DOCSLIB.ORG

Intranasal Corticosteroids Versus Oral H1 Receptor Antagonists

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Intranasal Corticosteroids Versus Oral H1 Receptor Antagonists Papers BMJ: first published as 10.1136/bmj.317.7173.1624 on 12 December 1998. Downloaded from Intranasal corticosteroids versus oral H1 receptor antagonists in allergic rhinitis: systematic review of randomised controlled trials John M Weiner, Michael J Abramson, Robert M Puy Department of Abstract showed that in Tasmania the prevalence of hay fever is Medicine, Monash 4 University, 41%, and that hay fever is the second most frequently Objective To determine whether intranasal 5 Melbourne, self reported condition in Australia. corticosteroids are superior to oral H receptor Victoria, 3181, 1 Apart from local disease, allergic rhinitis can cause Australia antagonists (antihistamines) in the treatment of considerable morbidity including chronic sinusitis and John M Weiner, allergic rhinitis. honorary senior otitis. The condition can also cause irritability and Meta-analysis of randomised controlled trials lecturer Design impaired sleep which can affect quality of life by comparing intranasal corticosteroids with oral Department of leading to poor performance at school or work, antihistamines. Epidemiology and absenteeism from school or work, and chronic Preventive Setting Randomised controlled trials conducted Medicine, Monash tiredness. It can also have detrimental effects on worldwide and published between 1966 and 1997. 16 University emotional and social wellbeing. Subjects 2267 subjects with allergic rhinitis in 16 Michael J Treatment of allergic rhinitis includes avoiding Abramson, randomised controlled trials. allergens (when possible), intranasal corticosteroids, associate professor Main outcome measures Nasal blockage, nasal short term decongestants, oral or topical H receptor Department of discharge, sneezing, nasal itch, postnasal drip, nasal 1 antagonists (antihistamines), intranasal cromoglycate, Allergy and Clinical discomfort, total nasal symptoms, nasal resistance, and Immunology, Alfred anticholinergic agents, and allergen immunotherapy.1 Hospital, Monash eye symptoms and global ratings. Outcomes measured Topical intranasal corticosteroids are said to be University on different scales were combined to determine pooled more effective than oral antihistamines in controlling Robert M Puy, odds ratios (categorical outcomes) or standardised visiting physician nasal blockage and discharge.17 Furthermore, oral mean differences (continuous outcomes). Assessment antihistamines are said to be better at treating nasal Correspondence to: of heterogeneity between studies, and subgroup Dr Weiner itch, sneezing, and eye symptoms.17There is also a per- jmweiner@allergynet. analyses of eye symptoms, were undertaken. ception, especially in popular reviews on allergic rhini- com.au Results Intranasal corticosteroids produced tis, that intranasal corticosteroids do not improve eye significantly greater relief than oral antihistamines of 8 BMJ 1998;317:1624–9 symptoms. nasal blockage (standardised mean difference − 0.63, To address these issues we reviewed published ran- 95% confidence interval − 0.73 to − 0.53), nasal domised controlled trials comparing intranasal discharge ( − 0.5, − 0.6 to − 0.4), sneezing ( − 0.49, − 0.59 to − 0.39), nasal itch ( − 0.38, − 0.49 to − 0.21), corticosteroids with oral antihistamines, and per- http://www.bmj.com/ postnasal drip ( − 0.24, − 0.42 to − 0.06), and total formed a meta-analysis on the efficacy of these nasal symptoms ( − 0.42, − 0.53 to − 0.32), and global interventions on relevant clinical outcomes. ratings gave an odds ratio for deterioration of symptoms of 0.26 (0.08 to 0.8). There were no Selection criteria significant differences between treatments for nasal We restricted our review to randomised controlled discomfort, nasal resistance, or eye