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Residual Effects of Acute and Subchronic Zolpidem Treatments on Attentional Processes in Aged Female Rats 急性和亚慢性唑吡坦治疗对老年雌性大鼠注意过程的残留影响
IF 2.5 4区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2025-12-11 DOI: 10.1111/fcp.70067
Marianne Leger, Michel Boulouard, Christophe Liet, Ben Grayson, Michael Harte, Joanna C. Neill, Marie-Laure Bocca, Véronique Lelong-Boulouard

Rational

Zolpidem, a hypnotic Z-drug commonly prescribed to promote sleep, is predominantly used over the age of 50. In this elderly population, adverse behavioral disturbances, impaired driving performance, and an increased risk of falls have been frequently reported. These concerns have raised questions about the residual adverse effects of zolpidem in older adults, particularly on cognitive processes such as executive and attentional functions.

Objectives

This study aimed to investigate the residual effects of zolpidem on attentional performance following either acute or subchronic administration in aged rats.

Methods

A zolpidem dose of 3 mg/kg and a 3-h postadministration time point were selected based on pharmacokinetic data from the literature and a dose–response analysis of its locomotor effects in the open-field test. Attentional performance was then assessed in aged female rats treated with either saline or zolpidem (acutely or for 7 days), using the 5-choice continuous performance task (5C-CPT).

Results

Acute zolpidem administration significantly reduced the percentage of correct responses, increased correct response latency, and showed a trend toward more omissions, indicative of impaired attentional performance and psychomotor slowing. These effects were not further observed after subchronic treatment, suggesting a potential tolerance over time.

Conclusion

Our findings highlight a critical period of vulnerability following the initiation of zolpidem treatment, during which residual cognitive impairments may emerge. Such effects may compromise complex tasks requiring sustained attention and processing speed, such as driving, especially in older adults.

唑吡坦是一种催眠药物,通常用于促进睡眠,主要用于50岁以上的人群。在老年人群中,不良行为障碍、驾驶能力受损和跌倒风险增加已被频繁报道。这些担忧引发了关于唑吡坦对老年人残留不良影响的问题,特别是对执行和注意力功能等认知过程的影响。目的探讨唑吡坦急性或亚慢性给药后对老年大鼠注意力表现的影响。方法根据文献的药代动力学数据,选择唑吡坦剂量为3 mg/kg,给药后3 h时间点,并对其在空地试验中的运动效应进行剂量-反应分析。然后用生理盐水或唑吡坦治疗老年雌性大鼠(急性或7天),使用5选择连续表现任务(5C-CPT)评估注意力表现。结果急性给予唑吡坦显著降低了正确反应的百分比,增加了正确反应的潜伏期,并呈现出更多的遗漏趋势,表明注意力表现受损和精神运动减慢。这些影响在亚慢性治疗后没有进一步观察到,这表明随着时间的推移存在潜在的耐受性。结论:我们的研究结果强调了在开始唑吡坦治疗后的关键脆弱期,在此期间可能出现残余的认知障碍。这种影响可能会影响需要持续注意力和处理速度的复杂任务,比如驾驶,尤其是老年人。
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引用次数: 0
Linking the NETSARC+ National Sarcoma Database With the SNDS to Evaluate Adjuvant and/or Neoadjuvant Therapy: Report on the Linkage Process and Result (Health Data Hub's DEEPSARC Pilot Project) 将NETSARC+国家肉瘤数据库与SNDS连接以评估辅助和/或新辅助治疗:连接过程和结果报告(健康数据中心的DEEPSARC试点项目)
IF 2.5 4区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2025-12-11 DOI: 10.1111/fcp.70066
Erwan Drezen, André Happe, Vincent Thevenet, Nicolas Penel, François Gouin, François Le Loarer, Gonzague Du Bouexic De Pinieux, Hugo Crochet, Claire Chemin Airiau, Françoise Ducimetiere, Simone Mathoulin Pelissier, Jean-Yves Blay, Emmanuel Oger

Background

DEEPSARC, one of the first projects running on the Health Data Hub, aimed to identify real-life treatment regimens that could improve overall survival. The project is based on matching the national database of the sarcoma reference network with the SNDS.

