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https://www.readbyqxmd.com/read/28340451/the-role-of-drug-drug-interactions-in-prostate-cancer-treatment-focus-on-abiraterone-acetate-prednisone-and-enzalutamide
#1
REVIEW
Marzia Del Re, Stefano Fogli, Lisa Derosa, Francesco Massari, Paul De Souza, Stefania Crucitta, Sergio Bracarda, Daniele Santini, Romano Danesi
Elderly patients with cancer may have comorbidities, each requiring additional pharmacologic treatment. Therefore, the occurrence of pharmacokinetic (PK) and pharmacodynamic (PD) interactions is very likely, and the risk of adverse reactions (ADRs), due to the narrow therapeutic window of anticancer drugs, is increased. Drug-drug interactions (DDIs) may occur in prostate cancer patients due to inhibition by abiraterone of liver cytochrome P450 (CYP)-dependent enzymes CYP2C8 and 2D6, which are involved in the metabolism of approximately 25% of all drugs, and induction by enzalutamide of CYP3A4, 2C9 and 2C19, which metabolize up to 50% of medications...
March 9, 2017: Cancer Treatment Reviews
https://www.readbyqxmd.com/read/28335637/reversing-the-anticoagulation-effects-of-dabigatran
#2
William E Dager, Linda Banares
The standard of care for oral anticoagulation therapy has primarily been warfarin, which is limited by its indirect mechanism-of-action, variable kinetics, tolerability, and routine monitoring concerns. The direct-acting oral anticoagulants (DOACs) have predictable pharmacokinetics and pharmacodynamics, and improved safety and efficacy compared to warfarin for the prevention of stroke in patients with nonvalvular atrial fibrillation and prevention or management of venous thromboembolism. Consequential bleeding is a concern with all anticoagulants...
March 24, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28329059/anticoagulation-for-pregnant-women-with-mechanical-heart-valves-a-systematic-review-and-meta-analysis
#3
Rohan D'Souza, Jackie Ostro, Prakesh S Shah, Candice K Silversides, Ann Malinowski, Kellie E Murphy, Mathew Sermer, Nadine Shehata
Aims: To review maternal and foetal outcomes in women with mechanical heart valves (MHVs) treated with vitamin-K antagonists (VKAs), first-trimester heparin followed by VKAs (sequential treatment), low molecular weight heparin (LMWH) and unfractionated heparin (UFH) during pregnancy, in order to inform practice. Methods and results: Medline, Embase and Central were searched from inception until February 2016. Two reviewers independently screened 1786 titles, reviewed 110 full-texts and extracted data and assessed risk-of-bias from 46 articles...
March 9, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28319424/rivaroxaban-in-patients-with-atrial-fibrillation-from-rocket-af-to-everyday-practice
#4
Gonzalo Barón-Esquivias, Francisco Marín, Marcelo Sanmartín
Registries and non-interventional studies offer relevant and complementary information to clinical trials, since they have a high external validity. Areas covered: The information regarding the efficacy and safety of rivaroxaban compared with warfarin, or rivaroxaban alone in clinical practice was reviewed in this manuscript. For this purpose, a search on MEDLINE and EMBASE databases was performed. The MEDLINE and EMBASE search included both medical subject headings (MeSH) and keywords including: atrial fibrillation (AF) OR warfarin OR clinical practice OR ROCKET AF AND rivaroxaban...
March 20, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28314139/patients-experiences-of-atrial-fibrillation-and-non-vitamin-k-antagonist-oral-anticoagulants-noacs-and-their-educational-needs-a-qualitative-study
#5
Danielle E Clarkesmith, Gregory Y H Lip, Deirdre A Lane
PURPOSE: Qualitative research on atrial fibrillation (AF) patient's experiences and perceptions of taking the non-vitamin K antagonist oral anticoagulants (NOACs) for stroke prevention is limited. This study explores patients' experiences of dabigatran and their recommendations for development of educational materials. PATIENTS AND METHODS: Semi-structured individual interviews with 8 warfarin-naive and 8 warfarin-experienced AF patients, using qualitative deductive thematic analysis...