symptoms. The trials, which provide the strongest evidence for the effi- effects on sneezing, total nasal symptoms, and eye cacy of any medical treatment. We included only stud- on 24 September 2021 by guest. Protected copyright. symptoms were significantly heterogeneous between ies that focused on allergic rhinitis, and we did not studies. Other combined outcomes were consider studies on the treatment of nasal polyps. homogeneous between studies. Subgroup analysis of For the purposes of our review, intranasal the outcome of eye symptoms suggested that the corticosteroids included beclomethasone dipropion- duration of assessment (averaged mean score over the ate, budesonide, flunisolide, fluocortin, fluticasone pro- study period versus mean score at end of study pionate, mometasone, and triamcinolone acetonide. period) might have accounted for the heterogeneity. All forms of delivery vehicle (aqueous and non- Conclusion The results of this systematic review, aqueous) were considered. We included studies of together with data on safety and cost effectiveness, comparisons with any form of oral antihistamine, but support the use of intranasal corticosteroids over oral excluded studies that used topical antihistamines or antihistamines as first line treatment for allergic rhinitis. topical mast cell stabilisers. Studies were also excluded if they were not randomised or not double blinded. For a study to be included in our review at least one Introduction of the following clinical outcomes had to be reported: Allergic rhinitis is a common disease characterised by nasal symptoms (including total nasal symptom nasal itch, sneezing, watery and mucous rhinorrhoea, scores), eye symptoms, global symptoms, drug require- and nasal obstruction.1 The condition is often ments for treating the rhinitis, nasal function accompanied by allergic conjunctivitis. In the past 30 (including measurements of nasal resistance), and years there has been a dramatic increase in the preva- assessment of quality of life. lence of allergic rhinitis, and studies from England, We excluded studies that reported only nasal chal- Sweden, and Australia have confirmed a doubling of lenge with specific allergens or non-clinical outcomes, prevalence over this time.2–4 Studies from Australia such as in vitro results of inflammatory mediators. We 1624 BMJ VOLUME 317 12 DECEMBER 1998 www.bmj.com Papers BMJ: first published as 10.1136/bmj.317.7173.1624 on 12 December 1998. Downloaded from considered studies published in languages other than Characteristics of included studies. All studies were double blind, double dummy,* English if the translated abstract indicated that the parallel group, randomised controlled trials except where indicated study was a randomised controlled trial of intranasal No of corticosteroids for rhinitis, and a translator was sought. participants with seasonal Age range Search strategy Study allergic rhinitis (mean age) Interventions Outcomes 10 We conducted Medline and Embase searches for Munch 61 16-56 (29) Budesonide 400 ìg Nasal symptoms randomised controlled trials of topical corticosteroids Dexchlorpheniramine 12 mg Eye symptoms 11 ì and rhinitis published between 1966 and 1997. Beswick 49 14-64 (28) Beclomethasone 400 g Nasal symptoms Terfenadine 120 mg Eye symptoms Specifically, studies were retrieved that were indexed as Global rating randomised controlled trials with treatments compris- 12 Wood 74 12-75 (28) Beclomethasone 400 ìg Nasal symptoms ing the following intranasal corticosteroids: beclo- Astemizole 10 mg Eye symptoms methasone dipropionate, budesonide, flunisolide, fluo- Lancer13 18 Not reported Beclomethasone 400 ìg Global rating cortin, fluticasone propionate, mometasone, and Terfenadine 120 mg Nasal resistance triamcinolone acetonide. Review articles identified in Juniper14 90 18-70 (41) Beclomethasone 400 ìg Nasal symptoms this process were surveyed for additional and earlier