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F Tillman, J Kim
WHAT IS KNOWN AND OBJECTIVE: A variety of medication classes are available for diabetes; however, treatment options become limited due to adverse effect profiles and cost. Current diabetes guidelines include agents not originally developed for diabetes treatment, bromocriptine and colesevelam. COMMENT: Other non-diabetes medications demonstrating haemoglobin A1c lowering, including agents for weight loss, depression, anaemia and coronary artery disease, are described in this review article...
April 19, 2018: Journal of Clinical Pharmacy and Therapeutics
Amy Jackson, Amyn Lalji, Mohammed Kabir, Ann Muls, Caroline Gee, Susan Vyoral, Clare Shaw, H Jervoise N Andreyev
Dietary fat ingestion triggers bile secretion into the gastrointestinal tract. Bile acid malabsorption affects >1% of the population, causing loose stool and other gastrointestinal symptoms. The diagnosis is frequently missed. Treatments are often considered ineffective. We evaluated low-fat diets for managing gastrointestinal symptoms in these patients. All patients reporting type 6 or 7 stool were offered a selenium-75 homocholic acid taurine (SeHCAT) scan. Prospective data in patients with 7-day scan retention <20% were analysed...
October 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
Morten Hansen, David P Sonne, Kristian H Mikkelsen, Lise Lotte Gluud, Tina Vilsbøll, Filip K Knop
AIM: To evaluate the effects of bile acid sequestrants (BASs) versus placebo, no intervention or active comparators on glycemic control in type 2 diabetes. METHODS: Data were retrieved and a systematic review with meta-analyses was performed. We evaluated bias control and subgroup and sensitivity analyses were performed to evaluate heterogeneity and bias. RESULTS: We included 17 trials with a total of 2950 patients randomized to BASs (colesevelam or colestimide) versus placebo, no intervention, statins or sitagliptin...
May 2017: Journal of Diabetes and its Complications
Marko Skelin, Tomo Lucijanić, Daniela Amidžić Klarić, Arnes Rešić, Miro Bakula, Ana-Marija Liberati-Čizmek, Hossein Gharib, Dario Rahelić
PURPOSE: Levothyroxine (LT4) is a drug with a narrow therapeutic index, applied in small amounts (micrograms), which makes interactions in the absorption phase clinically significant. The main aim of this article was to review and present the latest information on factors that affect the gastrointestinal absorption of this drug. METHODS: Relevant data were collected by using the MEDLINE, PubMed, EMBASE, Web of Science, Science Direct, and Scopus databases with the key words levothyroxine and absorption...
February 2017: Clinical Therapeutics
Catherine Lunven, Zuyu Guo, Sandrine Turpault, Astrid Delfolie, Nicolas Fauchoux, Timothy Turner, Francesca Baldinetti
No abstract text is available yet for this article.
June 2017: Journal of Clinical Pharmacology
L M Mena Bares, E Carmona Asenjo, M V García Sánchez, E Moreno Ortega, F R Maza Muret, M V Guiote Moreno, A M Santos Bueno, E Iglesias Flores, J M Benítez Cantero, J A Vallejo Casas
Chronic diarrhoea is a common entity in daily clinical practice and it leads to a loss in these patients quality of life. It may be the main symptom of multiple ethiologies including bile acid malabsorption (BAM) which has a comparable prevalence to celiac disease. The BAM results from imbalances in the homeostasis of bile acids in the enterohepatic circulation. It can be a consequence of ileal disease or ileal dysfunction (BAM type i), it can be considered idiopathic or primary (BAM type ii) or associated with other gastrointestinal entities (BAM type iii)...
January 2017: Revista Española de Medicina Nuclear e Imagen Molecular
T Blahová, L Peterková, M Leníček, M Vlachová, K Zemánková, V Adámková, L Vítek, J Kovář
The treatment of hypercholesterolemia with bile acid (BA) sequestrants results in upregulation of BA synthesis through the classical pathway initiated by cholesterol 7alpha-hydroxylase (CYP7A1). To characterize the detailed dynamics of serum lipid and BA concentrations and the BA synthesis rate in response to treatment with BA sequestrants and to determine whether the -203A/C promoter polymorphism of the CYP7A1 encoding gene (CYP7A1) affects such a response, this pilot study was carried out in healthy men (8 homozygous for the -203A allele and 8 homozygous for the -203C allele of CYP7A1)...
