalant (3 mg/kg over 10 min and if needed after 15 min, a second dose 2 mg/kg over 10 min) while in 42 patients (group B: 32 men, 10 women; mean age 64.81 ± 6 years) iv ibutilide was administered (1 mg over 10 min and if needed after 10 min, a second dose 1 mg over 10 min). Results: AF was successfully converted in 52.78 % of (n =19) patients of group A vs 52.38 % of (n =22) patients of group B (p =0.58), with an average time of conversion 11.8 ± 4.3 min for group A patients vs 33.9 ± 20.25 min for group B patients (p <0.0001). The average length of hospital stay for patients of group A was 17.64 ± 15.96 hours vs 41.09 ± 17.6 hours for patients of Group B (p <0.0001).
    [Show full text]
  • MRI Evidence That Glibenclamide Reduces Acute Lesion Expansion in a Rat Model of Spinal Cord Injury
    Spinal Cord (2013) 51, 823–827 OPEN & 2013 International Spinal Cord Society All rights reserved 1362-4393/13 www.nature.com/sc ORIGINAL ARTICLE MRI evidence that glibenclamide reduces acute lesion expansion in a rat model of spinal cord injury JM Simard1,2,3, PG Popovich4, O Tsymbalyuk1, J Caridi1, RP Gullapalli5, MJ Kilbourne6 and V Gerzanich1 Study design: Experimental, controlled, animal study. Objectives: To use non-invasive magnetic resonance imaging (MRI) to corroborate invasive studies showing progressive expansion of a hemorrhagic lesion during the early hours after spinal cord trauma and to assess the effect of glibenclamide, which blocks Sur1-Trpm4 channels implicated in post-traumatic capillary fragmentation, on lesion expansion. Setting: Baltimore. Methods: Adult female Long–Evans rats underwent unilateral impact trauma to the spinal cord at C7, which produced ipsilateral but not contralateral primary hemorrhage. In series 1 (six control rats and six administered glibenclamide), hemorrhagic lesion expansion was characterized using MRI at 1 and 24 h after trauma. In series 2, hemorrhagic lesion size was characterized on coronal tissue sections at 15 min (eight rats) and at 24 h after trauma (eight control rats and eight administered glibenclamide). Results: MRI (T2 hypodensity) showed that lesions expanded 2.3±0.33-fold (Po0.001) during the first 24 h in control rats, but only 1.2±0.07-fold (P40.05) in glibenclamide-treated rats. Measuring the areas of hemorrhagic contusion on tissue sections at the epicenter showed that lesions expanded 2.2±0.12-fold (Po0.001) during the first 24 h in control rats, but only 1.1±0.05-fold (P40.05) in glibenclamide-treated rats.
    [Show full text]
  • Ventricular Tachycardia Drugs Versus Devices John Camm St
    Cardiology Update 2015 Davos, Switzerland: 8-12th February 2015 Ventricular Arrhythmias Ventricular Tachycardia Drugs versus Devices John Camm St. George’s University of London, UK Imperial College, London, UK Declaration of Interests Chairman: NICE Guidelines on AF, 2006; ESC Guidelines on Atrial Fibrillation, 2010 and Update, 2012; ACC/AHA/ESC Guidelines on VAs and SCD; 2006; NICE Guidelines on ACS and NSTEMI, 2012; NICE Guidelines on heart failure, 2008; NICE Guidelines on Atrial Fibrillation, 2006; ESC VA and SCD Guidelines, 2015 Steering Committees: multiple trials including novel anticoagulants DSMBs: multiple trials including BEAUTIFUL, SHIFT, SIGNIFY, AVERROES, CASTLE- AF, STAR-AF II, INOVATE, and others Events Committees: one trial of novel oral anticoagulants and multiple trials of miscellaneous agents with CV adverse effects Editorial Role: Editor-in-Chief, EP-Europace and Clinical Cardiology; Editor, European Textbook of Cardiology, European Heart Journal, Electrophysiology of the Heart, and Evidence Based Cardiology Consultant/Advisor/Speaker: Astellas, Astra Zeneca, ChanRX, Gilead, Merck, Menarini, Otsuka, Sanofi, Servier, Xention, Bayer, Boehringer Ingelheim, Bristol- Myers Squibb, Daiichi Sankyo, Pfizer, Boston Scientific, Biotronik, Medtronic, St. Jude Medical, Actelion, GlaxoSmithKline, InfoBionic, Incarda, Johnson and Johnson, Mitsubishi, Novartis, Takeda Therapy for Ventricular Tachycardia Medical therapy Antiarrhythmic drugs Autonomic management Ventricular tachycardia Monomorphic Polymorphic Ventricular fibrillation Ventricular storms Ablation therapy Device therapy Surgical Defibrillation Catheter Antitachycardia pacing History of Antiarrhythmic Drugs 1914 - Quinidine 1950 - Lidocaine 1951 - Procainamide 1946 – Digitalis 1956 – Ajmaline 1962 - Verapamil 1962 – Disopyramide 1964 - Propranolol 1967 – Amiodarone 1965 – Bretylium 1972 – Mexiletine 1973 – Aprindine, Tocainide 1969 - Diltiazem 1975- Flecainide 1976 – Propafenone Encainide Ethmozine 2000 - Sotalol D-sotalol 1995 - Ibutilide (US) Recainam 2000 – Dofetilide US) IndecainideX Etc.