Astemizole 10 mg Eye symptoms citations. We also used Healthgate and Winspirs Robinson†15 20 15-58 (31) Beclomethasone 400 ìg Nasal symptoms software to search Medline for more recently published Terfenadine 120 mg Eye symptoms studies. Where relevant abstracts were identified in con- Bunnag16 69‡ 16-70 (30) Budesonide 200 ìg Nasal symptoms ference proceedings, Medline searches were conducted Astemizole 10 mg 17 and inquiries made of the authors or sponsoring Darnell 214 13-69 (28) Fluticasone 200 ìg Nasal symptoms companies to identify any subsequent full publications. Terfenadine 120 mg Eye symptoms Global rating Simpson18 143 >15 (27) Budesonide 400 ìg Nasal symptoms Methods Terfenadine 120 mg Eye symptoms Van Bavel19 232 >12 (40) Fluticasone 200 ìg Nasal symptoms Inclusion of studies in the review was decided by a sim- Terfenadine 120 mg Global rating ple majority of all three reviewers, who independently Schoenwetter20 298 >12 (31) Triamcinolone 220 ìg Nasal symptoms read the methods sections of papers identified by the Loratadine 10 mg Eye symptoms search strategy and applied the stated criteria. Quality Bernstein21 239 Adults (36) Triamcinolone 220 ìg Nasal symptoms assessment was performed by two reviewers (RMP and Astemizole 10 mg Eye symptoms JMW), who independently assessed the concealment of Global rating allocation following the guidelines of the Cochrane Bronsky22 348 >12 (30) Fluticasone 200 ìg Nasal symptoms Collaboration.9 We calculated the mean daily cost of Terfenadine 120 mg Global rating intranasal corticosteroids and of non-sedating oral Nasal resistance 23 antihistamines available in Australia. Brooks 60 Not reported Beclomethasone 336 ìg Nasal symptoms Loratadine 10 mg Eye symptoms Global rating http://www.bmj.com/ Statistical considerations Géhanno24 114 13-80 (39) Fluticasone 200 ìg Nasal symptoms We compared the effectiveness of intranasal
Load more

Recommended publications
  • (CD-P-PH/PHO) Report Classification/Justifica
    COMMITTEE OF EXPERTS ON THE CLASSIFICATION OF MEDICINES AS REGARDS THEIR SUPPLY (CD-P-PH/PHO) Report classification/justification of medicines belonging to the ATC group D07A (Corticosteroids, Plain) Table of Contents Page INTRODUCTION 4 DISCLAIMER 6 GLOSSARY OF TERMS USED IN THIS DOCUMENT 7 ACTIVE SUBSTANCES Methylprednisolone (ATC: D07AA01) 8 Hydrocortisone (ATC: D07AA02) 9 Prednisolone (ATC: D07AA03) 11 Clobetasone (ATC: D07AB01) 13 Hydrocortisone butyrate (ATC: D07AB02) 16 Flumetasone (ATC: D07AB03) 18 Fluocortin (ATC: D07AB04) 21 Fluperolone (ATC: D07AB05) 22 Fluorometholone (ATC: D07AB06) 23 Fluprednidene (ATC: D07AB07) 24 Desonide (ATC: D07AB08) 25 Triamcinolone (ATC: D07AB09) 27 Alclometasone (ATC: D07AB10) 29 Hydrocortisone buteprate (ATC: D07AB11) 31 Dexamethasone (ATC: D07AB19) 32 Clocortolone (ATC: D07AB21) 34 Combinations of Corticosteroids (ATC: D07AB30) 35 Betamethasone (ATC: D07AC01) 36 Fluclorolone (ATC: D07AC02) 39 Desoximetasone (ATC: D07AC03) 40 Fluocinolone Acetonide (ATC: D07AC04) 43 Fluocortolone (ATC: D07AC05) 46 2 Diflucortolone (ATC: D07AC06) 47 Fludroxycortide (ATC: D07AC07) 50 Fluocinonide (ATC: D07AC08) 51 Budesonide (ATC: D07AC09) 54 Diflorasone (ATC: D07AC10) 55 Amcinonide (ATC: D07AC11) 56 Halometasone (ATC: D07AC12) 57 Mometasone (ATC: D07AC13) 58 Methylprednisolone Aceponate (ATC: D07AC14) 62 Beclometasone (ATC: D07AC15) 65 Hydrocortisone Aceponate (ATC: D07AC16) 68 Fluticasone (ATC: D07AC17) 69 Prednicarbate (ATC: D07AC18) 73 Difluprednate (ATC: D07AC19) 76 Ulobetasol (ATC: D07AC21) 77 Clobetasol (ATC: D07AD01) 78 Halcinonide (ATC: D07AD02) 81 LIST OF AUTHORS 82 3 INTRODUCTION The availability of medicines with or without a medical prescription has implications on patient safety, accessibility of medicines to patients and responsible management of healthcare expenditure. The decision on prescription status and related supply conditions is a core competency of national health authorities.