Objectives

We aimed to report a transparent description of the linking process and its results.

Methods

The sarcoma database encompasses 33 548 patients matching the selection criteria divided into three subsets: 13507 patients with a complete dataset gathering clinical and pathological data; 5844 patients with clinical data alone; and 14 197 patients with pathological data alone. As no ICD-10 code reliably identifies patients with sarcoma, the subpopulation extracted from the SNDS was extended to 3 million patients who underwent surgery for their cancer. An indirect record linkage process used a combination (called a signature) of so-called chaining variables to uniquely identify a pair of patients from each of the bases. Two metrics (signature robustness and overall quality) were calculated for ease of interpretation.

Results

The overall matching rate of 73.1% (24 539 pairs out of 33 548 observations), reaching 90.5% in the intersection of the sarcomas databases (with extended data, 12 225 pairs out of 13 507 observations).

Conclusion

An optimized and transparent process led to a moderate matching rate but enhanced the confidence in true matching. Representativeness is an issue related to the missing data pattern across the three NETSARC databases. For instance, an individual present only in the RREPS database has a greater probability of not being linked.

DEEPSARC是在健康数据中心上运行的首批项目之一,旨在确定可以提高总体生存率的现实生活治疗方案。该项目基于将肉瘤参考网络的国家数据库与SNDS进行匹配。我们的目的是报告一个透明的描述连接过程及其结果。方法肉瘤数据库包含符合选择标准的33 548例患者,分为三个子集:13507例患者,具有完整的数据集,收集临床和病理数据;有单独临床资料的5844例;单纯病理资料14 197例。由于没有ICD-10代码可靠地识别肉瘤患者,因此从SNDS中提取的亚群扩展到300万因癌症接受手术的患者。间接记录链接过程使用所谓的连锁变量的组合(称为签名)来唯一地识别来自每个碱基的一对患者。为了便于解释,计算了两个指标(签名稳健性和总体质量)。结果总体匹配率为73.1%(33 548条观察结果中有24 539对),在肉瘤数据库的交叉点(扩展数据中有13 507条观察结果中有12 225对)达到90.5%。结论优化、透明的流程使匹配率适中,但增强了对真实匹配的信心。代表性是一个与三个NETSARC数据库中缺失的数据模式相关的问题。例如,只存在于RREPS数据库中的个人没有被链接的可能性更大。
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引用次数: 0
Differential Antipyretic Effects of Toll-Like Receptor 4 Signal Inhibitors in Male Rats toll样受体4信号抑制剂对雄性大鼠的不同解热作用。
IF 2.5 4区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2025-12-10 DOI: 10.1111/fcp.70059
Tuğçe Nomenoğlu, İbrahim Mert Yüksel, Soner Mamuk, Eyüp Sabri Akarsu

Background

Pattern recognition receptors (PRR) are responsible for detecting pathogens and danger signals in organisms. Toll-like receptor 4 (TLR4) recognizes lipopolysaccharide (LPS) and some danger-associated molecular patterns (DAMPs). Activation of this receptor initiates sickness behavior. Fever is a hallmark of this process.

Objectives

We hypothesized that TLR4 signal inhibitors may have antipyretic activity. We evaluated the effect of TLR4 signal inhibitors on LPS or carrageenan-induced fever in male Wistar rats.

Methods

Core body temperature was measured via telemetric implants. Fever was induced by injection of LPS (E. coli O111:B4, 250 μg/kg, sc) or carrageenan (50 mg/kg, sc). For TLR4 signal inhibition, LPS from Rhodobacter sphaeroides (LPS-RS), IAXO-102, or naltrexone was used. Intracardiac blood samples were collected for measurement of interleukin-6 (IL-6), an endogenous pyrogen cytokine in plasma, by ELISA during the initial phase of LPS-induced fever.

Results

LPS-RS pretreatment (25 or 100 μg/kg, sc) did not inhibit LPS-induced fever and plasma IL-6 elevation. Other alternative TLR4 signal inhibitors, such as IAXO-102 (3 mg/kg, sc) or naltrexone (10 mg/kg, sc), also failed to abolish LPS-induced fever. An intriguing finding is that LPS-RS or naltrexone inhibited the fever caused by carrageenan.

