Mohini Singh Bhadauriya, Harshita Singh, Manisha Suri, Mohd Hanifa, Anjana Bali
Background
Sepsis is a life threatening condition which triggers multiple organ failure. Sepsis-associated encephalopathy (SAE) is more prevalent form of sepsis which involves acute and long-term cerebral impairment. JAK/STAT pathway is one of the most crucial signaling cascades which promote neuroinflammation.
Objectives
The present investigation was designed to explore the possible role of JAK/STAT inhibitors in sepsis-induced cerebral injury and cognitive impairment in mice.
Methods
Swiss Albino mice underwent cecal ligation and puncture (CLP) to induce sepsis-associated cognitive deficits. Tofacitinib and baricitinib were administered orally one hour before CLP, followed by six days post-CLP administration. From days 7-12, behavioral changes were assessed through various tests, including open field (locomotor activity and non-associative memory), inhibitory avoidance (aversive memory), novel object recognition (recognition memory), and Morris-Water maze tests (spatial learning and memory). Neuronal injury (S-100 calcium-binding protein B, S100B and neuronal specific enolase, NSE) and inflammation (TNF-α) were assessed in the serum. Further, oxidative changes in the mouse brain were evaluated by measuring malondialdehyde and reduced glutathione levels.
Results
JAK/STAT inhibitors, including tofacitinib (7.5 and 15 mg/kgper os) and baricitinib (5 and 10 mg/kgper os), significantly ameliorated sepsis-induced deficits in non-associative, aversive, recognition and spatial memory in mice. Further, tofacitinib and baricitinib treatment decreased TNF-α, Malondialdehyde, S-100B and NSE in mice with sepsis while increasing the levels of reduced glutathione.
Conclusion
JAK/STAT inhibitors significantly decreased neuroinflammation, oxidative stress, and neuronal damage while enhancing cognitive function.
{"title":"JAK/STAT inhibitors mitigate sepsis-associated cerebral and cognitive injury","authors":"Mohini Singh Bhadauriya, Harshita Singh, Manisha Suri, Mohd Hanifa, Anjana Bali","doi":"10.1111/fcp.70005","DOIUrl":"https://doi.org/10.1111/fcp.70005","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Sepsis is a life threatening condition which triggers multiple organ failure. Sepsis-associated encephalopathy (SAE) is more prevalent form of sepsis which involves acute and long-term cerebral impairment. JAK/STAT pathway is one of the most crucial signaling cascades which promote neuroinflammation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The present investigation was designed to explore the possible role of JAK/STAT inhibitors in sepsis-induced cerebral injury and cognitive impairment in mice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Swiss Albino mice underwent cecal ligation and puncture (CLP) to induce sepsis-associated cognitive deficits. Tofacitinib and baricitinib were administered orally one hour before CLP, followed by six days post-CLP administration. From days 7-12, behavioral changes were assessed through various tests, including open field (locomotor activity and non-associative memory), inhibitory avoidance (aversive memory), novel object recognition (recognition memory), and Morris-Water maze tests (spatial learning and memory). Neuronal injury (S-100 calcium-binding protein B, S100B and neuronal specific enolase, NSE) and inflammation (TNF-α) were assessed in the serum. Further, oxidative changes in the mouse brain were evaluated by measuring malondialdehyde and reduced glutathione levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>JAK/STAT inhibitors, including tofacitinib (7.5 and 15 mg/kgper os) and baricitinib (5 and 10 mg/kgper os), significantly ameliorated sepsis-induced deficits in non-associative, aversive, recognition and spatial memory in mice. Further, tofacitinib and baricitinib treatment decreased TNF-α, Malondialdehyde, S-100B and NSE in mice with sepsis while increasing the levels of reduced glutathione.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>JAK/STAT inhibitors significantly decreased neuroinflammation, oxidative stress, and neuronal damage while enhancing cognitive function.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12657,"journal":{"name":"Fundamental & Clinical Pharmacology","volume":"39 3","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Malgorzata Ewa Belczyk, Malgorzata Elzbieta Knapik-Czajka, Jagoda Maria Drag, Anna Gawedzka, Angelika Bal
Background
α-ketoglutarate dehydrogenase complex (α-KGDH) belongs to mitochondrial 2-oxoacid dehydrogenases family and is the key regulatory enzyme of cell metabolism. It is functionally interconnected with glutamate dehydrogenase (GDH) which is a source of α-KG, a substrate for α-KGDH. Our previous studies demonstrated that simvastatin had an influence on 2-oxoacid dehydrogenases, including α-KGDH. Hence, we hypothesised that atorvastatin, one of the most commonly prescribed lipid-lowering drugs, may modify liver α-KGDH and GDH.
Objectives
The purpose of the present study was to evaluate the effect of atorvastatin on liver α-KGDH and GDH in rats with diet-induced hypercholesterolemia.