    [Show full text]
  • 1532 Corticosteroids
    1532 Corticosteroids olone; Ultraderm; Malaysia: Synalar†; Mex.: Cortifung-S; Cortilona; Gr.: Lidex; Ital.: Flu-21†; Topsyn; Mex.: Topsyn; Norw.: Metosyn; Pharmacopoeias. In Br. Cremisona; Farmacorti; Flumicin; Fluomex; Fusalar; Lonason; Synalar; Philipp.: Lidemol; Lidex; Singapore: Lidex†; Spain: Klariderm†; Novoter; BP 2008 (Fluocortolone Hexanoate). A white or creamy-white, Norw.: Synalar; NZ: Synalar; Philipp.: Aplosyn; Cynozet; Synalar; Syntop- Switz.: To p s y m ; To p s y m i n ; UK: Metosyn; USA: Lidex; Vanos. ic; Pol.: Flucinar; Port.: Oto-Synalar N; Synalar; Rus.: Flucinar (Флуцинар); odourless or almost odourless, crystalline powder. It exhibits pol- Multi-ingredient: Austria: Topsym polyvalent; Ger.: Jelliproct; Topsym ymorphism. Practically insoluble in water and in ether; very Sinaflan (Синафлан); S.Afr.: Cortoderm; Fluoderm; Synalar; Singapore: polyvalent; Hung.: Vipsogal†; Israel: Comagis; Mex.: Topsyn-Y; Philipp.: Flunolone-V; Spain: Co Fluocin Fuerte; Cortiespec; Fluocid Forte; Fluoder- Lidex NGN; Spain: Novoter Gentamicina; Switz.: Mycolog N; Topsym slightly soluble in alcohol and in methyl alcohol; slightly soluble mo Fuerte; Flusolgen; Gelidina; Intradermo Corticosteroi†; Synalar; Synalar polyvalent; UK: Vipsogal. in acetone and in dioxan; sparingly soluble in chloroform. Pro- Rectal Simple; Swed.: Synalar; Switz.: Synalar; Thai.: Cervicum; Flu- ciderm†; Flunolone-V; Fulone; Supralan; Synalar; UK: Synalar; USA: Capex; tect from light. Derma-Smoothe/FS; DermOtic; Fluonid; Flurosyn†; Retisert; Synalar; Syn- emol; Venez.: Bratofil; Fluquinol Simple†; Neo-Synalar; Neoflu†. Fluocortin Butyl (BAN, USAN, rINNM) ⊗ Fluocortolone Pivalate (BANM, rINNM) ⊗ Multi-ingredient: Arg.: Adop-Tar†; Tri-Luma; Austria: Myco-Synalar; Procto-Synalar; Synalar N; Belg.: Procto-Synalar; Synalar Bi-Otic; Braz.: Butil éster de la fluocortina; Butylis Fluocortinas; Fluocortine Fluocortolone, pivalate de; Fluocortolone Trimethylacetate; Dermobel†; Dermoxin; Elotin; Fluo-Vaso; Neocinolon; Otauril†; Otocort†; Butyle; SH-K-203.
    [Show full text]
  • Roger M. Katz, M.D. 11500W.Olympicblvd.,Suite630 Phone:(310)393-1550 Losangeles,CA90064 Fax:(310)478-3601
    Roger M. Katz, M.D. 11500W.OlympicBlvd.,Suite630 Phone:(310)393-1550 LosAngeles,CA90064 Fax:(310)478-3601 PERSONAL Date of Birth: February 23, 1938 Place of Birth: Menominee, Michigan / Marinette, Wisconsin EDUCATION 1956 Marinette High School Marinette, WI 1956 - 1960 Bachelors of Science, University of Wisconsin Madison, WI 1960 - 1961 Masters Program, University of Louisville Louisville, KY 1961 - 1965 Doctor of Medicine, University of Louisville Medical School Louisville, KY 1965 - 1967 Michael Reese Medical Center - Internship / Residency: Pediatrics Chicago, IL 1967 - 1968 David Geffen School of Medicine at UCLA - Chief Resident: Los Angeles, CA Department of Pediatrics 1968 - 1970 Harbor/UCLA General Hospital - Allergy/Immunology Fellowship Los Angeles, CA 1969 - 1970 UCLA School of Public Health - Masters Program Public Health Los Angeles, CA 1969 - 1970 UCLA School of Public Health - Management Development Program Los Angeles, CA for Physicians 1996 University of Southern California - School of Business Administration Los Angeles, CA BOARD CERTIFICATION 1970 Pediatrics Certificate No. 13810 1970 Sub Board of Pediatric Allergy Certificate No. 295 1972 Allergy / Immunology Certificate No. 201 1977 Allergy / Immunology Re-Certified 1980 Pediatrics Re-Certified 1980 Pediatrics Sub Board Allergy Re-Certified HONORS Sep 1967 - Jan 1968 Chief Resident, Pediatrics David Geffen School of Medicine at UCLA 1969 Travel Grant - American Academy of Allergy, 25th Annual Meeting, Bal Harbor, FL 1970 Manuscript Award: Clemens Von Perquet, "Status
    [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]
  • Contact Dermatitis to Medications and Skin Products