Conclusion

Data show that TLR4 signal inhibitors have differential antipyretic activity on fever suggesting that some alternative or complementary mechanisms might be operational for LPS-induced fever. Data also suggest that TLR4 signal inhibitors may be an alternative as a possible treatment option for DAMP-mediated clinical pathologies.

背景:模式识别受体(PRR)负责检测生物体中的病原体和危险信号。toll样受体4 (TLR4)识别脂多糖(LPS)和一些危险相关的分子模式(DAMPs)。这种受体的激活会引发疾病行为。发烧是这一过程的标志。目的:我们假设TLR4信号抑制剂可能具有解热活性。我们评估了TLR4信号抑制剂对LPS或卡拉胶诱导的雄性Wistar大鼠发热的影响。方法:通过遥测植入体测量核心体温。注射LPS(大肠杆菌O111:B4, 250 μg/kg, sc)或角叉菜胶(50 mg/kg, sc)诱导发热。TLR4信号抑制采用球形Rhodobacter sphaeroides LPS (LPS- rs)、IAXO-102或纳曲酮。采用ELISA法测定lps诱导发热初期心内血中内源性热原细胞因子白介素-6 (IL-6)的含量。结果:LPS-RS预处理(25或100 μg/kg, sc)对lps诱导的发热及血浆IL-6升高均无抑制作用。其他TLR4信号抑制剂,如IAXO-102 (3mg /kg, sc)或纳曲酮(10mg /kg, sc),也未能消除lps诱导的发热。一个有趣的发现是LPS-RS或纳曲酮可以抑制由卡拉胶引起的发热。结论:数据显示,TLR4信号抑制剂对发热有不同的解热作用,提示lps诱导的发热可能存在一些替代或补充机制。数据还表明,TLR4信号抑制剂可能是damp介导的临床病理的一种可能的治疗选择。
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引用次数: 0
Comparative Analysis of Intrathecal Lidocaine Combined With Guanfacine or Dexmedetomidine on Nociceptive and Motor Blockade in Rats 鞘内利多卡因联合冠法辛、右美托咪定对大鼠伤害和运动阻断作用的比较分析。
IF 2.5 4区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2025-11-20 DOI: 10.1111/fcp.70057
An-Kuo Chou, Chong-Chi Chiu, Yu-Wen Chen, Ching-Hsia Hung, Jhi-Joung Wang

The aim of this study was to examine the effects of intrathecal lidocaine combined with guanfacine or dexmedetomidine on nociceptive and motor blockade, in comparison to clonidine. Using a rat model of intrathecal injection, we evaluated the effects of lidocaine combined with guanfacine, dexmedetomidine, or clonidine on nociceptive and motor blockade. The dose-dependent effects of guanfacine on spinal nociceptive and motor blockade were compared to those of lidocaine, a well-known local anesthetic. Guanfacine (0.46 μmol/kg, 3 mM), dexmedetomidine (0.02 μmol/kg, 0.1 mM), or clonidine (1.52 μmol/kg, 10 mM) alone produced no spinal nociceptive or motor blockade. Co-administration of guanfacine (0.46 μmol/kg) or dexmedetomidine (0.02 μmol/kg) with lidocaine (3.14 or 8.38 μmol/kg) prolonged the duration of spinal blockade, an effect attenuated by yohimbine (0.76 μmol/kg), which alone produced no spinal nociceptive or motor blockade. In contrast, the addition of clonidine (1.52 μmol/kg) did not enhance the duration of lidocaine-induced spinal blockade. Guanfacine produced a dose-dependent spinal blockade of both nociceptive and motor functions. The potency ranking (ED50, 50% effective dose) of spinal blockade showed that guanfacine and lidocaine were equal. Guanfacine resulted in a markedly longer spinal block duration than lidocaine at equivalent anesthetic doses (ED25, ED50, and ED75). In summary, co-administration of subeffective doses of guanfacine or dexmedetomidine with lidocaine prolonged the duration of spinal blockade, likely involving α2-adrenergic receptors, whereas subeffective doses of clonidine did not. Guanfacine produced dose-dependent spinal blockade and was equipotent to lidocaine. At equianesthetic doses, guanfacine produced a longer duration of blockade than lidocaine.