Methods
Atorvastatin at dose 20 mg/kg b.wt. (HC + A group, n = 10) or vehicle (HC group, hypercholesterolemic control, n = 10) were administered to rats with hypercholesterolemia for 21 days. The normal control group was fed a standard diet (ST group, normal control, n = 10). α-KGDH and GDH activities as well as their protein levels were determined. Moreover, serum parameters of lipid profile and liver function were measured.
Results
Liver α-KGDH and GDH activities were lower in HC than in ST rats. Atorvastatin enhanced the inhibited activities of α-KGDH and GDH. Stimulation of α-KGDH and GDH by atorvastatin did not correspond with the increase in protein levels of these enzymes indicating that atorvastatin activated α-KGDH and GDH most likely via post-translational mechanism. Atorvastatin had a beneficial effect on serum lipid profile and did not change the parameters of liver function.
Conclusion
The present study demonstrated that atorvastatin ameliorated liver α-KGDH and GDH functions in rats with diet-induced hypercholesterolemia.
{"title":"Atorvastatin ameliorates α-KGDH and GDH functions in rats with diet-induced hypercholesterolemia","authors":"Malgorzata Ewa Belczyk, Malgorzata Elzbieta Knapik-Czajka, Jagoda Maria Drag, Anna Gawedzka, Angelika Bal","doi":"10.1111/fcp.70009","DOIUrl":"https://doi.org/10.1111/fcp.70009","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>α-ketoglutarate dehydrogenase complex (α-KGDH) belongs to mitochondrial 2-oxoacid dehydrogenases family and is the key regulatory enzyme of cell metabolism. It is functionally interconnected with glutamate dehydrogenase (GDH) which is a source of α-KG, a substrate for α-KGDH. Our previous studies demonstrated that simvastatin had an influence on 2-oxoacid dehydrogenases, including α-KGDH. Hence, we hypothesised that atorvastatin, one of the most commonly prescribed lipid-lowering drugs, may modify liver α-KGDH and GDH.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The purpose of the present study was to evaluate the effect of atorvastatin on liver α-KGDH and GDH in rats with diet-induced hypercholesterolemia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Atorvastatin at dose 20 mg/kg b.wt. (HC + A group, n = 10) or vehicle (HC group, hypercholesterolemic control, n = 10) were administered to rats with hypercholesterolemia for 21 days. The normal control group was fed a standard diet (ST group, normal control, n = 10). α-KGDH and GDH activities as well as their protein levels were determined. Moreover, serum parameters of lipid profile and liver function were measured.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Liver α-KGDH and GDH activities were lower in HC than in ST rats. Atorvastatin enhanced the inhibited activities of α-KGDH and GDH. Stimulation of α-KGDH and GDH by atorvastatin did not correspond with the increase in protein levels of these enzymes indicating that atorvastatin activated α-KGDH and GDH most likely via post-translational mechanism. Atorvastatin had a beneficial effect on serum lipid profile and did not change the parameters of liver function.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The present study demonstrated that atorvastatin ameliorated liver α-KGDH and GDH functions in rats with diet-induced hypercholesterolemia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12657,"journal":{"name":"Fundamental & Clinical Pharmacology","volume":"39 3","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
An overproduction of oxidized low-density lipoprotein (ox-LDL) can lead to vascular endothelial dysfunction. Relaxin-2, a novel peptide hormone, exhibits various biological functions within the cardiovascular system. However, the effects of Relaxin-2 in atherosclerosis (AS) are underreported.
Objectives
We aimed to investigate the regulatory role of Relaxin-2 in the endothelial function of human aortic endothelial cells (HAECs) upon ox-LDL stimulation.
Methods
HAECs were stimulated with ox-LDL (100 mg/l) and rhRelaxin-2 (25, 50 nM) for 24 h. Multiple techniques, including real-time PCR, Western blot analysis, ELISA, and Calcein AM staining, were applied.
Results
Treatment with human recombinant (rh) Relaxin-2 decreased lectin-like ox-LDL receptor 1 (LOX-1), a primary receptor for ox-LDL, in HAECs. rhRelaxin-2 also reduced the ox-LDL-induced expression of pro-inflammatory mediators such as interleukin 6 (IL-6), tumor necrosis factor-α (TNF-α), and monocyte chemoattractant protein-1 (MCP-1). Additionally, we observed increased expression of cyclooxygenase-2 (COX-2), prostaglandin E2 (PGE2), and high mobility group protein B1 (HMGB-1) in ox-LDL-challenged HAECs, which was diminished by rhRelaxin-2. Significantly, the heightened expression of intercellular cell adhesion molecule-1 (ICAM-1) and E-selectin in ox-LDL-stimulated HAECs was mitigated by rhRelaxin-2. Consequently, rhRelaxin-2 alleviated the attachment of THP-1 cells to HAECs in a dose-dependent manner. Mechanistically, we found that rhRelaxin-2 inhibited the expression of Egr-1, a central mediator of endothelial inflammation. Furthermore, overexpression of Egr-1 was found to negate the beneficial effects of rhRelaxin-2, suggesting that these effects are mediated by the suppression of Egr-1.
