DOCSLIB.ORG

University of Groningen Effectiveness and Safety of Medicines Used in COPD Patients Wang, Yuanyuan

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
University of Groningen Effectiveness and Safety of Medicines Used in COPD Patients Wang, Yuanyuan University of Groningen Effectiveness and safety of medicines used in COPD patients Wang, Yuanyuan DOI: 10.33612/diss.123921981 IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite from it. Please check the document version below. Document Version Publisher's PDF, also known as Version of record Publication date: 2020 Link to publication in University of Groningen/UMCG research database Citation for published version (APA): Wang, Y. (2020). Effectiveness and safety of medicines used in COPD patients: pharmacoepidemiological studies. University of Groningen. https://doi.org/10.33612/diss.123921981 Copyright Other than for strictly personal use, it is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), unless the work is under an open content license (like Creative Commons). The publication may also be distributed here under the terms of Article 25fa of the Dutch Copyright Act, indicated by the “Taverne” license. More information can be found on the University of Groningen website: https://www.rug.nl/library/open-access/self-archiving-pure/taverne- amendment. Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim. Downloaded from the University of Groningen/UMCG research database (Pure): http://www.rug.nl/research/portal. For technical reasons the number of authors shown on this cover page is limited to 10 maximum. Download date: 09-10-2021 Efectiveness and safety of medicines used in COPD patients Pharmacoepidemiological studies Yuanyuan Wang Paranymphs: Jurjen van der Schans Yanni Li Efectiveness and safety of medicines used in COPD patients Pharmacoepidemiological studies ISBN: 978-94-034-2555-9 (printed version) ISBN: 978-94-034-2554-2 (electric version) Author: Yuanyuan Wang Cover-design: IRINA SHI (photo) & Of Page (content) Printing: Of Page (www.ofpage.nl) The studies presented in this thesis were funded by University of Groningen and the China Scholarship Council (CSC) Scholarship. This thesis was conducted within the Groningen University Institute for Drug Exploration (GUIDE). Printing of this thesis was fnancially supported by the University of Groningen and the Graduate School of Science and Engineering (GSSE). Copyright ©Yuanyuan Wang, 2020, Groningen, The Netherlands. All rights reserved. No part of this book may be reproduced or transmitted in any form by any means, electronically or mechanically by photocopying, recording, or otherwise, without the written permission of the author. The copy right of previously published chapters of this thesis remains with the publisher or journal. Effectiveness and safety of medicines used in COPD patients Pharmacoepidemiological studies PhD thesis to obtain the degree of PhD at the University of Groningen on the authority of the Rector Magnificus Prof. C. Wijmenga and in accordance with the decision by the College of Deans. This thesis will be defended in public on Friday 8 May 2020 at 14.30 hours by Yuanyuan Wang born on 15 February 1988 in Henan, China Supervisors Prof. Ha Prof. H.M. oeen Assessment Committee Prof. T..M. erheij Prof. van der Palen Prof. tienstra Supervisors TABLE OF CONTENTS Prof. Ha Prof. H.M. oeen Chapter 1 General Introduction 7 Part I Efects of antibiotic use for COPD exacerbations and potential DDIs during COPD exacerbation management Assessment Committee Prof. T..M. erheij Chapter 2 Efects of Prophylactic Antibiotics on Patients with Stable COPD: 21 Prof. van der Palen A Systematic Review and Meta-Analysis of Prof. tienstra Randomized Controlled Trials Chapter 3 The infuence of age on real-life efects of doxycycline for 43 acute exacerbations among COPD outpatients: a population-based cohort study Chapter 4 Real-world short- and long-term efects of antibiotic therapy on 61 acute exacerbations of COPD in outpatients: a cohort study under the PharmLines Initiative Chapter 5 Improving antibacterial prescribing safety in 81 the management of COPD exacerbations: systematic review of observational and clinical studies on potential drug interactions associated with frequently prescribed antibacterials among COPD Patients Part II Neuropsychiatric safety of varenicline use for smoking cessation and the application of prescription