本研究的目的是检查鞘内利多卡因联合胍法辛或右美托咪定对伤害性和运动阻断的影响,并与可乐定进行比较。采用鞘内注射大鼠模型,我们评估了利多卡因联合胍法辛、右美托咪定或可乐定对伤害性和运动阻断的影响。我们比较了胍法辛与利多卡因(一种著名的局部麻醉剂)在脊髓伤害感受和运动阻断方面的剂量依赖性作用。胍法辛(0.46 μmol/kg, 3 mM)、右美托咪定(0.02 μmol/kg, 0.1 mM)或可乐定(1.52 μmol/kg, 10 mM)单独使用不会产生脊髓伤害性阻滞或运动阻滞。胍法辛(0.46 μmol/kg)或右美托咪定(0.02 μmol/kg)与利多卡因(3.14 μmol/kg或8.38 μmol/kg)联合用药可延长脊髓阻滞时间,育亨宾(0.76 μmol/kg)的作用减弱,单独用药不产生脊髓伤害性阻滞或运动阻滞。相反,可乐定(1.52 μmol/kg)的加入并没有延长利多卡因诱导的脊髓阻滞的持续时间。胍法辛对伤害和运动功能产生剂量依赖性的脊髓阻断。脊髓阻断剂的效价排序(ED50, 50%有效剂量)显示胍法辛与利多卡因相等。在同等麻醉剂量下(ED25、ED50和ED75),胍法辛导致的脊髓阻滞持续时间明显比利多卡因长。总之,亚有效剂量的胍法辛或右美托咪定与利多卡因合用可延长脊髓阻滞的持续时间,可能涉及α2-肾上腺素能受体,而亚有效剂量的可口定则没有。胍法辛产生剂量依赖性脊髓阻断,与利多卡因具有同等效力。在等麻醉剂量下,胍法辛比利多卡因产生更长的阻滞时间。
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引用次数: 0
Treprostinil Iontophoresis in Diabetic Foot Ulcers: A Single Ascending Dose Safety Study treprostiil离子导入治疗糖尿病足溃疡:单次递增剂量安全性研究。
IF 2.5 4区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2025-11-18 DOI: 10.1111/fcp.70054
Alicia Guigui, Enkeledja Hodaj, Marie Muller, Françoise Stanke-Labesque, Sophie Blaise, Jean-Luc Cracowski, Matthieu Roustit

Background

Diabetic foot ulcers (DFUs) represent a serious public health problem associated with significant morbidity and health costs. Despite optimal etiologic treatment and local care, amputation is frequent, stressing the need for new treatments. The benefit of systemic administration of vasodilators, such as prostacyclin analogues, has proven efficacy in other types of skin ulcers, but it is counterbalanced by potentially serious vasodilation-induced, concentration-dependent, adverse effects. Experimental data has shown the feasibility of local administration of treprostinil on the wound using iontophoresis.

Objective

We aimed to assess the safety of the local iontophoretic administration of treprostinil in patients with DFU through a single ascending dose safety study.

Methods

We conducted a prospective single ascending dose phase I study. Patients received a single dose of treprostinil applied via iontophoresis at a current density of 0.2 mA/cm2 for 30 min. Local and systemic adverse effects were monitored, and plasma treprostinil concentrations were measured over an 8-h follow-up period.

Results

Four patients were included, and received single doses of 0.025, 0.05, 0.1, and 0.25 mg/L at 0.2 mA/cm2 during 30 min, and were followed-up for 8 h. All patients did not present any significant adverse effect. Plasma concentration was below < 1.8 ng/mL 8 h after the administration.

Conclusions

Our results suggest that iontophoresis of treprostinil is a safe procedure at 0.25 mg/mL, without systemic adverse effect, suggesting its potential as a targeted treatment for DFUs.