December 13, 2016: Physiological Research
Niki Katsiki, Vasilios G Athyros, Asterios Karagiannis
Statins remain the cornerstone of lipid-lowering treatment. They significantly reducing cardiovascular morbidity and mortality in primary and secondary prevention settings. Statin-treated patients may present adverse events (clinical and/or biochemical) that can lead to treatment discontinuation or a reduction in the dose of statins. Statin intolerance may appear at any time during the treatment. In each case, secondary causes should be assessed and treated and lifestyle measures should be implemented. Up to 3 different statins can be tried at a low dose; statin dosing everyother- day or once weekly may be another option...
2016: Current Vascular Pharmacology
N Mottacki, M Simrén, A Bajor
BACKGROUND: Bile acid diarrhoea results from imbalances in the homoeostasis of bile acids in the enterohepatic circulation. It can be a consequence of ileal disease/dysfunction, associated with other GI pathology or can be idiopathic. AIMS: To summarise the different types of bile acid diarrhoea and discuss the currently available diagnostic methods and treatments. RESULTS: Bile acid diarrhoea is found in up to 40% of patients diagnosed as having functional diarrhoea/IBS-D, and in up to 80% of patients who have undergone ileal resection...
April 2016: Alimentary Pharmacology & Therapeutics
Maura Corsetti, Peter Whorwell
Irritable bowel syndrome (IBS) is a prevalent functional gastrointestinal disorder, which represents a major cost to healthcare services. Current pharmacological treatment includes fibre supplements, antispasmodics, laxatives, loperamide and antidepressants. This article reviews the novel pharmacological treatments already or recently approved for patients with IBS-C (lubiprostone, linaclotide) and IBS-D (alosetron, ramosetron, rifaximin, eluxadoline). Furthermore, results for drugs in development (plecanatide, ibudutant and ebastine) or used in chronic constipation or for other indications, with potential application in IBS (prucalopride, elobixibat, mesalazine, ondansetron and colesevelam) are also reviewed...
July 2016: Expert Review of Gastroenterology & Hepatology
M Hansen, M J Scheltema, D P Sonne, J S Hansen, M Sperling, J F Rehfeld, J J Holst, T Vilsbøll, F K Knop
AIM: To evaluate the effects of the primary human bile acid, chenodeoxycholic acid (CDCA), and the bile acid sequestrant (BAS) colesevelam, instilled into the stomach, on plasma levels of glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic polypeptide, glucose, insulin, C-peptide, glucagon, cholecystokinin and gastrin, as well as on gastric emptying, gallbladder volume, appetite and food intake. METHODS: On four separate days, nine patients with type 2 diabetes, and 10 matched healthy control subjects received bolus instillations of (i) CDCA, (ii) colesevelam, (iii) CDCA + colesevelam or (iv) placebo...
June 2016: Diabetes, Obesity & Metabolism
Supna Sandhu, Mandana Moosavi, Kamran Golmohammadi, Gordon A Francis
No abstract text is available yet for this article.
April 2016: Canadian Journal of Diabetes
P Pongcharoen, A B Fleischer
BACKGROUND AND OBJECTIVE: Many treatment modalities are used for itch treatment in daily medical practices without adequate evidence of their efficacy. The purpose of this study was to provide an evidence-based review of the literature as to the clinical benefits of systemic anti-itch treatments. DATABASES AND DATA TREATMENT: We performed a systematic review and, when appropriate, meta-analysis from available placebo-controlled randomized controlled trails (RCTs)...
January 2016: European Journal of Pain: EJP
Mohamed-Sami Trabelsi, Mehdi Daoudi, Janne Prawitt, Sarah Ducastel, Véronique Touche, Sama I Sayin, Alessia Perino, Cheryl A Brighton, Yasmine Sebti, Jérôme Kluza, Olivier Briand, Hélène Dehondt, Emmanuelle Vallez, Emilie Dorchies, Grégory Baud, Valeria Spinelli, Nathalie Hennuyer, Sandrine Caron, Kadiombo Bantubungi, Robert Caiazzo, Frank Reimann, Philippe Marchetti, Philippe Lefebvre, Fredrik Bäckhed, Fiona M Gribble, Kristina Schoonjans, François Pattou, Anne Tailleux, Bart Staels, Sophie Lestavel
Bile acids are signalling molecules, which activate the transmembrane receptor TGR5 and the nuclear receptor FXR. BA sequestrants (BAS) complex bile acids in the intestinal lumen and decrease intestinal FXR activity. The BAS-BA complex also induces glucagon-like peptide-1 (GLP-1) production by L cells which potentiates β-cell glucose-induced insulin secretion. Whether FXR is expressed in L cells and controls GLP-1 production is unknown. Here, we show that FXR activation in L cells decreases proglucagon expression by interfering with the glucose-responsive factor Carbohydrate-Responsive Element Binding Protein (ChREBP) and GLP-1 secretion by inhibiting glycolysis...