    [Show full text]
  • 5Mg/6Mg Tablets for Example Valsartan, Telmisartan, Irbesartan, Etc.), in Particular Ramipril 5Mg If You Have Diabetes-Related Kidney Problems, • Aliskiren
    PACKAGE LEAFLET: INFORMATION FOR THE USER • If you are taking any of the following medicines used to treat high blood pressure: • an ’angiotensin II receptor blocker (ARBs) (also known as sartans - 5mg/6mg Tablets for example valsartan, telmisartan, irbesartan, etc.), in particular Ramipril 5mg if you have diabetes-related kidney problems, • aliskiren. Piretanide 6mg Your doctor may check your kidney function, blood pressure, and the amount of electrolytes (e.g. potassium) in your blood at regular intervals. See information under the heading ’Do not take Trialix Tablets’. • You have gout Is this leaflet hard to see or read? • You feel dizzy or dehydrated. This can happen if you have lost a Phone 01 403 5600 for help lot of body salts or fluids (through being sick (vomiting), having Read all of this leaflet carefully before you start using this diarrhoea, sweating more than usual, being on a low salt diet, medicine because it contains important information for you. passing water very often or having had dialysis. It can also happen • Keep this leaflet. You may need to read it again if you are having trouble drinking or eating • If you have any further questions, ask your doctor or pharmacist • If you have been pre-treated with diuretics (drugs to increase • This medicine has been prescribed for you only. Do not pass it the rate of urination) on to others. It may harm them, even if their signs of illness are • You are going to receive an anaesthetic. This may be given for an the same as yours. operation or any dental work.
    [Show full text]
  • Patent Application Publication ( 10 ) Pub . No . : US 2019 / 0192440 A1
    US 20190192440A1 (19 ) United States (12 ) Patent Application Publication ( 10) Pub . No. : US 2019 /0192440 A1 LI (43 ) Pub . Date : Jun . 27 , 2019 ( 54 ) ORAL DRUG DOSAGE FORM COMPRISING Publication Classification DRUG IN THE FORM OF NANOPARTICLES (51 ) Int . CI. A61K 9 / 20 (2006 .01 ) ( 71 ) Applicant: Triastek , Inc. , Nanjing ( CN ) A61K 9 /00 ( 2006 . 01) A61K 31/ 192 ( 2006 .01 ) (72 ) Inventor : Xiaoling LI , Dublin , CA (US ) A61K 9 / 24 ( 2006 .01 ) ( 52 ) U . S . CI. ( 21 ) Appl. No. : 16 /289 ,499 CPC . .. .. A61K 9 /2031 (2013 . 01 ) ; A61K 9 /0065 ( 22 ) Filed : Feb . 28 , 2019 (2013 .01 ) ; A61K 9 / 209 ( 2013 .01 ) ; A61K 9 /2027 ( 2013 .01 ) ; A61K 31/ 192 ( 2013. 01 ) ; Related U . S . Application Data A61K 9 /2072 ( 2013 .01 ) (63 ) Continuation of application No. 16 /028 ,305 , filed on Jul. 5 , 2018 , now Pat . No . 10 , 258 ,575 , which is a (57 ) ABSTRACT continuation of application No . 15 / 173 ,596 , filed on The present disclosure provides a stable solid pharmaceuti Jun . 3 , 2016 . cal dosage form for oral administration . The dosage form (60 ) Provisional application No . 62 /313 ,092 , filed on Mar. includes a substrate that forms at least one compartment and 24 , 2016 , provisional application No . 62 / 296 , 087 , a drug content loaded into the compartment. The dosage filed on Feb . 17 , 2016 , provisional application No . form is so designed that the active pharmaceutical ingredient 62 / 170, 645 , filed on Jun . 3 , 2015 . of the drug content is released in a controlled manner. Patent Application Publication Jun . 27 , 2019 Sheet 1 of 20 US 2019 /0192440 A1 FIG .