sequence symmetry analysis in drug safety evaluation Chapter 6 Neuropsychiatric safety of varenicline in the general and 119 COPD population with and without psychiatric disorders: a retrospective inception cohort study in a real-world setting Chapter 7 Risk of neuropsychiatric adverse events associated with 145 varenicline treatment for smoking cessation: a prescription sequence symmetry analysis Chapter 8 Efect estimate comparison between the prescription 165 sequence symmetry analysis and parallel group study designs: a systematic review Chapter 9 General discussion 183 Chapter 10 Summary 197 Samenvatting 201 Acknowledgement 204 List of publications 208 About the author 211 CHAPTER 1 General Introduction General Introduction GENERAL INTRODUCTION 1 Chronic obstructive pulmonary disease According to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) report 2020, Chronic Obstructive Pulmonary Disease (COPD) is a common, preventable and treatable disease that is characterized by persistent respiratory symptoms and airfow limitation. Such symptoms are caused by airway and/or alveolar abnormalities usually triggered by signifcant exposure to noxious particles or gases.1 Cigarette smoking is the main independent causal risk factor for COPD with indoor and outdoor air pollution and occupational exposure to dust and noxious particles also being the risk factors for COPD.2 Moreover, host factors that may contribute to the development of COPD include age, genetics, airway hyper responsiveness and abnormal lung development.3-5 The prevalence of COPD varies across countries as well as regions within countries. According to the fndings of a global meta-analysis, the number of COPD cases increased to 384 million in 2010, with a global prevalence of 12% (ranging between 8% and 15%).6 COPD is commonly diagnosed in individuals aged 40 years or older based on the presence of associated symptoms and risk factors. However, a defnitive COPD diagnosis requires the performance of spirometry. The presence of a post- bronchodilator FEV1/FVC < 0.7 confrms the presence of airfow limitation and results in a COPD diagnosis. COPD patients are currently categorized into four GOLD stages of severity of airfow limitations based on the predicted value of FEV1: mild (stage I, FEV1 ≥ 80% predicted), moderate (stage II, 50% ≤ FEV1 < 80% predicted), severe (stage III, 1 30% ≤ FEV1 < 80% predicted) and very severe (stage IV, FEV1 < 30% predicted). A large prevalence study estimated that the rate of COPD for GOLD stage II and higher is around 10% in the general population, and a little higher in men than women (11.8% and 8.5%, respectively).7 COPD is one of the leading causes of morbidity and mortality worldwide.8 Its burden is predicted to increase in the coming decades as a result of continuous exposure to risk factors in developing countries and aging of the population worldwide, particularly in high-income countries.9 Smoking cessation interventions, increased physical activity, and early diagnosis and treatment of related comorbidities are considered key measures for reducing the health-economic burden of COPD. 10 Up to now, the key goals of COPD treatment have been to improve patients’ prognosis and prevent the disease from worsening. The main treatment used in the daily management of mild and moderate COPD is pharmacotherapy. Bronchodilators, including short- and long-acting β2-agonists (SABA and LABA) and short- and long-acting anticholinergics (SAMA and LAMA) are essential for managing and preventing symptoms, and combined treatment (SABA/SAMA, LABA/LAMA or LABA/ICS) may be used as appropriate. Non- 9 Chapter 1 pharmacological treatment comprises pulmonary rehabilitation (e.g., exercise training, education, and behavioral change).11 Oxygen therapy is necessary for patients with very severe COPD and lung surgery may also be necessary. Exacerbations of COPD and antibiotic use An exacerbation of COPD is defned as an acute worsening of respiratory symptoms that necessitates additional therapy.1 COPD patients can periodically experience acute exacerbations that may accelerate the decline in lung function, reduce the quality of life, and increase mortality and health-care costs.12,13 14 Infections, especially bacterial infections, and infammation are thought to be an important trigger for exacerbations of COPD. Previous studies have found that bacteria are responsible for around 40% to 50% of