March 7, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28300284/predictors-and-variability-of-drug-eluting-vs-bare-metal-stent-selection-in-contemporary-percutaneous-coronary-intervention-insights-from-the-prism-study
#6
Ali Shafiq, Kensey Gosch, Amit P Amin, Henry H Ting, John A Spertus, Adam C Salisbury
Drug-eluting stents (DES) reduce risk of in-stent restenosis after percutaneous coronary intervention (PCI) but require dual antiplatelet therapy (DAPT) for a longer term than bare-metal stents (BMS). Few studies have examined clinical predictors of DES vs BMS, and variability in provider selection between DES and BMS in clinical practice has not been well described. These insights can inform our understanding of current practice and may identify opportunities to improve decision-making stent selection decinsion-making...
March 16, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28290558/-real-world-data-on-novel-oral-anticoagulants-the-added-value-of-registries-and-observational-studies-focus-on-apixaban
#7
Francesco Pelliccia, Gaetano Tanzilli, Michele Schiariti, Nicola Viceconte, Cesare Greco, Carlo Gaudio
Anticoagulant therapy has been used with great effect for decades for the prevention of stroke among patients with atrial fibrillation. In recent years, the therapeutic armamentarium has been strengthened considerably, with the addition of anticoagulants acting through novel pathways. The currently available novel agents are apixaban, rivaroxaban and dabigatran. These novel oral anticoagulants (NOACs) were approved for use on the basis of major clinical trials clearly demonstrating improved risk reductions compared to warfarin for stroke and/or major bleeding events...
December 2016: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28286333/early-non-persistence-with-dabigatran-and-rivaroxaban-in-patients-with-atrial-fibrillation
#8
Cynthia A Jackevicius, Meytal Agvil Tsadok, Vidal Essebag, Clare Atzema, Mark J Eisenberg, Jack V Tu, Lingyun Lu, Elham Rahme, P Michael Ho, Mintu Turakhia, Karin H Humphries, Hassan Behlouli, Limei Zhou, Louise Pilote
OBJECTIVE: Dabigatran and rivaroxaban are novel oral anticoagulants (NOACs) approved for stroke prevention in atrial fibrillation (AF). Although NOACs are more convenient than warfarin, their lack of monitoring may predispose patients to non-persistence. Limited information is available on NOAC non-persistence rates and related clinical outcomes in clinical practice. METHODS: We conducted a retrospective cohort study using administrative data from Ontario, Canada, from January 1998 to March 2014 of patients with AF who were dispensed dabigatran or rivaroxaban...
March 12, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28279251/oral-anticoagulants-for-primary-prevention-treatment-and-secondary-prevention-of-venous-thromboembolic-disease-and-for-prevention-of-stroke-in-atrial-fibrillation-systematic-review-network-meta-analysis-and-cost-effectiveness-analysis
#9
Jonathan Ac Sterne, Pritesh N Bodalia, Peter A Bryden, Philippa A Davies, Jose A López-López, George N Okoli, Howard Hz Thom, Deborah M Caldwell, Sofia Dias, Diane Eaton, Julian Pt Higgins, Will Hollingworth, Chris Salisbury, Jelena Savović, Reecha Sofat, Annya Stephens-Boal, Nicky J Welton, Aroon D Hingorani
BACKGROUND: Warfarin is effective for stroke prevention in atrial fibrillation (AF), but anticoagulation is underused in clinical care. The risk of venous thromboembolic disease during hospitalisation can be reduced by low-molecular-weight heparin (LMWH): warfarin is the most frequently prescribed anticoagulant for treatment and secondary prevention of venous thromboembolism (VTE). Warfarin-related bleeding is a major reason for hospitalisation for adverse drug effects. Warfarin is cheap but therapeutic monitoring increases treatment costs...
March 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28276567/patient-values-and-preferences-for-antithrombotic-therapy-in-atrial-fibrillation-a-narrative-systematic-review
#10
Peter S Loewen, Angela Tianshu Ji, Anita Kapanen, Alison McClean
Guidelines recommend that patients' values and preferences should be considered when selecting stroke prevention therapy for atrial fibrillation (SPAF). However, doing so is difficult, and tools to assist clinicians are sparse. We performed a narrative systematic review to provide clinicians with insights into the values and preferences of AF patients for SPAF antithrombotic therapy. Narrative systematic review of published literature from database inception. RESEARCH QUESTIONS: 1) What are patients' AF and SPAF therapy values and preferences? 2) How are SPAF therapy values and preferences affected by patient factors? 3) How does conveying risk information affect SPAF therapy preferences? and 4) What is known about patient values and preferences regarding novel oral anticoagulants (NOACs) for SPAF? Twenty-five studies were included...