    [Show full text]
  • Safety and Efficacy of Vernakalant for the Conversion of Atrial Fibrillation to Sinus Rhythm; a Phase 3B Randomized Controlled Trial Gregory N
    Beatch and Mangal BMC Cardiovascular Disorders (2016) 16:113 DOI 10.1186/s12872-016-0289-0 RESEARCH ARTICLE Open Access Safety and efficacy of vernakalant for the conversion of atrial fibrillation to sinus rhythm; a phase 3b randomized controlled trial Gregory N. Beatch1* and Brian Mangal2 Abstract Background: Atrial fibrillation (AF) is a common cardiac arrhythmia that is associated with significant health risks. One strategy to mitigate the risks associated with long-term AF is to convert AF to sinus rhythm (SR). This study assessed the efficacy and safety of vernakalant hydrochloride for the pharmacological conversion of AF to SR. Methods: Patients with recent-onset (duration >3 h– ≤ 7 days) symptomatic AF and no evidence or history of congestive heart failure were randomized in a 2:1 ratio to receive vernakalant or placebo. Patients received an infusion of vernakalant (3 mg/kg) or placebo over 10 min, followed by a second infusion of vernakalant (2 mg/kg) or placebo 15 min later if AF had not been terminated. The primary efficacy endpoint was conversion of AF to SR for at least 1 min within 90 min of the start of drug infusion. The primary safety endpoint was a composite of: occurrence of clinically significant hypotension, clinically significant ventricular arrhythmia (including torsades de pointes, ventricular tachycardia or ventricular fibrillation) or death within 2 h of starting the drug infusion. Results: A total of 217 patients were randomized to receive vernakalant (n = 145) or placebo (n =72).Ofthe129 individuals who received vernakalant, 59 (45.7 %) converted to SR compared with one of the 68 patients (1.5 %) who received placebo (p < 0.0001).
    [Show full text]
  • Drug and Medication Classification Schedule
    KENTUCKY HORSE RACING COMMISSION UNIFORM DRUG, MEDICATION, AND SUBSTANCE CLASSIFICATION SCHEDULE KHRC 8-020-1 (11/2018) Class A drugs, medications, and substances are those (1) that have the highest potential to influence performance in the equine athlete, regardless of their approval by the United States Food and Drug Administration, or (2) that lack approval by the United States Food and Drug Administration but have pharmacologic effects similar to certain Class B drugs, medications, or substances that are approved by the United States Food and Drug Administration. Acecarbromal Bolasterone Cimaterol Divalproex Fluanisone Acetophenazine Boldione Citalopram Dixyrazine Fludiazepam Adinazolam Brimondine Cllibucaine Donepezil Flunitrazepam Alcuronium Bromazepam Clobazam Dopamine Fluopromazine Alfentanil Bromfenac Clocapramine Doxacurium Fluoresone Almotriptan Bromisovalum Clomethiazole Doxapram Fluoxetine Alphaprodine Bromocriptine Clomipramine Doxazosin Flupenthixol Alpidem Bromperidol Clonazepam Doxefazepam Flupirtine Alprazolam Brotizolam Clorazepate Doxepin Flurazepam Alprenolol Bufexamac Clormecaine Droperidol Fluspirilene Althesin Bupivacaine Clostebol Duloxetine Flutoprazepam Aminorex Buprenorphine Clothiapine Eletriptan Fluvoxamine Amisulpride Buspirone Clotiazepam Enalapril Formebolone Amitriptyline Bupropion Cloxazolam Enciprazine Fosinopril Amobarbital Butabartital Clozapine Endorphins Furzabol Amoxapine Butacaine Cobratoxin Enkephalins Galantamine Amperozide Butalbital Cocaine Ephedrine Gallamine Amphetamine Butanilicaine Codeine
    [Show full text]
  • SUMMARY the Effects of Piretanide and Furosemide on Systemic Arterial