exacerbations.15,16 S. pneumoniae, H. infuenza, P. aeruginosa, M. catarrhalis, A. baumannii, and S. aureus were the most frequently reported bacteria that cause exacerbations of COPD.16-18 According to the GOLD guideline, the main goals in treatment of COPD exacerbations are minimizing the negative impact of the current exacerbation and preventing subsequent exacerbations.1 Because almost 40% of exacerbations are bacteria-caused respiratory tract infections,16 the use of antibiotics has become a common component in the management of acute exacerbations among COPD patients, both in terms of treatment and prevention.1,19 Notably, recommendations in prophylactic use of antibiotics in the management
Load more

Recommended publications
  • The Role of Nanobiosensors in Therapeutic Drug Monitoring
    Journal of Personalized Medicine Review Personalized Medicine for Antibiotics: The Role of Nanobiosensors in Therapeutic Drug Monitoring Vivian Garzón 1, Rosa-Helena Bustos 2 and Daniel G. Pinacho 2,* 1 PhD Biosciences Program, Universidad de La Sabana, Chía 140013, Colombia; [email protected] 2 Therapeutical Evidence Group, Clinical Pharmacology, Universidad de La Sabana, Chía 140013, Colombia; [email protected] * Correspondence: [email protected]; Tel.: +57-1-8615555 (ext. 23309) Received: 21 August 2020; Accepted: 7 September 2020; Published: 25 September 2020 Abstract: Due to the high bacterial resistance to antibiotics (AB), it has become necessary to adjust the dose aimed at personalized medicine by means of therapeutic drug monitoring (TDM). TDM is a fundamental tool for measuring the concentration of drugs that have a limited or highly toxic dose in different body fluids, such as blood, plasma, serum, and urine, among others. Using different techniques that allow for the pharmacokinetic (PK) and pharmacodynamic (PD) analysis of the drug, TDM can reduce the risks inherent in treatment. Among these techniques, nanotechnology focused on biosensors, which are relevant due to their versatility, sensitivity, specificity, and low cost. They provide results in real time, using an element for biological recognition coupled to a signal transducer. This review describes recent advances in the quantification of AB using biosensors with a focus on TDM as a fundamental aspect of personalized medicine. Keywords: biosensors; therapeutic drug monitoring (TDM), antibiotic; personalized medicine 1. Introduction The discovery of antibiotics (AB) ushered in a new era of progress in controlling bacterial infections in human health, agriculture, and livestock [1] However, the use of AB has been challenged due to the appearance of multi-resistant bacteria (MDR), which have increased significantly in recent years due to AB mismanagement and have become a global public health problem [2].
    [Show full text]
  • 207988Orig1s000
    CENTER FOR DRUG EVALUATION AND RESEARCH APPLICATION NUMBER: 207988Orig1s000 RISK ASSESSMENT and RISK MITIGATION REVIEW(S) Department of Health and Human Services Food and Drug Administration Center for Drug Evaluation and Research Office of Surveillance and Epidemiology Office of Medication Error Prevention and Risk Management RISK EVALUATION AND MITIGATION STRATEGY (REMS) REVIEW Date: December 20, 2015 Reviewer(s): Jasminder Kumar, PharmD Division of Risk Management (DRISK) Acting Team Leader: Jamie Wilkins Parker, Pharm.D., DRISK Deputy Director: Reema Mehta, Pharm.D., M.P.H., DRISK Director: Cynthia LaCivita, Pharm.D. Subject: Review evaluates if a REMS is needed for Zurampic (lesinurad) Drug Name: Zurampic (lesinurad) Therapeutic Class: Uricosuric agent Dosage form and route: 200mg tablet for oral administration Application Type/Number: NDA 207988 Applicant/Sponsor: Ardea Biosciences Inc. OSE RCM #: 2015-52 *** This document contains proprietary and confidential information that should not be released to the public. *** 1 Reference ID: 3863300 CONTENTS 1 INTRODUCTION ................................................................................................................... 3 1.1 Product Background ......................................................................................................... 3 1.2 Disease Background ......................................................................................................... 3 1.3 Regulatory History ..........................................................................................................