Conclusion
Our findings propose a novel therapeutic approach with rhRelaxin-2 for patients with atherosclerosis.
{"title":"Relaxin-2 mitigates the interaction between monocytes and endothelial cells by suppressing Egr-1","authors":"Jing Bai, Hui Zhou","doi":"10.1111/fcp.70007","DOIUrl":"https://doi.org/10.1111/fcp.70007","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>An overproduction of oxidized low-density lipoprotein (ox-LDL) can lead to vascular endothelial dysfunction. Relaxin-2, a novel peptide hormone, exhibits various biological functions within the cardiovascular system. However, the effects of Relaxin-2 in atherosclerosis (AS) are underreported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>We aimed to investigate the regulatory role of Relaxin-2 in the endothelial function of human aortic endothelial cells (HAECs) upon ox-LDL stimulation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>HAECs were stimulated with ox-LDL (100 mg/l) and rhRelaxin-2 (25, 50 nM) for 24 h. Multiple techniques, including real-time PCR, Western blot analysis, ELISA, and Calcein AM staining, were applied.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Treatment with human recombinant (rh) Relaxin-2 decreased lectin-like ox-LDL receptor 1 (LOX-1), a primary receptor for ox-LDL, in HAECs. rhRelaxin-2 also reduced the ox-LDL-induced expression of pro-inflammatory mediators such as interleukin 6 (IL-6), tumor necrosis factor-α (TNF-α), and monocyte chemoattractant protein-1 (MCP-1). Additionally, we observed increased expression of cyclooxygenase-2 (COX-2), prostaglandin E2 (PGE2), and high mobility group protein B1 (HMGB-1) in ox-LDL-challenged HAECs, which was diminished by rhRelaxin-2. Significantly, the heightened expression of intercellular cell adhesion molecule-1 (ICAM-1) and E-selectin in ox-LDL-stimulated HAECs was mitigated by rhRelaxin-2. Consequently, rhRelaxin-2 alleviated the attachment of THP-1 cells to HAECs in a dose-dependent manner. Mechanistically, we found that rhRelaxin-2 inhibited the expression of Egr-1, a central mediator of endothelial inflammation. Furthermore, overexpression of Egr-1 was found to negate the beneficial effects of rhRelaxin-2, suggesting that these effects are mediated by the suppression of Egr-1.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our findings propose a novel therapeutic approach with rhRelaxin-2 for patients with atherosclerosis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12657,"journal":{"name":"Fundamental & Clinical Pharmacology","volume":"39 3","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lucie-Marie Scailteux, Julien Bezin, Marion Gundelwein, Julien Edeline, Emmanuel Oger, Frédéric Balusson, Antoine Pariente
Introduction
(Pre-)clinical studies have not ruled out a potential risk of second primary cancer (SCP) under the effect of some new androgen receptor pathway inhibitors (ARPIs), especially enzalutamide (ENZ).
Methods
Using the French health reimbursement claims database (Système National des Données de Santé), we designed a case–control study nested in a 2013–2020 cohort of new users of androgen-deprivation therapy. The cases were patients with a first diagnosis of SPC, identified beyond 12 months following cohort entry and up to December 31st, 2021; up to 10 controls were matched per case, based on age and cohort entry date. The main analysis focused on patients who had not switched to a different ARPI. Applying a one-year lag time, we determined the most frequent and longest cumulative exposure patterns to abiraterone (ABI) or ENZ and estimated the odds ratios.
Results
The cohort comprised 147 092 patients, including 7928 cases and 78 554 controls eligible for analysis. The SPCs mainly involve the digestive organs, the urinary tract, or the lungs. Recent and short exposure to ENZ was associated with SPC: OR 1.7, 95% CI [1.2–2.4]. Recent one full year of exposure to ABI, as well as full-year plus part of the second year, was associated with SPC: OR 1.8 [1.2–2.7] and 2.3 [1.3–4.0], respectively.
Discussion/Conclusion
SPC cases were mainly observed among recently exposed patients, which could be linked to a detection bias. The insufficient number of patients exposed over many years means that no definitive conclusions can be drawn.