背景:糖尿病足溃疡(DFUs)是一个严重的公共卫生问题,与显著的发病率和卫生费用相关。尽管有最佳的病因治疗和局部护理,截肢是频繁的,强调需要新的治疗方法。全身使用血管扩张剂(如前列环素类似物)的益处已被证明对其他类型的皮肤溃疡有效,但它被潜在的严重血管扩张性、浓度依赖性不良反应所抵消。实验数据表明,用离子导入法在创面局部给药曲前列地尼是可行的。目的:我们旨在通过单次递增剂量安全性研究,评估局部离子穿刺给药treprostiil对DFU患者的安全性。方法:我们进行了一项前瞻性单次递增剂量I期研究。患者接受单剂量treprostiil离子导入,电流密度为0.2 mA/cm2,持续30分钟。监测局部和全身不良反应,并在8小时的随访期间测量血浆曲前列素浓度。结果:纳入4例患者,分别给予0.025、0.05、0.1、0.25 mg/L单剂量0.2 mA/cm2,疗程30 min,随访8 h。所有患者均未出现明显的不良反应。结论:我们的研究结果表明,0.25 mg/mL的treprostiil离子导入是一种安全的过程,没有全身不良反应,表明其有潜力作为DFUs的靶向治疗。
{"title":"Treprostinil Iontophoresis in Diabetic Foot Ulcers: A Single Ascending Dose Safety Study","authors":"Alicia Guigui,&nbsp;Enkeledja Hodaj,&nbsp;Marie Muller,&nbsp;Françoise Stanke-Labesque,&nbsp;Sophie Blaise,&nbsp;Jean-Luc Cracowski,&nbsp;Matthieu Roustit","doi":"10.1111/fcp.70054","DOIUrl":"10.1111/fcp.70054","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Diabetic foot ulcers (DFUs) represent a serious public health problem associated with significant morbidity and health costs. Despite optimal etiologic treatment and local care, amputation is frequent, stressing the need for new treatments. The benefit of systemic administration of vasodilators, such as prostacyclin analogues, has proven efficacy in other types of skin ulcers, but it is counterbalanced by potentially serious vasodilation-induced, concentration-dependent, adverse effects. Experimental data has shown the feasibility of local administration of treprostinil on the wound using iontophoresis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We aimed to assess the safety of the local iontophoretic administration of treprostinil in patients with DFU through a single ascending dose safety study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a prospective single ascending dose phase I study. Patients received a single dose of treprostinil applied via iontophoresis at a current density of 0.2 mA/cm<sup>2</sup> for 30 min. Local and systemic adverse effects were monitored, and plasma treprostinil concentrations were measured over an 8-h follow-up period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four patients were included, and received single doses of 0.025, 0.05, 0.1, and 0.25 mg/L at 0.2 mA/cm<sup>2</sup> during 30 min, and were followed-up for 8 h. All patients did not present any significant adverse effect. Plasma concentration was below &lt; 1.8 ng/mL 8 h after the administration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our results suggest that iontophoresis of treprostinil is a safe procedure at 0.25 mg/mL, without systemic adverse effect, suggesting its potential as a targeted treatment for DFUs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12657,"journal":{"name":"Fundamental & Clinical Pharmacology","volume":"39 6","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12627982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145549057","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}
引用次数: 0
Extracellular Remodeling, Tissue Fibrosis, and Clinical Translation 细胞外重塑、组织纤维化和临床转化。
IF 2.5 4区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2025-11-14 DOI: 10.1111/fcp.70055
Yves Fromes
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引用次数: 0
Investigation of the Immune System Effects of Desloratadine on Lipopolysaccharide-Stimulated Mammalian Macrophage Cells 地氯雷他定对脂多糖刺激的哺乳动物巨噬细胞免疫系统影响的研究。
IF 2.5 4区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2025-11-10 DOI: 10.1111/fcp.70056
Batuhan Yurtseven, Ömer Mete Başkan, Esra Aydemir, Furkan Ayaz

Background

Neuroimmune interactions are central to inflammatory and neurological disorders. Desloratadine (DES), a second-generation H1 antihistamine, has been suggested to exert immunomodulatory effects, yet its impact on innate immune cells remains unclear.