    Clinical Reviews in Allergy & Immunology (2019) 56:41–59 https://doi.org/10.1007/s12016-018-8705-0 Contact Dermatitis to Medications and Skin Products Henry L. Nguyen1 & James A. Yiannias2 Published online: 25 August 2018 # Springer Science+Business Media, LLC, part of Springer Nature 2018 Abstract Consumer products and topical medications today contain many allergens that can cause a reaction on the skin known as allergic contact dermatitis. This review looks at various allergens in these products and reports current allergic contact dermatitis incidence and trends in North America, Europe, and Asia. First, medication contact allergy to corticosteroids will be discussed along with its five structural classes (A, B, C, D1, D2) and their steroid test compounds (tixocortol-21-pivalate, triamcinolone acetonide, budesonide, clobetasol-17-propionate, hydrocortisone-17-butyrate). Cross-reactivities between the steroid classes will also be examined. Next, estrogen and testosterone transdermal therapeutic systems, local anesthetic (benzocaine, lidocaine, pramoxine, dyclonine) antihistamines (piperazine, ethanolamine, propylamine, phenothiazine, piperidine, and pyrrolidine), top- ical antibiotics (neomycin, spectinomycin, bacitracin, mupirocin), and sunscreen are evaluated for their potential to cause contact dermatitis and cross-reactivities. Finally, we examine the ingredients in the excipients of these products, such as the formaldehyde releasers (quaternium-15, 2-bromo-2-nitropropane-1,3 diol, diazolidinyl urea, imidazolidinyl urea, DMDM hydantoin), the non- formaldehyde releasers (isothiazolinones, parabens, methyldibromo glutaronitrile, iodopropynyl butylcarbamate, and thimero- sal), fragrance mixes, and Myroxylon pereirae (Balsam of Peru) for contact allergy incidence and prevalence. Furthermore, strategies, recommendations, and two online tools (SkinSAFE and the Contact Allergen Management Program) on how to avoid these allergens in commercial skin care products will be discussed at the end.
    [Show full text]
  • Basic Skin Care and Topical Therapies for Atopic Dermatitis
    REVIEWS Basic Skin Care and Topical Therapies for Atopic Dermatitis: Essential Approaches and Beyond Sala-Cunill A1*, Lazaro M2*, Herráez L3, Quiñones MD4, Moro-Moro M5, Sanchez I6, On behalf of the Skin Allergy Committee of Spanish Society of Allergy and Clinical Immunology (SEAIC) 1Allergy Section, Internal Medicine Department, Hospital Universitario Vall d'Hebron, Barcelona, Spain 2Allergy Department, Hospital Universitario de Salamanca, Alergoasma, Salamanca, Spain 3Allergy Department, Hospital Universitario 12 de Octubre, Madrid, Spain 4Allergy Section, Hospital Monte Naranco, Oviedo, Spain 5Allergy Department, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain 6Clínica Dermatología y Alergia, Badajoz, Spain *Both authors contributed equally to the manuscript J Investig Allergol Clin Immunol 2018; Vol. 28(6): 379-391 doi: 10.18176/jiaci.0293 Abstract Atopic dermatitis (AD) is a recurrent and chronic skin disease characterized by dysfunction of the epithelial barrier, skin inflammation, and immune dysregulation, with changes in the skin microbiota and colonization by Staphylococcus aureus being common. For this reason, the therapeutic approach to AD is complex and should be directed at restoring skin barrier function, reducing dehydration, maintaining acidic pH, and avoiding superinfection and exposure to possible allergens. There is no curative treatment for AD. However, a series of measures are recommended to alleviate the disease and enable patients to improve their quality of life. These include adequate skin hydration and restoration of the skin barrier with the use of emollients, antibacterial measures, specific approaches to reduce pruritus and scratching, wet wrap applications, avoidance of typical AD triggers, and topical anti-inflammatory drugs. Anti-inflammatory treatment is generally recommended during acute flares or, more recently, for preventive management.