{"title":"Second primary cancers and hormonal therapies for prostate cancer: A nested case–control study","authors":"Lucie-Marie Scailteux, Julien Bezin, Marion Gundelwein, Julien Edeline, Emmanuel Oger, Frédéric Balusson, Antoine Pariente","doi":"10.1111/fcp.70004","DOIUrl":"https://doi.org/10.1111/fcp.70004","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>(Pre-)clinical studies have not ruled out a potential risk of second primary cancer (SCP) under the effect of some new androgen receptor pathway inhibitors (ARPIs), especially enzalutamide (ENZ).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using the French health reimbursement claims database (Système National des Données de Santé), we designed a case–control study nested in a 2013–2020 cohort of new users of androgen-deprivation therapy. The cases were patients with a first diagnosis of SPC, identified beyond 12 months following cohort entry and up to December 31st<sup>,</sup> 2021; up to 10 controls were matched per case, based on age and cohort entry date. The main analysis focused on patients who had not switched to a different ARPI. Applying a one-year lag time, we determined the most frequent and longest cumulative exposure patterns to abiraterone (ABI) or ENZ and estimated the odds ratios.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The cohort comprised 147 092 patients, including 7928 cases and 78 554 controls eligible for analysis. The SPCs mainly involve the digestive organs, the urinary tract, or the lungs. Recent and short exposure to ENZ was associated with SPC: OR 1.7, 95% CI [1.2–2.4]. Recent one full year of exposure to ABI, as well as full-year plus part of the second year, was associated with SPC: OR 1.8 [1.2–2.7] and 2.3 [1.3–4.0], respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion/Conclusion</h3>\u0000 \u0000 <p>SPC cases were mainly observed among recently exposed patients, which could be linked to a detection bias. The insufficient number of patients exposed over many years means that no definitive conclusions can be drawn.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12657,"journal":{"name":"Fundamental & Clinical Pharmacology","volume":"39 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/fcp.70004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Edouard Januel, Jean Christophe Corvol, Philippe Remy, Wassilios G. Meissner, Claire Thiriez, Aymeric Lanore, Cecilia Bonnet, Jean-Philippe Azulay, Caroline Giordana, David Maltete, Solene Frismand, Christine Tranchant, Francois Sellal, Alain Jager, Matthieu Béreau, Giovanni Castelnovo, Anne Evelyne Vallet, Maryse Lapeyre-Mestre, Jean-Denis Turc, Olivier Rascol, Florence Tubach, DUMP study group
Context
After observing increased sudden death risk associated with domperidone use, the European Medicines Agency (EMA) imposed usage restrictions in 2014, limiting age (≤60 years), daily dose (≤30 mg/day), and duration (≤7 days). Nausea commonly occurs as an adverse effect of dopaminergic drugs in Parkinson's disease (PD) patients, with few alternative anti-emetic options. This study aimed to assess domperidone prescription patterns in French PD patients.
Methods
In this multicenter study, all consecutive PD patients from participating expert centers, hospitals, and private neurologists were included. We documented demographics, clinical data, comorbidities, domperidone use (indication, dose, and duration), and concurrent medications (related to PD or not). Domperidone misuse was assessed based on EMA guidelines.
Results
Between January and October 2021, 1579 patients from 16 centers (12 French PD expert centers, two general hospitals, and two private practice neurologists) were included. Among them, 109 (7%) received domperidone: 32 (29%) for nausea during apomorphine infusion, 71 (65%) for nausea during other dopaminergic therapies, and three (3%) for orthostatic hypotension. Domperidone misuse was found in 103 patients (95%): treatment duration >7 days (84%), age >60 years (79%), contraindicated drug interactions (6%), and contraindications due to cardiac comorbidity (5%). Only one patient exceeded the recommended dose (30 mg/day).
Conclusion
Domperidone is still prescribed in France for PD patients with dopaminergic-induced nausea, mostly disregarding EMA guidelines due to patient age (>60 years) and prolonged treatment (>7 days). Our study underscores the unmet need for managing gastrointestinal symptoms in PD, highlighting the inadequacy of EMA guidelines in this population.
{"title":"Use and misuse of domperidone in patients living with Parkinson disease in France","authors":"Edouard Januel, Jean Christophe Corvol, Philippe Remy, Wassilios G. Meissner, Claire Thiriez, Aymeric Lanore, Cecilia Bonnet, Jean-Philippe Azulay, Caroline Giordana, David Maltete, Solene Frismand, Christine Tranchant, Francois Sellal, Alain Jager, Matthieu Béreau, Giovanni Castelnovo, Anne Evelyne Vallet, Maryse Lapeyre-Mestre, Jean-Denis Turc, Olivier Rascol, Florence Tubach, DUMP study group","doi":"10.1111/fcp.70002","DOIUrl":"https://doi.org/10.1111/fcp.70002","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Context</h3>\u0000 \u0000 <p>After observing increased sudden death risk associated with domperidone use, the European Medicines Agency (EMA) imposed usage restrictions in 2014, limiting age (≤60 years), daily dose (≤30 mg/day), and duration (≤7 days). Nausea commonly occurs as an adverse effect of dopaminergic drugs in Parkinson's disease (PD) patients, with few alternative anti-emetic options. This study aimed to assess domperidone prescription patterns in French PD patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this multicenter study, all consecutive PD patients from participating expert centers, hospitals, and private neurologists were included. We documented demographics, clinical data, comorbidities, domperidone use (indication, dose, and duration), and concurrent medications (related to PD or not). Domperidone misuse was assessed based on EMA guidelines.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Between January and October 2021, 1579 patients from 16 centers (12 French PD expert centers, two general hospitals, and two private practice neurologists) were included. Among them, 109 (7%) received domperidone: 32 (29%) for nausea during apomorphine infusion, 71 (65%) for nausea during other dopaminergic therapies, and three (3%) for orthostatic hypotension. Domperidone misuse was found in 103 patients (95%): treatment duration >7 days (84%), age >60 years (79%), contraindicated drug interactions (6%), and contraindications due to cardiac comorbidity (5%). Only one patient exceeded the recommended dose (30 mg/day).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Domperidone is still prescribed in France for PD patients with dopaminergic-induced nausea, mostly disregarding EMA guidelines due to patient age (>60 years) and prolonged treatment (>7 days). Our study underscores the unmet need for managing gastrointestinal symptoms in PD, highlighting the inadequacy of EMA guidelines in this population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12657,"journal":{"name":"Fundamental & Clinical Pharmacology","volume":"39 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/fcp.70002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143582026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study examined the effects of beta-blockers and the combination of carteolol/oxprenolol with epinephrine on spinal nociceptive and motor blockades and compared them with propranolol.