Methods

J774.2 macrophages were treated with DES (1–10 μg/mL) ± lipopolysaccharide (LPS, 1 μg/mL). Cytokine secretion (IL-6, TNF-α, IL-12p40, GM-CSF) was measured by ELISA, and cell viability was assessed using Trypan Blue exclusion.

Results

DES induced a dose-dependent suppression of TNF-α, with significant inhibition at higher concentrations, and reduced IL-12p40 at 10 μg/mL. IL-6 showed a modest, nonsignificant decrease, whereas GM-CSF was increased, indicating a pro-inflammatory effect on macrophage activation. No cytotoxicity was detected at any dose.

Conclusions

DES selectively modulates macrophage responses, strongly inhibiting TNF-α and IL-12p40 while enhancing GM-CSF, reflecting a dual anti- and pro-inflammatory profile. These findings support further investigation of DES in neuroinflammatory and immune-mediated conditions.

背景:神经免疫相互作用是炎症和神经系统疾病的核心。地氯雷他定(DES)是第二代H1抗组胺药,已被认为具有免疫调节作用,但其对先天免疫细胞的影响尚不清楚。方法:用DES (1 ~ 10 μg/mL)±脂多糖(LPS, 1 μg/mL)处理巨噬细胞J774.2。ELISA法检测细胞因子(IL-6、TNF-α、IL-12p40、GM-CSF)分泌,台盼蓝法测定细胞活力。结果:DES对TNF-α具有剂量依赖性抑制作用,浓度越高,IL-12p40浓度越低,IL-12p40浓度越低。IL-6表现出适度的、不显著的降低,而GM-CSF则升高,表明其对巨噬细胞活化具有促炎作用。在任何剂量下均未检测到细胞毒性。结论:DES选择性调节巨噬细胞反应,强烈抑制TNF-α和IL-12p40,同时增强GM-CSF,反映了抗炎和促炎的双重特征。这些发现支持进一步研究DES在神经炎症和免疫介导疾病中的作用。
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引用次数: 0
Impact of Direct Oral Anticoagulant Uptake on Hospitalizations for Stroke/Transient Ischemic Attack, Intracranial Hemorrhage, and Gastrointestinal Bleeding in Individuals With Atrial Fibrillation: A Population-Based Study 直接口服抗凝剂对房颤患者中风/短暂性脑缺血发作、颅内出血和胃肠道出血住院的影响:一项基于人群的研究
IF 2.5 4区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2025-10-07 DOI: 10.1111/fcp.70051
Tony Antoniou, Daniel McCormack, Tianru Wang, Mina Tadrous, Tara Gomes

Background

Direct-acting oral anticoagulants (DOACs) have largely replaced warfarin for stroke prevention in patients with atrial fibrillation, yet their population-level impact on health outcomes and costs remains unclear. We examined whether the widespread uptake of DOACs was associated with changes in hospitalization rates and costs for stroke/transient ischemic attack (TIA), intracranial hemorrhage (ICH), and gastrointestinal bleeding among individuals with atrial fibrillation receiving publicly funded anticoagulation.

Methods

We conducted a population-based ecological time series study using administrative health data from Ontario, Canada, between 2003 and 2021. We used segmented negative binomial regression and generalized additive models to estimate immediate and post-DOAC uptake trends in hospitalization rates and costs following increased use of DOACs in 2012.

Results

We identified 12,134 hospitalizations for ICH, 59 946 for gastrointestinal bleeding, and 40 724 for stroke/TIA among anticoagulated individuals with atrial fibrillation. Following DOAC uptake, ICH rates (rate ratio [RR]: 0.88; 95% CI: 0.86–0.90) and costs (RR: 0.74; 95% CI: 0.62–0.88) declined immediately, with continued quarterly declines. Gastrointestinal bleeding rates increased initially (RR: 1.17; 95% CI: 1.14–1.20) and declined over time (RR per quarter: 0.99; 95% CI: 0.99–0.99). Gastrointestinal bleeding-related costs did not change significantly. Stroke/TIA rates remained stable, but hospitalization costs declined ($366 per 1000 individuals per quarter; 95% CI: −$562 to −$170).

