1,722,242 research outputs found
Aclidinium bromide, a novel long-acting muscarinic M3 antagonist for the treatment of COPD
No full textAclidinium bromide is a novel, inhaled, long-acting antimuscarinic agent being developed by Almirall Prodesfarma SA and Forest Laboratories Inc as a once-daily treatment for COPD. In preclinical studies, aclidinium bromide demonstrated a comparable profile to tiotropium bromide, with a slightly quicker onset of action but shorter duration of action. Clinical trials have demonstrated an unquestionably interesting pharmacological profile characterized by a faster rate of onset of the smooth muscle relaxing activity than tiotropium bromide and a rapid plasma hydrolysis in human plasma to inactive metabolites that may account for its favorable cardiovascular safety profile. However, the disappointing efficacy results of the recent phase III trials have cast doubt on the real advantage of introducing this drug on the market. Discussions with the FDA concluded that more trials are needed to assess selected dosing regimens, including higher and/or more frequent doses. At the time of publication, further phase III trials with aclidinium bromide were ongoing, and the developing companies were also extending development to combinations of aclidinium bromide with formoterol or an undisclosed inhaled corticosteroid
Pharmacology of the small airways [Farmacologia delle piccole vie aeree]
No full text[No abstract available
Adequate surrogate parameters in COPD studies [Surrogatparameter bei COPD]
No full text[No abstract available
Tiotropium could provide benefits in the early stage of COPD, but further studies are needed
No full textPhysiologic and biological markers to assess the progression of chronic obstructive pulmonary disease [Quali parametri funzionali e biologici per la valutazione della progressione della broncopneumopatia cronica ostruttiva]
No full textChronic obstructive pulmonary disease (COPD) is a multi-component disease characterised by a range of pathological changes, which include mucus hypersecretion, airway narrowing and loss of alveoli in the lungs, and loss of lean body mass and cardiovascular effects at a systemic level. COPD patients are also heterogeneous in terms of clinical presentation, disease severity and rate of disease progression. Their degree of airflow limitation, as measured by FEV1, is known to be poorly correlated to severity of symptoms, which adds to the difficulties of researchers who are trying to improve the definition of COPD and current disease staging systems. Since the relationship between spirometry and symptoms appears to be poor, measures of lung physiology may not adequately describe alone both the social impact of COPD and the effectiveness of therapeutic interventions in individual patients. Most researchers regard patient-centred outcomes such as symptoms, exacerbations, exercise capacity and health-related quality of life as important as changes in lung function. At this time, no surrogate marker of COPD or its exacerbations has been identified other than FEV1, but the value of FEV1 as a surrogate marker is limited. Mortality dyspnea and health-related quality of life remain the most important clinical outcomes in COPD research. Other potential surrogate markers should be included as secondary endpoints in future clinical trials. This may lead to the identification of biomarkers that correlate with patient-centred outcomes. Generation of such data may also help in the development of new hypotheses for future clinical trials
Cytoreductive therapy for patients with essential thrombocythemia at high risk of thromboembolic complications. The difficult choice of the optimal drug
No full textEditorial on therapeutic decision making in patients with essential thrombocythemia
Benefits and risks of JAK inhibition
No full textOn 16 November 2011, the US Food and Drug Administration (FDA) approved ruxolitinib, a small-molecule inhibitor of JAK1/2, for the treatment of patients with intermediate- or high-risk myelofibrosis, including primary myelofibrosis, post-polycythemia vera myelofibrosis, and post-essential thrombocythemia myelofibrosis. In this issue of Blood, Porpaczy et al report findings of a study showing that JAK1/2 inhibitor treatment is associated with an increased risk for aggressive B-cell lymphomas
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