    Cardiac Effects of Piretanide and Furosemide on Intact Anesthetized Dogs and on Isolated Atria Shigetoshi CHIBA, M.D., Yasuyuki FURUKAWA, M.D., Kimiaki SAEGUSA, M.D., and Yasuhiro OGIWARA, M.D. SUMMARY The effects of piretanide and furosemide on systemic arterial blood pressure and heart rate were examined in the anesthetized dog and the ef- fects on atrial rate and contractile force were assessed in isolated atrial muscle perfused with heparinized arterial blood from a donor dog. When piretanide was administered intravenously to intact dogs, the de- pressor and bradycardic responses were produced dose-dependently. There were no significant simultaneous chronotropic or inotropic changes in the isolated atrium. On the other hand, furosemide (1-3 mg/kg) did not induce significant changes in either systemic blood pressure or heart rate in the intact dog. The atrial rate and developed tension were also not affected in the isolated atrium. A potent beta-adrenoceptor blocking agent, propranolol (1mg/kg i.v.), consistently produced a significant de- pressor response and a profound negative chronotropic effect in the intact dogs; significant negative chronotropic and isotropic effects were also observed in the isolated atrium. When large doses of piretanide and furosemide were injected intraarterially into the sinus node artery of the isolated atrium, atropine-insensitive negative chronotropic and inotropic effects were induced dose-dependently. The potency of the negative chronotropic effect of piretanide was slightly greater than that of furo- semide, but the negative inotropic effect of piretanide was slightly smaller than that of furosemide. These data indicate that piretanide has a de- pressor effect without significant cardiac influences.
    [Show full text]
  • Effects of Glibenclamide and Glimepiride Compared in Type II DM Patients in Accordance with Lipid Parameters, ESF and Glycated Haemoglobin
    British Journal of Applied Science & Technology 10(3): 1-10, 2015, Article no.BJAST.17537 ISSN: 2231-0843 SCIENCEDOMAIN international www.sciencedomain.org Effects of Glibenclamide and Glimepiride Compared in Type II DM Patients in Accordance with Lipid Parameters, ESF and Glycated Haemoglobin K. Chandra Mouli Krishna1, B. Sowmya2, Bandopadhyay Mamata3 and M. Prasad Naidu4* 1NRI Institute of Medical College, Sangivalasa, Visakhapatnam -531162, Andhra Pradesh, India. 2Kamala Nursing Home, Marripalem, Visakhapatnam - 530018, Andhra Pradesh, India. 3Department of Pharmacology, Maharaja Institute of Medical Sciences, Nellimarla, Vizinagaram - 535217, Andhra Pradesh, India. 4Department of Biochemistry, Narayana Medical College and Hospital, Nellore-524003, Andhra Pradesh, India. Authors’ contributions This work was carried out in collaboration between all authors. All authors read and approved the final manuscript. Article Information DOI: 10.9734/BJAST/2015/17537 Editor(s): (1) Gautam R. Ullal, Course Director Neuroscience and Foundations of Clinical Medicine, Medical University of Americas, West Indies. Reviewers: (1) Ayşenur Yeğin, Clinical Biochemistry, Antalya Research and Educational Hospital, Turkey. (2) Anonymous, The Third Hospital of Hebei Medical University, China. (3) Anonymous, MGM Medical College, Navi-Mumbai, India. Complete Peer review History: http://sciencedomain.org/review-history/9912 Received 17th March 2015 th Original Research Article Accepted 5 June 2015 Published 27th June 2015 ABSTRACT The population of Indian adults suffering from diabetes is expected to increase threefold, from 19.4 million in 1995 to 57.2 million in 2025. The objective of the study was to evaluate the efficacy and safety of antidiabetic drug and to find out their cardio protective action in patients with diabetes mellitus.