    [Show full text]
  • Environmental Risk Assessment of Antibiotics: Investigations Into Cyanobacteria Interspecies Sensitivities and Establishing Appropriate Protection Limits
    Environmental Risk Assessment of Antibiotics: Investigations into Cyanobacteria Interspecies Sensitivities and Establishing Appropriate Protection Limits Submitted by Gareth Curtis Le Page to the University of Exeter as a thesis for the degree of Doctor of Philosophy in Biological Sciences In December 2018 This thesis is available for Library use on the understanding that it is copyright material and that no quotation from the thesis may be published without proper acknowledgement I certify that all material in this thesis which is not my own work has been identified and that no material has previously been submitted and approved for the award of a degree by this or any other University. Signature: …………………………………………………………...(Gareth Le Page) 1 Abstract Antibiotics have been described as a ‘wonder drug’ that have transformed medicine since their discovery at the beginning of the 20th century and are used globally in safeguarding human and animal health. Environmental risk assessment (ERA) aims to ensure their environmental safety by setting protection limits that seek to prevent adverse effects upon populations and ecosystem function. In the case of antibiotics however, there is concern that ERA may not be fully protective of bacterial populations. This thesis examines the ERA of antibiotics and highlights that protection limits may in some cases be under-protective or over-protective for bacteria populations (including cyanobacteria), depending on the antibiotic mode of action and the species on which the protection limit is based. The first section of the thesis contains a systematic review including a meta-analysis of all publically available aquatic ecotoxicity data. The results illustrate that generally bacteria are the most sensitive taxa to antibiotics compared with eukaryotes but that interspecies variability in sensitivity among bacteria can range by up to five orders of magnitude.
    [Show full text]
  • Guidelines for Management of Gout. Part 1: Systematic Nonpharmacologic and Pharmacologic Therapeutic Approaches to Hyperuricemia DINESH KHANNA,1 JOHN D
    Arthritis Care & Research Vol. 64, No. 10, October 2012, pp 1431–1446 DOI 10.1002/acr.21772 © 2012, American College of Rheumatology SPECIAL ARTICLE 2012 American College of Rheumatology Guidelines for Management of Gout. Part 1: Systematic Nonpharmacologic and Pharmacologic Therapeutic Approaches to Hyperuricemia DINESH KHANNA,1 JOHN D. FITZGERALD,2 PUJA P. KHANNA,1 SANGMEE BAE,2 MANJIT K. SINGH,3 TUHINA NEOGI,4 MICHAEL H. PILLINGER,5 JOAN MERILL,6 SUSAN LEE,7 SHRADDHA PRAKASH,2 MARIAN KALDAS,2 MANEESH GOGIA,2 FERNANDO PEREZ-RUIZ,8 WILL TAYLOR,9 FRE´ DE´ RIC LIOTE´ ,10 HYON CHOI,4 JASVINDER A. SINGH,11 NICOLA DALBETH,12 SANFORD KAPLAN,13 VANDANA NIYYAR,14 DANIELLE JONES,14 STEVEN A. YAROWS,15 BLAKE ROESSLER,1 GAIL KERR,16 CHARLES KING,17 GERALD LEVY,18 DANIEL E. FURST,2 N. LAWRENCE EDWARDS,19 BRIAN MANDELL,20 H. RALPH SCHUMACHER,21 MARK ROBBINS,22 2 7 NEIL WENGER, AND ROBERT TERKELTAUB Guidelines and recommendations developed and/or endorsed by the American College of Rheumatology (ACR) are intended to provide guidance for particular patterns of practice and not to dictate the care of a particular patient. The ACR considers adherence to these guidelines and recommendations to be voluntary, with the ultimate determi- nation regarding their application to be made by the physician in light of each patient’s individual circumstances. Guidelines and recommendations are intended to promote beneficial or desirable outcomes but cannot guarantee any specific outcome. Guidelines and recommendations developed or endorsed by the ACR are subject to periodic revision as warranted by the evolution of medical knowledge, technology, and practice.
    [Show full text]
  • Lesinurad Cuts Uric Acid in Refractory Gout
    20 ARTHRITIS AUGUST 2011 • RHEUMATOLOGY NEWS Lesinurad Cuts Uric Acid in Refractory Gout Ninety percent of patients who remained on fore the end of this year, said Barry D. a uric acid transporter molecule in the Quart, Pharm.D., president of Ardea kidney that takes uric acid out of urine treatment for 28 weeks met the study’s target level. Biosciences, the San Diego–based com- and places it back into the blood. pany that is developing the drug. The study led by Dr. Perez-Ruiz en- BY MITCHEL L. ZOLER mg/day of lesinurad also appeared safe, The phase III study will likely focus on rolled patients who met the 1977 gout di- with no adverse effects or other safety the 200-mg and 400-mg/day dosages, as agnosis criteria of the American FROM THE ANNUAL EUROPEAN CONGRESS OF RHEUMATOLOGY concerns seen during the limited treat- over time most patients appeared to re- Rheumatism Association (now the ment period reported, said Dr. Perez- spond to these lower dosages. American College of Rheumatology) LONDON – An investigational drug Ruiz, a rheumatologist at Hospital de “Almost no one needs 600 mg/day to and who had a serum uric acid level that boosts uric acid secretion led to sig- Cruces in Barakaldo, Spain. get a response,” Dr. Quart said in an in- greater than 6 mg/dL despite being on terview. a stable dose of 200-600 mg allopurinol Major Finding: After 4 weeks of treatment with a combination of 200-600 Although the current study used pa- for at least 6 weeks.