    [Show full text]
  • (12) United States Patent (10) Patent No.: US 7,544,192 B2 Eaton Et Al
    US007544192B2 (12) United States Patent (10) Patent No.: US 7,544,192 B2 Eaton et al. (45) Date of Patent: Jun. 9, 2009 (54) SINUS DELIVERY OF SUSTAINED RELEASE 5,443,498 A 8, 1995 Fontaine THERAPEUTICS 5,512,055 A 4/1996 Domb et al. 5,664,567 A 9, 1997 Linder (75) Inventors: Donald J. Eaton, Woodside, CA (US); 5,693,065. A 12/1997 Rains, III Mary L. Moran, Woodside, CA (US); 5,792,100 A 8/1998 Shantha Rodney Brenneman, San Juan Capistrano, CA (US) (73) Assignee: Sinexus, Inc., Palo Alto, CA (US) (Continued) (*) Notice: Subject to any disclaimer, the term of this FOREIGN PATENT DOCUMENTS patent is extended or adjusted under 35 U.S.C. 154(b) by 992 days. WO WOO1/02024 1, 2001 (21) Appl. No.: 10/800,162 (22) Filed: Mar 12, 2004 (Continued) (65) Prior Publication Data OTHER PUBLICATIONS US 2005/OO437O6A1 Feb. 24, 2005 Hosemann, W. et al. (Mar. 2003, e-pub. Oct. 10, 2002). “Innovative s Frontal Sinus Stent Acting as a Local Drug-Releasing System.' Eur: Related U.S. Application Data Arch. Otorhinolarynolo. 260:131-134. (60) Provisional application No. 60/454,918, filed on Mar. (Continued) 14, 2003. Primary Examiner Kevin C Sirmons (51) Int. Cl Assistant Examiner Catherine NWitczak A. iM sI/00 (2006.01) (74) Attorney, Agent, or Firm Morrison & Foerster LLP (52) U.S. Cl. ........................ 604/506; 604/510; 604/514 (57) ABSTRACT (58) Field of Classification Search .............. 604/93.01, 604/891.1. 890.1, 57, 59-64, 510, 514,506; S lication file f 606/196 The invention provides biodegradable implants for treating ee application file for complete search history.
    [Show full text]
  • Wo 2008/127291 A2
    (12) INTERNATIONAL APPLICATION PUBLISHED UNDER THE PATENT COOPERATION TREATY (PCT) (19) World Intellectual Property Organization International Bureau (43) International Publication Date PCT (10) International Publication Number 23 October 2008 (23.10.2008) WO 2008/127291 A2 (51) International Patent Classification: Jeffrey, J. [US/US]; 106 Glenview Drive, Los Alamos, GOlN 33/53 (2006.01) GOlN 33/68 (2006.01) NM 87544 (US). HARRIS, Michael, N. [US/US]; 295 GOlN 21/76 (2006.01) GOlN 23/223 (2006.01) Kilby Avenue, Los Alamos, NM 87544 (US). BURRELL, Anthony, K. [NZ/US]; 2431 Canyon Glen, Los Alamos, (21) International Application Number: NM 87544 (US). PCT/US2007/021888 (74) Agents: COTTRELL, Bruce, H. et al.; Los Alamos (22) International Filing Date: 10 October 2007 (10.10.2007) National Laboratory, LGTP, MS A187, Los Alamos, NM 87545 (US). (25) Filing Language: English (81) Designated States (unless otherwise indicated, for every (26) Publication Language: English kind of national protection available): AE, AG, AL, AM, AT,AU, AZ, BA, BB, BG, BH, BR, BW, BY,BZ, CA, CH, (30) Priority Data: CN, CO, CR, CU, CZ, DE, DK, DM, DO, DZ, EC, EE, EG, 60/850,594 10 October 2006 (10.10.2006) US ES, FI, GB, GD, GE, GH, GM, GT, HN, HR, HU, ID, IL, IN, IS, JP, KE, KG, KM, KN, KP, KR, KZ, LA, LC, LK, (71) Applicants (for all designated States except US): LOS LR, LS, LT, LU, LY,MA, MD, ME, MG, MK, MN, MW, ALAMOS NATIONAL SECURITY,LLC [US/US]; Los MX, MY, MZ, NA, NG, NI, NO, NZ, OM, PG, PH, PL, Alamos National Laboratory, Lc/ip, Ms A187, Los Alamos, PT, RO, RS, RU, SC, SD, SE, SG, SK, SL, SM, SV, SY, NM 87545 (US).