March 9, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28237982/associations-between-ischemic-stroke-follow-up-socioeconomic-status-and-adherence-to-secondary-preventive-drugs-in-southern-sweden-observations-from-the-swedish-stroke-register-riksstroke
#11
Teresa Ullberg, Eva-Lotta Glader, Elisabet Zia, Jesper Petersson, Marie Eriksson, Bo Norrving
BACKGROUND: Currently, the knowledge that one has on adequate stroke follow-up practices is limited. We report associations between 90-day stroke follow-up, socio-economy and adherence to secondary prevention in southern Sweden. METHODS: Data on 5,602 patients with ischemic stroke January 1, 2008-December 31, 2010, were obtained from Riksstroke and linked to official registers for information on education, birth country, doctor's follow-ups, and secondary prevention...
February 25, 2017: Neuroepidemiology
https://www.readbyqxmd.com/read/28231618/the-patients-perspective-of-inr-self-testing-remote-communication-of-test-results-and-confidence-to-move-to-self-management
#12
Anne Grogan, Michael Coughlan, Geraldine Prizeman, Niamh o'Connell, Nora O'Mahony, Katherine Quinn, Gabrielle McKee
AIM: The aim of this study was to elicit the perceptions of patients, who self-tested their INR and communicated their results via a text or phone messaging system, to determine their satisfaction with the education and support that they received and to establish their confidence to move to self-management. BACKGROUND: Self-testing of INR has been shown to be reliable and is fast becoming common practice. As innovations are introduced to point of care testing, more research is needed to elicit patients' perceptions of the self-testing process...
February 23, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28210634/potential-of-a-pharmacogenetic-guided-algorithm-to-predict-optimal-warfarin-dosing-in-a-high-risk-hispanic-patient-role-of-a-novel-nqo1-2-polymorphism
#13
Dagmar F Hernandez-Suarez, Karla Claudio-Campos, Javier E Mirabal-Arroyo, Bianca A Torres-Hernández, Angel López-Candales, Kyle Melin, Jorge Duconge
Deep abdominal vein thrombosis is extremely rare among thrombotic events secondary to the use of contraceptives. A case to illustrate the clinical utility of ethno-specific pharmacogenetic testing in warfarin management of a Hispanic patient is reported. A 37-year-old Hispanic Puerto Rican, non-gravid female with past medical history of abnormal uterine bleeding on hormonal contraceptive therapy was evaluated for abdominal pain. Physical exam was remarkable for unspecific diffuse abdominal tenderness, and general initial laboratory results-including coagulation parameters-were unremarkable...
October 2016: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28187492/are-evidence-standards-different-for-genomic-vs-clinical-based-precision-medicine-a-quantitative-analysis-of-individualized-warfarin-therapy
#14
Devender S Dhanda, Gregory F Guzauskas, Josh J Carlson, Anirban Basu, David L Veenstra
Evidence requirements for implementation of precision medicine (PM), whether informed by genomic or clinical data, are not well defined. Evidence requirements are driven by uncertainty and its attendant consequences; these aspects can be quantified by a novel technique in health economics, value of information analysis (VOI). We utilized VOI analysis to compare the evidence levels over time for warfarin dosing based on pharmacogenomic- vs. amiodarone-warfarin drug-drug interaction information. The primary outcome was the expected value of perfect information (EVPI), which is an estimate of the upper limit of the societal value of conducting future research...
February 10, 2017: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28180233/abnormal-vaginal-bleeding-in-women-with-venous-thromboembolism-treated-with-apixaban-or-warfarin
#15
Marjolein P A Brekelmans, Luuk J J Scheres, Suzanne M Bleker, Barbara A Hutten, Anne Timmermans, Harry R Büller, Saskia Middeldorp
Abnormal vaginal bleeding can complicate direct oral anticoagulant (DOAC) treatment. We aimed to investigate the characteristics of abnormal vaginal bleeding in patients with venous thromboembolism (VTE) receiving apixaban or enoxaparin/warfarin. Data were derived from the AMPLIFY trial. We compared the incidence of abnormal vaginal bleeding between patients in both treatment arms and collected information on clinical presentation, diagnostic procedures, management and outcomes. In the AMPLIFY trial, 1122 women were treated with apixaban and 1106 received enoxaparin/warfarin...