    [Show full text]
  • Structural Basis for Potent Inhibitory Activity of the Antibiotic Tigecycline During Protein Synthesis
    Structural basis for potent inhibitory activity of the antibiotic tigecycline during protein synthesis Lasse Jennera,b,1, Agata L. Starostac,1, Daniel S. Terryd,e, Aleksandra Mikolajkac, Liudmila Filonavaa,b,f, Marat Yusupova,b, Scott C. Blanchardd, Daniel N. Wilsonc,g,2, and Gulnara Yusupovaa,b,2 aInstitut de Génétique et de Biologie Moléculaire et Cellulaire, Institut National de la Santé et de la Recherche Médicale U964, Centre National de la Recherche Scientifique, Unité Mixte de Recherche 7104, 67404 Illkirch, France; bUniversité de Strasbourg, F-67084 Strasbourg, France; cGene Center and Department for Biochemistry, University of Munich, 81377 Munich, Germany; dDepartment of Physiology and Biophysics, Weill Medical College of Cornell University, New York, NY 10065; eTri-Institutional Training Program in Computational Biology and Medicine, New York, NY 10065; fMax Planck Institute for Biophysical Chemistry, 37077 Göttingen, Germany; and gCenter for Integrated Protein Science Munich, University of Munich, 81377 Munich, Germany Edited by Rachel Green, Johns Hopkins University, Baltimore, MD, and approved January 17, 2013 (received for review September 28, 2012) + Here we present an X-ray crystallography structure of the clinically C1054 via a coordinated Mg2 ion (Fig. 1 D and E), as reported relevant tigecycline antibiotic bound to the 70S ribosome. Our previously for tetracycline (2). In addition, ring A of tigecycline + structural and biochemical analysis indicate that the enhanced coordinates a second Mg2 ion to facilitate an indirect interaction potency of tigecycline results from a stacking interaction with with the phosphate-backbone of G966 in h31 (Fig. 1 C–E). We also nucleobase C1054 within the decoding site of the ribosome.
    [Show full text]
  • Treatment with Sub-Inhibitory Kanamycin Induces Adaptive Resistance to Aminoglycoside Antibiotics Via the Acrd Multidrug Efflux Pump in Escherichia Coli K-12
    Journal of Experimental Microbiology and Immunology (JEMI) Vol. 16: 11 – 16 Copyright © April 2012, M&I UBC Treatment with Sub-inhibitory Kanamycin Induces Adaptive Resistance to Aminoglycoside Antibiotics via the AcrD Multidrug Efflux Pump in Escherichia coli K-12 Kiran Sidhu, Martha Talbot, Kirstin Van Mil, and Meghan Verstraete Department of Microbiology & Immunology, University of British Columbia Research has shown that exposing Escherichia coli cells to sub-inhibitory concentrations of kanamycin induces adaptive resistance upon subsequent exposure to lethal levels of both structurally-similar and unrelated antibiotics. AcrD is an efflux pump that forms a complex with the outer membrane pore TolC and the periplasmic membrane fusion protein AcrA. Together, this complex works to export a variety of aminoglycosides and amphiphilic compounds from the cell. The involvement of AcrD in the observed adaptive resistance was assessed by comparing the induction of adaptive resistance upon exposure to kanamycin in wild- type and acrD-deficient Escherichia coli strains. Both strains were pretreated with sub- inhibitory concentrations of kanamycin and subsequently exposed to lethal concentrations of ampicillin, kanamycin, nalidixic acid, streptomycin, and tetracycline. Growth was monitored over 18 hours via optical density readings. Comparing the relative growth of the different treatments revealed that adaptive resistance was only induced in the wild-type strain towards kanamycin and streptomycin. This indicates that AcrD is necessary for the induced adaptive resistance and that it is specific to aminoglycosides. Additionally, molecular techniques were used to assess the level of expression of acrA, which was found to be upregulated in both the wild-type and acrD deletion strains following pretreatment with kanamycin.