Methods
Nociceptive and motor blockades were assessed in rats after intrathecal injection of carteolol, oxprenolol, metoprolol, acebutolol, and sotalol. Carteolol and oxprenolol were used in combination with epinephrine for spinal nociceptive and motor blockades. Propranolol was used as a control.
Results
At the same dose of 0.6 μmol, carteolol and oxprenolol are more potent than propranolol, and the duration of action of carteolol and oxprenolol is longer than or the same as that of propranolol. At ED50 (50% effective dose), the potency rankings of drugs are carteolol > oxprenolol > propranolol (P > 0.01). At ED25, ED50, and ED75, the time to full recovery induced by carteolol was longer than that induced by oxprenolol or propranolol. When 1:40,000 epinephrine was added to beta-blocker (carteolol, oxprenolol, and propranolol) at ED50, spinal blockades and duration of action were increased compared to beta-blockers alone (P > 0.05).
Conclusion
Carteolol and oxprenolol are more effective than propranolol on spinal blockades, while other beta-blockers are relatively ineffective. Compared to propranolol, the duration of action of carteolol and oxprenolol is longer or the same. Epinephrine enhances spinal blockades of carteolol, oxprenolol, and propranolol, suggesting that alpha-adrenergic receptors may play an important role in enhancing the anti-nociceptive effects of beta-blockers.
{"title":"Adrenaline enhances nociceptive and motor blockades by intrathecal carteolol and oxprenolol in rats","authors":"Chong-Chi Chiu, Kuo-Sheng Liu, Chieh-Yu Liu, Ching-Hsia Hung, Yu-Wen Chen, Jhi-Joung Wang","doi":"10.1111/fcp.70003","DOIUrl":"https://doi.org/10.1111/fcp.70003","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study examined the effects of beta-blockers and the combination of carteolol/oxprenolol with epinephrine on spinal nociceptive and motor blockades and compared them with propranolol.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Nociceptive and motor blockades were assessed in rats after intrathecal injection of carteolol, oxprenolol, metoprolol, acebutolol, and sotalol. Carteolol and oxprenolol were used in combination with epinephrine for spinal nociceptive and motor blockades. Propranolol was used as a control.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>At the same dose of 0.6 μmol, carteolol and oxprenolol are more potent than propranolol, and the duration of action of carteolol and oxprenolol is longer than or the same as that of propranolol. At ED<sub>50</sub> (50% effective dose), the potency rankings of drugs are carteolol > oxprenolol > propranolol (<i>P</i> > 0.01). At ED<sub>25</sub>, ED<sub>50</sub>, and ED<sub>75</sub>, the time to full recovery induced by carteolol was longer than that induced by oxprenolol or propranolol. When 1:40,000 epinephrine was added to beta-blocker (carteolol, oxprenolol, and propranolol) at ED<sub>50</sub>, spinal blockades and duration of action were increased compared to beta-blockers alone (<i>P</i> > 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Carteolol and oxprenolol are more effective than propranolol on spinal blockades, while other beta-blockers are relatively ineffective. Compared to propranolol, the duration of action of carteolol and oxprenolol is longer or the same. Epinephrine enhances spinal blockades of carteolol, oxprenolol, and propranolol, suggesting that alpha-adrenergic receptors may play an important role in enhancing the anti-nociceptive effects of beta-blockers.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12657,"journal":{"name":"Fundamental & Clinical Pharmacology","volume":"39 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143513849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Edwin Brokaar, Jonathan Knikman, Loes Visser, Frederiek van den Bos, Linda Henricks, Carin Lunenburg, Femke de Man, Hans Gelderblom, Jan Schellens, Ron Mathijssen, Henk-Jan Guchelaar, Johanneke Portielje, Annemieke Cats, Wout Postmus, Nienke de Glas
Background
Despite the implementation of DPYD genotype-guided dosing, approximately 1 in 3 patients receiving fluoropyrimidine-containing chemotherapy continues to experience severe toxicity. While clinical studies have demonstrated a favorable tolerance among highly selected fit older adults, real-world studies have shown an increased risk of toxicity.
