Biomedical subjects

Gillian M Keating

Publications and source records attributed to Gillian M Keating.

At least 73 records · Page 4Linked to original sources

PubMed2004

Ciprofloxacin extended release: in the treatment of urinary tract infections and uncomplicated pyelonephritis.

Ciprofloxacin extended release (XR) is a new oral formulation of a fluoroquinolone that allows once-daily administration while maintaining therapeutic serum levels of the drug. The maximum plasma concentrations (Cmax) of once-daily ciprofloxacin XR 500 mg was higher than that of twice-daily ciprofloxacin immediate release 250 mg and the Cmax of once-daily ciproflocaxin XR 1000 mg was higher than that of twice-daily ciprofloxacin 500 mg. No accumulation of ciprofloxacin XR at steady state was observed in healthy men and all other pharmacokinetic parameters were similar to those of the immediate-release formulation. In patients with uncomplicated urinary tract infection (UTI), bacteriological eradication rates were similar in recipients of ciprofloxacin XR and immediate-release ciprofloxacin at the test-of-cure (TOC) visit, as were rates of persistence or new infection. Clinical cure rates were also similar in the two treatment groups. Bacteriological eradication occurred in 89% of ciprofloxacin XR and 85% of immediate-release ciprofloxacin recipients with complicated UTIs or acute uncomplicated pyelonephritis at the TOC visit. Clinical cure rates were also similar in the two treatment groups. black triangle Ciprofloxacin XR was generally well tolerated in patients with uncomplicated or complicated UTIs or acute uncomplicated pyelonephritis and showed similar tolerability to that of the immediate-release formulation.

Administration, Oral↗

PubMed2004

Spotlight on vardenafil in erectile dysfunction.

UNLABELLED: Vardenafil (Levitra) is a potent and highly selective oral phosphodiesterase type 5 (PDE5) inhibitor. Vardenafil improved erectile function in men with mild to severe erectile dysfunction (ED) of varying aetiology in two randomised, double-blind, multicentre, fixed-dose studies of 12 or 26 weeks' duration. Men receiving vardenafil 10 or 20mg had significantly greater improvements in International Index of Erectile Function (IIEF) questionnaire erectile function domain scores than placebo recipients. Moreover, improvements in penetration and maintenance of erection (assessed using IIEF or Sexual Encounter Profile [SEP] questions) were significantly greater with vardenafil 5-20mg than with placebo. Improvements in IIEF intercourse satisfaction and orgasmic function domain scores were significantly greater with vardenafil 10 or 20mg than with placebo and the proportion of patients with a positive response to a Global Assessment Question (GAQ) concerning improvement in erections after 12 or 26 weeks' therapy was significantly higher with vardenafil 5-20mg than with placebo. Vardenafil improved erectile function in men with ED associated with diabetes mellitus or ED following unilateral or bilateral nerve-sparing radical retropubic prostatectomy in two randomised, double-blind, multicentre, fixed-dose, 3-month studies. In both studies, improvements from baseline in the erectile function domain score of the IIEF and in positive responses to SEP questions were significantly greater with vardenafil 10 or 20mg than with placebo. In addition, a significantly higher proportion of vardenafil 10 or 20mg recipients than placebo recipients had positive GAQ responses. Vardenafil was generally well tolerated in men with ED; treatment-emergent adverse events were of mild to moderate intensity and transient in nature. The most commonly reported adverse events (typical of those seen with PDE5 inhibitors) in vardenafil 5-20mg recipients included headache, flushing, rhinitis, dyspepsia and sinusitis. There were no reports of abnormal colour vision in men with ED taking vardenafil at clinically recommended doses (5-20mg). CONCLUSION: Vardenafil is a potent and highly selective oral PDE5 inhibitor. It is effective and generally well tolerated in men with mild to severe ED of varying aetiology, as well as in men with ED associated with diabetes mellitus or ED after radical prostatectomy. Vardenafil should be considered a first-line treatment option in men with ED who are suitable candidates for oral PDE5 inhibitor therapy.

Administration, Oral↗

PubMed2004

Darifenacin: in the treatment of overactive bladder.