    [Show full text]
  • Tetracyclines, Oral Therapeutic Class Review (TCR)
    Tetracyclines, Oral Therapeutic Class Review (TCR) September 1, 2019 No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, digital scanning, or via any information storage or retrieval system without the express written consent of Magellan Rx Management. All requests for permission should be mailed to: Magellan Rx Management Attention: Legal Department 6950 Columbia Gateway Drive Columbia, Maryland 21046 The materials contained herein represent the opinions of the collective authors and editors and should not be construed to be the official representation of any professional organization or group, any state Pharmacy and Therapeutics committee, any state Medicaid Agency, or any other clinical committee. This material is not intended to be relied upon as medical advice for specific medical cases and nothing contained herein should be relied upon by any patient, medical professional or layperson seeking information about a specific course of treatment for a specific medical condition. All readers of this material are responsible for independently obtaining medical advice and guidance from their own physician and/or other medical professional in regard to the best course of treatment for their specific medical condition. This publication, inclusive of all forms contained herein, is intended to be educational in nature and is intended to be used for informational purposes only. Send comments and suggestions to [email protected]. September
    [Show full text]
  • Antihyperuricemics Review 10/25/2010
    Antihyperuricemics Review 10/25/2010 Copyright © 2009 – 2010 by Provider Synergies, L.L.C. All rights reserved. Printed in the United States of America. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, digital scanning, or via any information storage and retrieval system without the express written consent of Provider Synergies, L.L.C. All requests for permission should be mailed to: Attention: Copyright Administrator Intellectual Property Department Provider Synergies, L.L.C. 10101 Alliance Rd, Ste 201 Cincinnati, Ohio 45242 The materials contained herein represent the opinions of the collective authors and editors and should not be construed to be the official representation of any professional organization or group, any state Pharmacy and Therapeutics committee, any state Medicaid Agency, or any other clinical committee. This material is not intended to be relied upon as medical advice for specific medical cases and nothing contained herein should be relied upon by any patient, medical professional or layperson seeking information about a specific course of treatment for a specific medical condition. All readers of this material are responsible for independently obtaining medical advice and guidance from their own physician and/or other medical professional in regard to the best course of treatment for their specific medical condition. This publication, inclusive of all forms contained herein, is intended to be educational in nature and is intended to be used for informational purposes only. Send comments and suggestions to [email protected]. Antihyperuricemics Review FDA-Approved Indications1,2 Drug Manufacturer Indication(s) allopurinol generic - Management of patients with signs and symptoms (Zyloprim® )3 of primary or secondary gout (acute attacks, tophi, joint destruction, uric acid lithiasis, and/or nephropathy).
    [Show full text]
  • Lesinurad Combined with Allopurinol
    ARTHRITIS & RHEUMATOLOGY Vol. 69, No. 1, January 2017, pp 203–212 DOI 10.1002/art.39840 VC 2016, American College of Rheumatology Lesinurad Combined With Allopurinol A Randomized, Double-Blind, Placebo-Controlled Study in Gout Patients With an Inadequate Response to Standard-of-Care Allopurinol (a US-Based Study) Kenneth G. Saag,1 David Fitz-Patrick,2 Jeff Kopicko,3 Maple Fung,3 Nihar Bhakta,3 Scott Adler,4 Chris Storgard,3 Scott Baumgartner,3 and Michael A. Becker5 Objective. Lesinurad is a selective uric acid re- serum UA level of <6.0 mg/dl at month 6. Key secondary absorption inhibitor used for the treatment of gout in com- end points were the mean gout flare rate requiring treat- bination with a xanthine oxidase inhibitor. The Combining ment (months 7–12) and the proportions of patients with Lesinurad with Allopurinol Standard of Care in Inade- complete resolution of ‡1 target tophus (month 12). Safety quate Responders (CLEAR 1) study, a 12-month, multi- assessments included adverse events and laboratory data. center, randomized, double-blind, placebo-controlled Results. The study patients (n 5 603) were predom- phase III trial, was conducted to investigate daily lesinurad inantlymaleandhadamean6 SD age of 51.9 6 11.3 (200 mg or 400 mg orally) added to allopurinol versus pla- years, a gout duration of 11.8 6 9.4 years, a baseline serum cebo plus allopurinol in patients with serum urate (UA) UA level of 6.94 6 1.27 mg/dl, and were receiving an allopu- levels above a target of <6.0 mg/dl.