Objective
To identify predictors of severe toxicity or treatment deintensification in older DPYD wild-type adults receiving fluoropyrimidine-containing chemotherapy.
Method
Patients wild type for four tested DPYD variants, aged ≥65 years, who participated in a prospective clinical trial investigating genotype-guided individualized fluoropyrimidine dosing, were eligible for the study. The association between tumor-, treatment-, and patient-related characteristics and the occurrence of severe toxicity (grade ≥3, CTCAE v5.0) was analyzed in univariate and multivariate logistic regression analyses. The same analyses were performed for a composite endpoint of severe toxicity or treatment deintensification (including dose reduction, cycle delay, or discontinuation).
Results
A total of 311 patients were included. Median age was 71.2 years and 58.8% were male. Grade ≥3 toxicity occurred in 23.2% of patients. In multivariate analysis, none of the characteristics studied were significantly associated with the occurrence of grade ≥3 toxicity. The composite endpoint occurred in 41.2% of patients and was associated with the use of full dose monotherapy in multivariate analysis.
Conclusion
Despite DPYD genotype-based dosing, grade ≥3 toxicity and treatment deintensification frequently occur in older patients treated with fluoropyrimidine chemotherapy. No patient-related variables were found to be associated with grade ≥3 toxicity, but treatment with dose-reduced monotherapy resulted in fewer treatment deintensification or severe toxicity events.
{"title":"Severe fluoropyrimidine toxicity in older adults with cancer with DPYD wild type","authors":"Edwin Brokaar, Jonathan Knikman, Loes Visser, Frederiek van den Bos, Linda Henricks, Carin Lunenburg, Femke de Man, Hans Gelderblom, Jan Schellens, Ron Mathijssen, Henk-Jan Guchelaar, Johanneke Portielje, Annemieke Cats, Wout Postmus, Nienke de Glas","doi":"10.1111/fcp.70000","DOIUrl":"https://doi.org/10.1111/fcp.70000","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Despite the implementation of <i>DPYD</i> genotype-guided dosing, approximately 1 in 3 patients receiving fluoropyrimidine-containing chemotherapy continues to experience severe toxicity. While clinical studies have demonstrated a favorable tolerance among highly selected fit older adults, real-world studies have shown an increased risk of toxicity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To identify predictors of severe toxicity or treatment deintensification in older <i>DPYD</i> wild-type adults receiving fluoropyrimidine-containing chemotherapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Patients wild type for four tested <i>DPYD</i> variants, aged ≥65 years, who participated in a prospective clinical trial investigating genotype-guided individualized fluoropyrimidine dosing, were eligible for the study. The association between tumor-, treatment-, and patient-related characteristics and the occurrence of severe toxicity (grade ≥3, CTCAE v5.0) was analyzed in univariate and multivariate logistic regression analyses. The same analyses were performed for a composite endpoint of severe toxicity or treatment deintensification (including dose reduction, cycle delay, or discontinuation).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 311 patients were included. Median age was 71.2 years and 58.8% were male. Grade ≥3 toxicity occurred in 23.2% of patients. In multivariate analysis, none of the characteristics studied were significantly associated with the occurrence of grade ≥3 toxicity. The composite endpoint occurred in 41.2% of patients and was associated with the use of full dose monotherapy in multivariate analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Despite <i>DPYD</i> genotype-based dosing, grade ≥3 toxicity and treatment deintensification frequently occur in older patients treated with fluoropyrimidine chemotherapy. No patient-related variables were found to be associated with grade ≥3 toxicity, but treatment with dose-reduced monotherapy resulted in fewer treatment deintensification or severe toxicity events.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12657,"journal":{"name":"Fundamental & Clinical Pharmacology","volume":"39 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/fcp.70000","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143438949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xiaolin Zhang, Huiliang Hu, Ziran Li, Peng Zhang, Lei Pan, Lei Wang, Jingqin Mao, Feng Li, Lijun Zhang
Background
Sivelestat sodium, an inhibitor of neutrophil elastase, was broadly used in the treatment of severe pneumonia. However, the pharmacokinetic (PK) characteristics of sivelestat in patients with severe pneumonia were still unknown.
Objectives
To understand the PK characteristics of sivelestat for optimizing the dose in Chinese patients with severe pneumonia.
Methods
In this study, we enrolled 15 participants who received sivelestat 300–500 mg every 24 h with an infusion duration of 5 to 14 days. Blood samples of 48 were collected and separated for plasma drug concentration detection by an ultra-high-performance liquid chromatography/tandem mass spectrometry. A population pharmacokinetic (PPK) analysis of sivelestat was performed using a monolix2024R1 software. A Monte Carlo simulation was conducted to assess various dosing schedules and varying covariate levels within the desired therapeutic drug-monitoring concentration range (Cmin,ss 8–12 mg/L).