February 9, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28136132/r-warfarin-clearances-from-plasma-associated-with-polymorphic-cytochrome-p450-2c19-and-simulated-by-individual-physiologically-based-pharmacokinetic-models-for-11-cynomolgus-monkeys
#16
Masahiro Utoh, Takashi Kusama, Tomonori Miura, Marina Mitsui, Mirai Kawano, Takahiro Hirano, Makiko Shimizu, Yasuhiro Uno, Hiroshi Yamazaki
1. Cynomolgus monkey cytochrome P450 2C19 (formerly known as P450 2C75), homologous to human P450 2C19, has been identified as R-warfarin 7-hydroxylase. In this study, simulations of R-warfarin clearance in individual cynomolgus monkeys genotyped for P450 2C19 p.[(Phe100Asn; Ala103Val; Ile112Leu)] were performed using individual simplified physiologically based pharmacokinetic (PBPK) modeling. 2. Pharmacokinetic parameters and absorption rate constants, volumes of the systemic circulation, and hepatic intrinsic clearances for individual PBPK models were estimated for eleven cynomolgus monkeys...
January 30, 2017: Xenobiotica; the Fate of Foreign Compounds in Biological Systems
https://www.readbyqxmd.com/read/28135054/integrated-analysis-of-genetic-variation-and-gene-expression-reveals-novel-variant-for-increased-warfarin-dose-requirement-in-african-americans
#17
Wenndy Hernandez, Eric R Gamazon, Keston Aquino-Michaels, Erin Smithberger, Travis J O'Brien, Arthur F Harralson, Matthew Tuck, April Barbour, Larisa H Cavallari, Minoli A Perera
BACKGROUND: Warfarin is commonly used to control and prevent thromboembolic disorders. However, due to warfarin's complex dose-requirement relationship, safe and effective use is challenging. Pharmacogenomics-guided warfarin dosing algorithms that include the well-established VKORC1 and CYP2C9 polymorphisms explain only a small proportion of inter-individual variability in African Americans (AAs). OBJECTIVES: We aimed to assess whether transcriptomic analyses could be used to identify regulatory variants associated with warfarin dose response in AAs...
January 30, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28118749/warfarin-interaction-with-hepatic-cytochrome-p-450-enzyme-inducing-anticonvulsants
#18
Nathan P Clark, Kim Hoang, Thomas Delate, John R Horn, Daniel M Witt
BACKGROUND: Initiation of cytochrome P-450 (CYP)-inducing anticonvulsant medications during warfarin therapy may decrease anticoagulant effect and necessitate frequent warfarin dose adjustments to maintain therapeutic response measured by the international normalized ratio (INR). Clinical information regarding interactions between warfarin and these medications is limited. This study investigated warfarin dose and INR response following CYP-inducing anticonvulsant initiation among chronic warfarin users...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28099971/warfarin-associated-nonuremic-calciphylaxis
#19
Wesley Yung-Hsu Yu, Tina Bhutani, Rachel Kornik, Laura B Pincus, Theodora Mauro, Michael D Rosenblum, Lindy P Fox
Importance: Classic calciphylaxis associated with renal failure is a life-threatening disease. Warfarin-associated calciphylaxis without renal injury has been described, but whether it is a subset of classic calciphylaxis or a different entity remains unknown. We describe 1 case of warfarin-associated calciphylaxis, present data from 2 others from our institution, and review all cases of warfarin-associated calciphylaxis available in the literature. Our review indicates that warfarin-associated calciphylaxis is clinically and pathophysiologically distinct from classic calciphylaxis...
March 1, 2017: JAMA Dermatology
https://www.readbyqxmd.com/read/28074382/engaging-hmong-adults-in-genomic%C3%A2-and%C3%A2-pharmacogenomic-research-toward-reducing-health-disparities-in-genomic-knowledge-using-a-community-based-participatory-research-approach
#20
Kathleen A Culhane-Pera, Robert J Straka, MaiKia Moua, Youssef Roman, Pachia Vue, Kang Xiaaj, May Xia Lo, Mai Lor
Advancing precision medicine relies in part on examining populations that may exhibit unique genetic variants that impact clinical outcomes. Failure to include diverse populations in genomic-based research represents a health disparity. We implemented a community-based participatory research (CBPR) process with the Hmong community in Minnesota, who were refugees from Laos, in order to assess the feasibility of conducting genomic and pharmacogenomic-based research for genetic variants that are relevant to the Hmong community...
January 10, 2017: Journal of Community Genetics
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