    [Show full text]
  • Norm Norm-Vet 2013
    2O13 NORM NORM-VET Usage of Antimicrobial Agents and Occurrence of Antimicrobial Resistance in Norway DESIGN, FORSIDE: IDA SKAAR IDA FORSIDE: DESIGN, – SVANEGODKJENT TRYKKSAK – 241 762 241 – TRYKKSAK SVANEGODKJENT – ISSN: 1502-2307 (print) / 1890-9965 (electronic) AS MEDIA LUNDBLAD 2013 NORM NORM-VET Usage of Antimicrobial Agents and Occurrence of Antimicrobial Resistance in Norway ISSN: 1502-2307 (print) / 1890-9965 (electronic) Any use of data from NORM/NORM-VET 2013 should include specific reference to this report. Suggested citation: NORM/NORM-VET 2013. Usage of Antimicrobial Agents and Occurrence of Antimicrobial Resistance in Norway. Tromsø / Oslo 2014. ISSN:1502-2307 (print) / 1890-9965 (electronic). This report is available at www.vetinst.no and www.antibiotikaresistens.no 1 NORM / NORM-VET 2013 CONTRIBUTORS AND PARTICIPANTS Editors: Gunnar Skov Simonsen NORM, Univ. Hosp. of North Norway Anne Margrete Urdahl NORM-VET, Norwegian Veterinary Institute Authors: Cecilie Torp Andersen Candida spp. [email protected] Oslo Univ. Hosp. Trude Margrete Arnesen Tuberculosis [email protected] Norw. Inst. of Pub. Health Hege Salvesen Blix Antibiotic usage in humans [email protected] Norw. Inst. of Pub. Health Dominique Caugant Meningococci [email protected] Norw. Inst. of Pub. Health Petter Elstrøm MRSA [email protected] Norw. Inst. of Pub. Health Kari Grave Antibiotic usage in animals [email protected] Norw. Vet. Inst. Ina Haagensen Enteropathogenic bacteria from humans [email protected] Norw. Inst. of Pub. Health Kjersti Wik Larssen MRSA [email protected] St. Olav Univ. Hosp. Madelaine Norström Bacteria from animals [email protected] Norw.
    [Show full text]
  • The Effect of Kanamycin and Tetracycline on Growth and Photosynthetic Activity of Two Chlorophyte Algae
    Hindawi Publishing Corporation BioMed Research International Volume 2016, Article ID 5656304, 8 pages http://dx.doi.org/10.1155/2016/5656304 Research Article The Effect of Kanamycin and Tetracycline on Growth and Photosynthetic Activity of Two Chlorophyte Algae Khawaja Muhammad Imran Bashir and Man-Gi Cho Department of Biotechnology, Division of Energy and Bioengineering, Dongseo University, Busan, Republic of Korea Correspondence should be addressed to Man-Gi Cho; [email protected] Received 20 April 2016; Revised 22 July 2016; Accepted 26 July 2016 Academic Editor: Jinsong Ren Copyright © 2016 K. M. I. Bashir and M.-G. Cho. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Antibiotics are routinely used in microalgae culture screening, stock culture maintenance, and genetic transformation. By studying the effect of antibiotics on microalgae growth, we can estimate the least value to inhibit growth of undesired pathogens inalgal culture. We studied the effect of kanamycin and tetracycline on the growth and photosynthetic activity of two chlorophyte −1 microalgae, Dictyosphaerium pulchellum and Micractinium pusillum. We measured CFU mL on agar plates, optical density, fluorescence yields, and photosynthetic inhibition. Our results showed a significant effectof kan and tet on the tested microalgae species except tet, which showed a minor effect on M. pusillum. Both antibiotics are believed to interact with the protein synthesis machinery; hence, the inhibitory effect of the tested antibiotics was further confirmed by isolation and quantification of thewhole −1 cell protein. A significant reduction in protein quantity was observed at concentrations more than 5mgL , except M.
    [Show full text]