Results
The patients had a mean age of 65 years (range, 35–87), with 2 females and 13 males. These data were best described by a one-compartment model with proportional residual error. The apparent distribution volume and apparent clearance (CL) of sivelestat were 20.88 L and 1.79 L/h, respectively. The clearance of sivelestat is influenced by the covariate total bilirubin (TBIL), prompting a recommendation for a reduced dose in patients with elevated TBIL levels.
Conclusion
In conclusion, our findings suggest that the CL/F in patients with severe pneumonia is similar to that in healthy individuals. TBIL can affect CL/F of sivelestat; therefore, TBIL-based dosing regimens provide a practical strategy for achieving sivelestat therapy.
{"title":"Population pharmacokinetics of sivelestat in Chinese patients with severe pneumonia","authors":"Xiaolin Zhang, Huiliang Hu, Ziran Li, Peng Zhang, Lei Pan, Lei Wang, Jingqin Mao, Feng Li, Lijun Zhang","doi":"10.1111/fcp.70001","DOIUrl":"https://doi.org/10.1111/fcp.70001","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Sivelestat sodium, an inhibitor of neutrophil elastase, was broadly used in the treatment of severe pneumonia. However, the pharmacokinetic (PK) characteristics of sivelestat in patients with severe pneumonia were still unknown.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To understand the PK characteristics of sivelestat for optimizing the dose in Chinese patients with severe pneumonia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this study, we enrolled 15 participants who received sivelestat 300–500 mg every 24 h with an infusion duration of 5 to 14 days. Blood samples of 48 were collected and separated for plasma drug concentration detection by an ultra-high-performance liquid chromatography/tandem mass spectrometry. A population pharmacokinetic (PPK) analysis of sivelestat was performed using a monolix2024R1 software. A Monte Carlo simulation was conducted to assess various dosing schedules and varying covariate levels within the desired therapeutic drug-monitoring concentration range (C<sub>min,ss</sub> 8–12 mg/L).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The patients had a mean age of 65 years (range, 35–87), with 2 females and 13 males. These data were best described by a one-compartment model with proportional residual error. The apparent distribution volume and apparent clearance (CL) of sivelestat were 20.88 L and 1.79 L/h, respectively. The clearance of sivelestat is influenced by the covariate total bilirubin (TBIL), prompting a recommendation for a reduced dose in patients with elevated TBIL levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In conclusion, our findings suggest that the CL/F in patients with severe pneumonia is similar to that in healthy individuals. TBIL can affect CL/F of sivelestat; therefore, TBIL-based dosing regimens provide a practical strategy for achieving sivelestat therapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12657,"journal":{"name":"Fundamental & Clinical Pharmacology","volume":"39 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143379903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alina Chykharivska, Leonid Kagan, Mary Wagner, Luigi Brunetti
Background
Levetiracetam (LEV) is an antiepileptic drug (AED) used to treat a variety of seizures in adult and pediatric populations. It is an ideal AED due to its favorable pharmacokinetic (PK) and pharmacodynamic profile and lack of interactions with other AEDs.
Methods
This retrospective cohort study was designed to identify covariates that affect LEV clearance and volume of distribution and to generate a population PK model. Adults with a seizure history receiving LEV during hospital admission with a minimum of one serum LEV concentration available were included in the study. Population PK modeling and covariate testing was performed with MONOLIX Suite 2020R1 (Lixoft, France).
Results
A total of 162 serum concentrations were collected from 143 patients. Age, sex, body weight descriptors, serum creatinine, creatinine clearance (CrCL), serum albumin, liver enzymes, and total bilirubin were evaluated. Body surface area (BSA) was a significant covariate for the apparent volume of distribution (V/F). The exclusion of BSA as a covariate of V/F increased the objective function value (OFV) 5.6. CrCL was a significant covariate of apparent plasma clearance (CL/F). The exclusion of CrCL increased the OFV by 18.16 and significantly increased the root square error (RSE) % of the between-subject variabilities of the parameters.
Conclusion
LEV clearance is an effective predictor of serum concentration. CrCL was a significant covariate influencing LEV clearance, and BSA was found to influence the volume of distribution. Further studies are needed to determine the effect of body weight descriptors on LEV clearance and, ultimately, outcomes.