Conclusion

DOAC uptake was associated with reduced ICH rates and costs and an initial increase but subsequent decline in gastrointestinal bleeding rates. Despite stable stroke rates, reduced costs suggest potential long-term economic benefits. Our findings support the real-world effectiveness and safety of DOACs.

背景:直接作用口服抗凝剂(DOACs)已在很大程度上取代华法林用于房颤患者的卒中预防,但其在人群水平上对健康结局和成本的影响尚不清楚。我们研究了在接受公共资助抗凝治疗的房颤患者中,DOACs的广泛应用是否与卒中/短暂性脑缺血发作(TIA)、颅内出血(ICH)和胃肠道出血的住院率和费用的变化有关。方法:我们利用加拿大安大略省2003年至2021年间的行政卫生数据进行了一项基于人口的生态时间序列研究。我们使用分段负二项回归和广义相加模型来估计2012年doac使用增加后住院率和费用的即时和后吸收趋势。结果:在抗凝房颤患者中,我们确定了12,134例脑出血住院,59946例胃肠道出血住院,40724例卒中/TIA住院。采用DOAC后,ICH率(比率比[RR]: 0.88; 95% CI: 0.86-0.90)和成本(RR: 0.74; 95% CI: 0.62-0.88)立即下降,并持续季度下降。胃肠道出血率最初增加(RR: 1.17; 95% CI: 1.14-1.20),并随着时间的推移下降(每季度RR: 0.99; 95% CI: 0.99-0.99)。胃肠道出血相关费用没有显著变化。卒中/TIA发生率保持稳定,但住院费用下降(每季度每1000人366美元;95% CI: - 562美元至- 170美元)。结论:DOAC摄取与脑出血率和成本降低以及胃肠道出血率的初始增加和随后下降有关。尽管中风率稳定,但降低的成本表明潜在的长期经济效益。我们的研究结果支持doac在现实世界中的有效性和安全性。
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引用次数: 0
Sex and Age Differences in Suspected Bleeding Reporting With Acetyl Salicylic Acid: A Descriptive Study in the Global Pharmacovigilance Database, Vigibase 乙酰水杨酸可疑出血报告的性别和年龄差异:全球药物警戒数据库(Vigibase)的描述性研究。
IF 2.5 4区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2025-10-07 DOI: 10.1111/fcp.70053
Jean-Louis Montastruc, Alessandra Bura-Rivière

Objective

The present study was performed to investigate putative sex differences in the reporting of acetyl salicylic acid (ASA)–related bleeding in the global pharmacovigilance database.

Methods

Using Vigibase, the global pharmacovigilance database, all bleeding reports with ASA between January 1, 2008, and December 31, 2021, in adults were included. The main bleeding locations with ASA were compared in men versus women. A secondary objective was to analyze possible age differences. Results are presented as reporting odds ratios (RORs) with their 95% confidence interval.

Results

Among 29 034 bleeding with ASA, the most frequent were gastrointestinal (41.2%), neurological (21.3%), and nasal (13.6%). Higher ROR values were found in men for all bleeding in general (ROR = 1.56 [1.51–1.61]) but also for gastrointestinal, neurological, nasal, and renal locations. Similar trends were found for “serious” reports (except for gastrointestinal bleeding). Neurological fatal reports were more frequently reported in men. These sex differences were also found in all the age categories. Higher ROR values were found in patients from 65 years.

Conclusion

The risk of total, “serious,” and fatal bleeding reporting with ASA was higher in men than in women and after 65 years. Similar conclusions can be made for the most frequent locations of ASA-associated bleeding: gastrointestinal followed by neurological and nasal ones.