    [Show full text]
  • Intranasal Steroids and the Myth of Mucosal Atrophy: a Systematic Review of Original Histological Assessments
    Intranasal steroids and the myth of mucosal atrophy: A systematic review of original histological assessments Misha M. Verkerk, M.B.B.S.,1 Daman Bhatia, M.B.B.S.,2 Janet Rimmer, F.R.A.C.P.,3 Peter Earls, F.R.C.P.A.,4 Raymond Sacks, M.D.,5 and Richard J. Harvey, M.D.6 ABSTRACT Background: Intranasal corticosteroids (INCSs) are well established in the treatment of allergic rhinitis, chronic rhinosinusitis, and nasal polyposis. Although reversible atrophy of keratinized skin is seen with corticosteroids, the respiratory mucosa is histologically very different and but concerns remain among patients and some health-care professionals over local side effects on nasal respiratory mucosa. A systematic review and meta-analysis were performed of the available evidence for nasal mucosal atrophy as an adverse effect of INCSs in patients with sinonasal disease. Methods: A systematic search of Embase (1974-) and Medline (1946-) databases to September 27, 2013 was performed. Inclusion criteria selected any study where the histopathology of nasal mucosa was assessed in patients with sinonasal disease using intranasally administered corticosteroids with or without a control group. Results: Twenty-three hundred sixty-four publications were retrieved with a subsequent full text review of 149 publications for 34 articles that met the selection criteria. These articles included 11 randomized controlled trials, 5 cohorts, and 20 case series. Duration of treatment varied from 5 days to 5.5 years. “Mucosal atrophy” as an outcome was reported in 17 studies. The definition of “mucosal atrophy” was highly variable with a definition given in only 10 studies.
    [Show full text]
  • A Systematic Review of the Safety of Topical Therapies for Atopic Dermatitis J
    REVIEW ARTICLE DOI 10.1111/j.1365-2133.2006.07538.x A systematic review of the safety of topical therapies for atopic dermatitis J. Callen, S. Chamlin,* L.F. Eichenfield, C. Ellis,à M. Girardi,§ M. Goldfarb,à J. Hanifin,– P. Lee, D. Margolis,** A.S. Paller,* D. Piacquadio, W. Peterson, K. Kaulback,àà M. Fennerty– and B.U. Wintroub§§ Department of Dermatology, University of Louisville, Louisville, KY, U.S.A. *Department of Dermatology, Northwestern University’s Feinberg School of Medicine, Chicago, IL, U.S.A. Department of Dermatology, University of California San Diego, San Diego, CA, U.S.A. àDepartment of Dermatology, University of Michigan Medical School, Ann Arbor, MI, U.S.A. §Department of Dermatology, Yale University School of Medicine, New Haven, CT, U.S.A. –Department of Dermatology, Oregon Health and Science University, Portland, OR, U.S.A. **Departments of Dermatology and Gastroenterology, University of Pennsylvania School of Medicine, Philadelphia, PA, U.S.A. Department of Gastroenterology, University of Texas Southwestern Medical Center at Dallas, Dallas, TX, U.S.A. ààMedical Advisory Secretariat, Ministry of Health and Long Term Care, Toronto, ON, Canada §§Department of Dermatology, University of California San Francisco, 1701 Division Street, Room 338, San Francisco, CA 94143-0316, U.S.A. Summary Correspondence Background The safety of topical therapies for atopic dermatitis (AD), a common Bruce U. Wintroub. and morbid disease, has recently been the focus of increased scrutiny, adding E-mail: [email protected] confusion as how best to manage these patients. Objectives The objective of these systematic reviews was to determine the safety of Accepted for publication 9 June 2006 topical therapies for AD.