July 2, 2015: Nature Communications
Stephanie Ross, Matthew D'Mello, Sonia S Anand, John Eikelboom, Alexandre F R Stewart, Nilesh J Samani, Robert Roberts, Guillaume Paré
BACKGROUND: Statins lower low-density lipoprotein cholesterol (LDL-C) and risk of coronary artery disease (CAD), but they may be ineffective or not tolerated. Bile acid sequestrants (BAS) reduce LDL-C, yet their clinical efficacy on CAD remains controversial. METHODS AND RESULTS: We conducted a systematic review and meta-analysis of randomized controlled trials to assess the effect of cholestyramine and colesevelam. We then used Mendelian randomization to estimate the effect of BAS on reducing the risk of CAD...
August 2015: Circulation. Cardiovascular Genetics
Oluwafikunayo Orekoya, John McLaughlin, Eugenia Leitao, Wendy Johns, Simon Lal, Peter Paine
Although recognised as a cause of chronic diarrhoea for over forty years, diagnostic tests and treatments for bile acid malabsorption (BAM) remain controversial. Recent National Institute for Health and Care Excellence (NICE) guidelines highlighted the lack of evidence in the field, and called for further research. This retrospective study explores the BAM subtype and severity, the use and response to bile acid sequestrants (BAS) and the prevalence of abnormal colonic histology. 264 selenium-75-labelled homocholic acid conjugated taurine (SeHCAT)-tested patient records were reviewed and the severity and subtype of BAM, presence of colonic histopathology and response to BAS were recorded...
June 2015: Clinical Medicine: Journal of the Royal College of Physicians of London
Michael Camilleri
Bile acid diarrhea (BAD) is usually seen in patients with ileal Crohn's disease or ileal resection. However, 25% to 50% of patients with functional diarrhea or diarrhea-predominant irritable bowel syndrome (IBS-D) also have evidence of BAD. It is estimated that 1% of the population may have BAD. The causes of BAD include a deficiency in fibroblast growth factor 19 (FGF-19), a hormone produced in enterocytes that regulates hepatic bile acid (BA) synthesis. Other potential causes include genetic variations that affect the proteins involved in BA enterohepatic circulation and synthesis or in the TGR5 receptor that mediates the actions of BA in colonic secretion and motility...
May 23, 2015: Gut and Liver
Juan F Ascaso, Pedro Mata, Cristina Arbona, Fernando Civeira, Pedro Valdivielso, Luis Masana
Homozygous familial hypercholesterolaemia (HoFH) is a rare life-threatening disease characterized by markedly elevated circulating levels of low-density lipoprotein cholesterol (LDL-C) and accelerated, premature atherosclerotic cardiovascular disease (ACVD). The Consensus Panel on Familial Hypercholesterolaemia of the European Atherosclerosis Society (EAS) has recently published a clinical guide to diagnose and manage HoFH (Eur Heart J. 2014;35:2146-57). Both the Spanish Society of Atherosclerosis (SEA) and Familial Hypercholesterolaemia Foundation (FHF) consider this European Consensus document of great value and utility...
March 2015: Clínica e Investigación en Arteriosclerosis
Luigi Brunetti, Evelyn Hermes DeSantis
Diabetes mellitus (DM) is a chronic disease with a U.S. prevalence of 25.8 million, and 90-95% of all cases are type-2 diabetes mellitus (T2DM). Despite the known mortality and morbidity associated with T2DM, the majority of patients do not achieve their hemoglobin A1c (HbA1c) goals. Nonadherence is one of the contributing factors to the lackluster attainment of treatment goals. Drug tolerability may impact medication nonadherence; therefore, strategies to improve tolerability are important. Colesevelam, a second-generation bile acid resin, was designed with greater specificity and affinity for bile acids...
January 2015: P & T: a Peer-reviewed Journal for Formulary Management
Genovefa Kolovou, Ioannis Vasiliadis, Nikos Gontoras, Vana Kolovou, Georgios Hatzigeorgiou
The genetic causes of cholesterol metabolism disorders usually lead to premature atherosclerosis. The most well recognized genetically caused hypercholesterolemia is familial hypercholesterolemia. Although the disease is well known, as the discovery of low-density lipoprotein receptor, the classical treatment with lipid-lowering drugs (statins, fibrates, ezetimibe, colesevelam) is still not adequate and new options are seeking. This review is an attempt to analyze the microsomal transfer protein (MTP) inhibitors as a new approach for treatment of familial hypercholesterolemia, to reviews the literature according to MTP inhibitors and finally to provide original findings...
April 2015: Cardiovascular Therapeutics
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