目的:本研究旨在调查全球药物警戒数据库中乙酰水杨酸(ASA)相关出血报告的性别差异。方法:使用全球药物警戒数据库Vigibase,纳入2008年1月1日至2021年12月31日期间所有成人ASA出血报告。将ASA的主要出血部位在男性和女性中进行比较。第二个目的是分析可能存在的年龄差异。结果以95%置信区间的报告优势比(RORs)表示。结果:29 034例ASA出血中,以胃肠道出血(41.2%)、神经系统出血(21.3%)和鼻腔出血(13.6%)最为常见。男性一般出血的ROR值较高(ROR = 1.56[1.51-1.61]),但胃肠道、神经系统、鼻腔和肾脏部位的ROR值也较高。在“严重”报告中也发现了类似的趋势(除了胃肠道出血)。神经系统死亡报告在男性中更为常见。这些性别差异也存在于所有年龄段。65岁以上的患者ROR值较高。结论:65岁后ASA报告的全部、“严重”和致命出血的风险在男性中高于女性。asa相关出血最常见的部位也可以得出类似的结论:胃肠道,其次是神经系统和鼻腔。
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引用次数: 0
Topical Probiotic Therapy Reduces Chemotherapy-Induced Oral Mucositis: Preclinical Evaluation in a Rat Model 局部益生菌治疗减少化疗引起的口腔黏膜炎:大鼠模型的临床前评估。
IF 2.5 4区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2025-10-06 DOI: 10.1111/fcp.70050
Buse Kose Demirezen, Eren Demirpolat, Arzu Yay, Ozge Cengiz Mat, Mustafa Ermis

Background

Oral mucositis (OM) is a debilitating complication of chemotherapy and radiotherapy, characterized by painful ulcerations and inflammation of the oral mucosa. Current treatments provide limited efficacy and often lack regenerative properties. This study aimed to evaluate the therapeutic potential of topically administered probiotics in a rat model of OM.

Methods

OM was induced in Sprague–Dawley rats using 5-fluorouracil (5-FU) and acetic acid. Rats were randomized into groups receiving topical formulations of Lactobacillus acidophilus, Lactobacillus reuteri, Bacillus clausii, Bacillus coagulans, Lactobacillus plantarum, sucralfate, triamcinolone, and control. Treatments were applied for 5 consecutive days. OM severity was assessed using macroscopic and histopathological scoring, fibrosis grading, and inflammatory markers (TNF-α, IL-10, PGE2).

Results

L. acidophilus and L. reuteri significantly reduced macroscopic and histopathological OM scores compared to controls. L. acidophilus also demonstrated a notable reduction in fibrosis and PGE2 levels (p < 0.05), suggesting anti-inflammatory and antifibrotic activity. B. clausii and B. coagulans showed moderate efficacy, while sucralfate and triamcinolone reduced mucosal inflammation but were less effective in tissue regeneration. No significant changes in IL-10 were observed across groups.

Conclusion

Topically applied probiotics, particularly L. acidophilus, exhibit significant therapeutic potential in attenuating chemotherapy-induced OM by modulating inflammation and promoting mucosal healing. These findings support further exploration of localized probiotic therapies as a novel, non-systemic approach to manage OM in clinical settings.

背景:口腔黏膜炎(OM)是化疗和放疗的一种使人衰弱的并发症,其特征是口腔黏膜疼痛性溃疡和炎症。目前的治疗方法疗效有限,而且往往缺乏再生特性。本研究旨在评估局部给予益生菌对OM大鼠模型的治疗潜力。方法:用5-氟尿嘧啶(5-FU)和乙酸诱导sd大鼠OM。将大鼠随机分为两组,分别给予嗜酸乳杆菌、罗伊氏乳杆菌、克劳氏芽孢杆菌、凝固芽孢杆菌、植物乳杆菌、硫糖钠、曲安奈德和对照组。连续处理5 d。通过宏观和组织病理学评分、纤维化分级和炎症标志物(TNF-α、IL-10、PGE2)评估OM的严重程度。结果:与对照组相比,嗜酸乳杆菌和罗伊氏乳杆菌显著降低了宏观和组织病理学OM评分。结论:局部应用益生菌,特别是嗜酸乳杆菌,通过调节炎症和促进粘膜愈合,在减轻化疗诱导的OM方面表现出显著的治疗潜力。这些发现支持进一步探索局部益生菌疗法作为一种新的、非系统性的方法来管理临床环境中的OM。
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引用次数: 0
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Fundamental & Clinical Pharmacology
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