    [Show full text]
  • BDS: CALUX Bioassays
    Water safety assessment by Bioassays Cell based toxicity screening by a panel of CALUX bioassays Dr. Peter A. Behnisch Director BioDetection Systems, Amsterdam, The Netherlands Email: [email protected] ©BDS all rights reserved Who we are BioDetection Systems B.V. (“BDS”) is a Dutch company and ISO 17025 accredited service laboratory providing biological detection systems, such as the innovative CALUX bioassays for the determination of ultra low levels of a variety of highly potent materials. Mission To provide innovative bioassays and implement their use to the highest international standards. Partner in many international projects related to water: • EC FP6 “TECHNEAU ” • Rhine Monitoring Project (RIWA) • EC FP7 ChemScreen for REACH/3Rs • Dutch Projects, z. Bsp. LEOS, ZORG, Genes4Water ©BDS all2 rights reserved CALUX ® Principles Add substrate (luciferin) LightLight measurement Toxicity via luminometer Luciferase Dioxin Proteins Endocrine Enzymes Disrupting Chemicals Transport protein Dioxin receptor Dioxin Hormonebinding Binding Hsp Dioxin Responsive Transcription Element (CRE) Nucleus Cytosol ©BDS all rights reserved 1 Panel of CALUX ® biotests • Endocrine ER AR PR KappaB nrf2 cytox p53 TR GR RAR • Acute DR KappaB p21 cytox PPAR • Repro ER AR PR TR GR RAR • Immuno DR KappaB nrf2 cytox PPAR p53 ER AR PR p21 GR RAR DR KappaB nrf2 cytox PPAR • Development ER AR PR TR GR RAR ER AR TR DR KappaB GR RAR DR nrf2 cytox KappaB PPAR p53 cytox PPAR • Muta/carcinogen p21 ©BDS all rights reserved BDS’s CALUX and typical applications (1) • DR-CALUX (dioxins, furans, PCBs, POPs, PAKs, Ah receptor ligands) • ERα-CALUX (natural, synthetic and plant-like estrogens, pseudo-estrogens, DES, endocrine disrupters, tamoxifen and other anti-estrogens) • ERβ-CALUX (like ERα-CALUX, but more for plant-like estrogens ) • AR-CALUX (androgens, anabolic steroids, pseudo- androgens, antibiotic growth promoters, nandrolone, flutamide e.a.
    [Show full text]
  • United States Patent (10) Patent No.: US 9.447,027 B2 Milan Et Al
    US009447027B2 (12) United States Patent (10) Patent No.: US 9.447,027 B2 Milan et al. (45) Date of Patent: Sep. 20, 2016 (54) TREATING LONG QT SYNDROME 2004/O1972.71 A1* 10, 2004 Kunka et al. ................... 424/45 2006/0173058 A1* 8, 2006 Brown .................... CO7C 65/05 514,381 (75) Inventors: Es l, St. MS 2006/0173508 A1* 8, 2006 Stone ................. A61N 1,36085 aVId S. Peal, SomerV11 le. (US) 607/40 (73) Assignee: The General Hospital Corporation, FOREIGN PATENT DOCUMENTS Boston, MA (US) JP 11209328 A1 * 8, 1999 (*) Notice: Subject to any disclaimer, the term of this patent is extended or adjusted under 35 OTHER PUBLICATIONS U.S.C. 154(b) by 86 days. Nademanee, K. et al., Annals of the New York Academy of Sciences vol. 522, pp. 536-552, published 2006.* (21) Appl. No.: 13/822,264 Chouabe, C. et al., Molecular Pharmacology vol. 54 pp. 696-703, published 1998.* (22) PCT Filed: Oct. 20, 2011 Nishizawa, S., et al., (American Journal of Emergency Medicine vol. 27, pp. 1167.e1-1167.e3, published Nov. 2009).* (86). PCT No.: PCT/US2011/057087 Nishizawa et al., (American Journal of Emergency Medicine vol. 27, pp. 1167.el -1167.e3, published Nov. 2009).* S 371 (c)(1), Nishizawa et al (American Journal of Emergency Medicine vol. 27. (2), (4) Date: Jul. 22, 2013 pp. 1167.e1-1167.e3, published Nov. 2009).* Anderson et al., “Most LQT2 Mutations Reduce Kv11.1 (hERG) Current by a Class 2 (Trafficking-Deficient) Mechanism.” Circula (87) PCT Pub. No.: WO2012/054718 tion 113:365-373, 2006, 10 pages.
    [Show full text]