    [Show full text]
  • BMJ Open Is Committed to Open Peer Review. As Part of This Commitment We Make the Peer Review History of Every Article We Publish Publicly Available
    BMJ Open is committed to open peer review. As part of this commitment we make the peer review history of every article we publish publicly available. When an article is published we post the peer reviewers’ comments and the authors’ responses online. We also post the versions of the paper that were used during peer review. These are the versions that the peer review comments apply to. The versions of the paper that follow are the versions that were submitted during the peer review process. They are not the versions of record or the final published versions. They should not be cited or distributed as the published version of this manuscript. BMJ Open is an open access journal and the full, final, typeset and author-corrected version of record of the manuscript is available on our site with no access controls, subscription charges or pay-per-view fees (http://bmjopen.bmj.com). If you have any questions on BMJ Open’s open peer review process please email [email protected] BMJ Open Pediatric drug utilization in the Western Pacific region: Australia, Japan, South Korea, Hong Kong and Taiwan Journal: BMJ Open ManuscriptFor ID peerbmjopen-2019-032426 review only Article Type: Research Date Submitted by the 27-Jun-2019 Author: Complete List of Authors: Brauer, Ruth; University College London, Research Department of Practice and Policy, School of Pharmacy Wong, Ian; University College London, Research Department of Practice and Policy, School of Pharmacy; University of Hong Kong, Centre for Safe Medication Practice and Research, Department
    [Show full text]
  • Tubular Action of Diuretics: Distal Effects on Electrolyte Transport and Acidification
    CORE Metadata, citation and similar papers at core.ac.uk Provided by Elsevier - Publisher Connector Kidney International, Vol. 28 (1985), pp. 477—489 Tubular action of diuretics: Distal effects on electrolyte transport and acidification MAX HROPOT, NICOLE FOWLER, BERTIL KARLMARK, and GERHARD GIEBISCH Department of Physiology, Yale University School of Medicine, New Haven, Connecticut, USA Tubular action of diuretics: Distal effects on electrolyte transport and Micropuncture studies in rodents and dogs and experiments acidification. We used clearance and free-flow micropuncture tech-on isolated segments of rabbit tubules have outlined the main niques to evaluate the influence of several diuretic agents, given both individually and in various combinations, on transport of sodium,tubular sites of action of diuretic agents. In general, diuretics potassium, and fluid, and on acidification and ammonium transport, act at well-defined nephron sites by inhibiting salt and water within the distal tubule of the rat kidney. The loop diuretics, furosemide reabsorption. As a result of their primary tubular actions, and piretanide, sharply increased fractional delivery of fluid, sodium,frequently they effect delivery of a larger fluid load to more and potassium into the distal tubule, and, as a result, sodium reabsorp- distally located nephron sites. Thus, even when these sites are tion and potassium secretion were enhanced in this nephron segment. These two drugs also stimulated urinary acidification and increasednot directly affected by the diuretic, the final action of a given urinary phosphate, titratable acid, and ammonium excretion. Theseagent will be modified significantly by secondary effects on the effects took place both within the loop of Henle and along the distal transport function of more distal segments.
    [Show full text]
  • Azosemide Is More Potent Than Bumetanide and Various Other Loop
    www.nature.com/scientificreports OPEN Azosemide is more potent than bumetanide and various other loop diuretics to inhibit the sodium- Received: 21 November 2017 Accepted: 14 June 2018 potassium-chloride-cotransporter Published: xx xx xxxx human variants hNKCC1A and hNKCC1B Philip Hampel 1,2, Kerstin Römermann1, Nanna MacAulay 3 & Wolfgang Löscher1,2 The Na+–K+–2Cl− cotransporter NKCC1 plays a role in neuronal Cl− homeostasis secretion and represents a target for brain pathologies with altered NKCC1 function. Two main variants of NKCC1 have been identifed: a full-length NKCC1 transcript (NKCC1A) and a shorter splice variant (NKCC1B) that is particularly enriched in the brain. The loop diuretic bumetanide is often used to inhibit NKCC1 in brain disorders, but only poorly crosses the blood-brain barrier. We determined the sensitivity of the two human NKCC1 splice variants to bumetanide and various other chemically diverse loop diuretics, using the Xenopus oocyte heterologous expression system. Azosemide was the most potent NKCC1 inhibitor (IC50s 0.246 µM for hNKCC1A and 0.197 µM for NKCC1B), being about 4-times more potent than bumetanide. Structurally, a carboxylic group as in bumetanide was not a prerequisite for potent NKCC1 inhibition, whereas loop diuretics without a sulfonamide group were less potent. None of the drugs tested were selective for hNKCC1B vs. hNKCC1A, indicating that loop diuretics are not a useful starting point to design NKCC1B-specifc compounds. Azosemide was found to exert an unexpectedly potent inhibitory efect and as a non-acidic compound, it is more likely to cross the blood-brain barrier than bumetanide. Te Na+–K+–2Cl− cotransporter NKCC1 (encoded by SLC12A2) plays an important role in Cl- uptake in neu- rons both in developing brain and in adult sensory neurons1,2.
    [Show full text]