{"title":"Real-world interpatient variability in the pharmacokinetics of levetiracetam","authors":"Alina Chykharivska, Leonid Kagan, Mary Wagner, Luigi Brunetti","doi":"10.1111/fcp.13059","DOIUrl":"https://doi.org/10.1111/fcp.13059","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Levetiracetam (LEV) is an antiepileptic drug (AED) used to treat a variety of seizures in adult and pediatric populations. It is an ideal AED due to its favorable pharmacokinetic (PK) and pharmacodynamic profile and lack of interactions with other AEDs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort study was designed to identify covariates that affect LEV clearance and volume of distribution and to generate a population PK model. Adults with a seizure history receiving LEV during hospital admission with a minimum of one serum LEV concentration available were included in the study. Population PK modeling and covariate testing was performed with MONOLIX Suite 2020R1 (Lixoft, France).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 162 serum concentrations were collected from 143 patients. Age, sex, body weight descriptors, serum creatinine, creatinine clearance (CrCL), serum albumin, liver enzymes, and total bilirubin were evaluated. Body surface area (BSA) was a significant covariate for the apparent volume of distribution (V/F). The exclusion of BSA as a covariate of V/F increased the objective function value (OFV) 5.6. CrCL was a significant covariate of apparent plasma clearance (CL/F). The exclusion of CrCL increased the OFV by 18.16 and significantly increased the root square error (RSE) % of the between-subject variabilities of the parameters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>LEV clearance is an effective predictor of serum concentration. CrCL was a significant covariate influencing LEV clearance, and BSA was found to influence the volume of distribution. Further studies are needed to determine the effect of body weight descriptors on LEV clearance and, ultimately, outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12657,"journal":{"name":"Fundamental & Clinical Pharmacology","volume":"39 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/fcp.13059","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143248512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Laïyna Lilo Aouichi, Elise Pape, Jean-Yves Jouzeau, Valérie Gibaja, Eyrian Aubin-Beale, Allan Kolodziej, Catherine Feliu, Elodie Marchand, Nicolas Gambier, Julien Scala-Bertola
Background and Objectives
Ketamine is a psychoactive substance used for its stimulant and hallucinogenic properties. As the use of ketamine may lead to impaired driving, we aimed to assess the occurrence of ketamine in the driving population tested positive for narcotics in roadside checks using oral fluid analysis. Oral fluid concentrations of ketamine and norketamine were examined to determine the percentage of drivers susceptible to ketamine impairment.
Methods
A retrospective descriptive study was conducted over a 32-month period in 2020–2023 on drivers who tested positive to the DrugWipe®5S saliva test in our region of northeastern France. Mass spectrometry was used to confirm the DrugWipe®5S result and to determine oral fluid concentrations of ketamine and norketamine.
Results
During the entire study period, 3364 drivers were tested positive at the roadside using the DrugWipe®5S rapid test. After mass spectrometry, 3043 drivers were finally confirmed as true positives. Ketamine was detected in 88 drivers who were 80.7% male, 95.4% polydrug users and were 27.5 ± 7.1 years old, representing 2.6% of the total driver population. Ketamine concentrations were 821 ± 2264 and 7.8 ± 12.3 ng/mL in the presence and absence of norketamine, respectively. Finally, 26.1% of the ketamine-positive drivers had a ketamine oral fluid concentration potentially associated with impaired driving.
Conclusion
Ketamine and norketamine should be added to the list of drugs to be tested in oral fluid for driving under the influence of drugs. Besides blood or urine, oral fluid could be an interesting alternative biological matrix for addiction medicine.
{"title":"Detection of ketamine in the oral fluid of drivers in northeastern France during the years 2020–2023","authors":"Laïyna Lilo Aouichi, Elise Pape, Jean-Yves Jouzeau, Valérie Gibaja, Eyrian Aubin-Beale, Allan Kolodziej, Catherine Feliu, Elodie Marchand, Nicolas Gambier, Julien Scala-Bertola","doi":"10.1111/fcp.13060","DOIUrl":"https://doi.org/10.1111/fcp.13060","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objectives</h3>\u0000 \u0000 <p>Ketamine is a psychoactive substance used for its stimulant and hallucinogenic properties. As the use of ketamine may lead to impaired driving, we aimed to assess the occurrence of ketamine in the driving population tested positive for narcotics in roadside checks using oral fluid analysis. Oral fluid concentrations of ketamine and norketamine were examined to determine the percentage of drivers susceptible to ketamine impairment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective descriptive study was conducted over a 32-month period in 2020–2023 on drivers who tested positive to the DrugWipe®5S saliva test in our region of northeastern France. Mass spectrometry was used to confirm the DrugWipe®5S result and to determine oral fluid concentrations of ketamine and norketamine.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During the entire study period, 3364 drivers were tested positive at the roadside using the DrugWipe®5S rapid test. After mass spectrometry, 3043 drivers were finally confirmed as true positives. Ketamine was detected in 88 drivers who were 80.7% male, 95.4% polydrug users and were 27.5 ± 7.1 years old, representing 2.6% of the total driver population. Ketamine concentrations were 821 ± 2264 and 7.8 ± 12.3 ng/mL in the presence and absence of norketamine, respectively. Finally, 26.1% of the ketamine-positive drivers had a ketamine oral fluid concentration potentially associated with impaired driving.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Ketamine and norketamine should be added to the list of drugs to be tested in oral fluid for driving under the influence of drugs. Besides blood or urine, oral fluid could be an interesting alternative biological matrix for addiction medicine.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12657,"journal":{"name":"Fundamental & Clinical Pharmacology","volume":"39 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143248514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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