Darifenacin is a selective muscarinic M3-receptor antagonist that has been evaluated in clinical trials in patients with overactive bladder syndrome (OAB) using a controlled-release formulation. In multicentre, randomised, double-blind trials in patients with OAB, darifenacin 7.5 or 15 mg once daily for 12 weeks significantly reduced the frequency of urinary incontinence, frequency of micturition and frequency and severity of urgency versus placebo. A significant difference from placebo was apparent 2 weeks after starting treatment. At a dosage of 30 mg once daily, darifenacin significantly prolonged warning time compared with placebo. Darifenacin 15 mg once daily for 2 weeks was as effective as oxybutynin 5 mg three times daily at reducing the frequency of urinary incontinence and frequency and severity of urgency in patients with OAB. Darifenacin was generally well tolerated in clinical trials. The most common adverse events were dry mouth and constipation. CNS tolerability appeared to be similar to that of placebo. Darifenacin had no adverse effect on cognitive function in healthy elderly volunteers.

Adult↗

PubMed2004

Budesonide/formoterol: in chronic obstructive pulmonary disease.

Budesonide/formoterol is a fixed-dose combination of the corticosteroid budesonide and the long-acting beta2-agonist formoterol, and is inhaled via the Turbuhaler device. In two large, randomised, double-blind, 12-month studies, patients with severe chronic obstructive pulmonary disease (COPD) receiving budesonide/formoterol 320/9 microg twice daily had a significantly higher forced expiratory volume in 1 second (FEV1) and significantly higher morning and evening peak expiratory flow at trial endpoint than recipients of budesonide or placebo; FEV1 was significantly higher than with formoterol in the larger study. In both studies, the rate of COPD exacerbations and exacerbations requiring oral corticosteroids was significantly reduced with budesonide/formoterol versus formoterol and placebo. Moreover, the time to first exacerbation was significantly prolonged with budesonide/formoterol versus all other treatment arms in the larger study. At 12 months, significant improvements in health-related quality-of-life scores were seen with budesonide/formoterol versus placebo in both studies. The reduction in total and individual symptom scores was significantly greater with budesonide/formoterol than with budesonide or placebo in the smaller study. Budesonide/formoterol was generally well tolerated by patients with severe COPD. The tolerability profile of the combination was similar to that of the individual components with no increase in the incidence of adverse events.

Administration, Inhalation↗

PubMed2004

Daptomycin.

Daptomycin is a lipopeptide antibacterial with rapid in vitro activity against Gram-positive cocci. It is approved for use in patients with complicated skin and skin structure infections (cSSSIs) caused by specified Gram-positive cocci. In vitro, daptomycin was active against Staphylococcus aureus (including meticillin-resistant strains), Streptococcus pyogenes, S. agalactiae, group C and G beta-haemolytic streptococci and vancomycin-susceptible Enterococcus faecalis. Bactericidal activity in vitro was rapid and concentration dependent. In two randomised, investigator-blinded, multicentre trials in patients with cSSSIs, intravenous daptomycin 4 mg/kg once daily was as effective as standard therapy (intravenous semi-synthetic penicillin 4-12 g/day or vancomycin 1 g 12-hourly). Clinical success rates assessed 6-20 days after treatment end were 82.1% in daptomycin recipients and 82.9% in recipients of standard therapy (pooled data). In patients with cSSSIs, the adverse event profiles of daptomycin and vancomycin were similar. Creatine phosphokinase (CPK) levels increased in 2.8% of daptomycin recipients and 1.8% of patients who received standard therapy; only one daptomycin recipient (0.2%) experienced increased CPK levels and muscle symptoms that were not associated with any comorbid factors.

Animals↗

PubMed2004

Intravenous esomeprazole.

The proton pump inhibitor esomeprazole comprises the S-isomer of omeprazole. An intravenous formulation of the drug has been developed for use in patients not able to take oral drugs. The level of gastric acid control was similar with intravenous and oral esomeprazole in two studies in healthy volunteers receiving 20 or 40 mg once daily for 5 days. In addition, a similar level of gastric acid control occurred with intravenous esomeprazole 40 mg administered by infusion or injection once daily for 10 days. In healthy volunteers, intravenous esomeprazole provided faster and more effective gastric acid control than intravenous pantoprazole (40 mg once daily for 5 days). In addition, control of basal and pentagastrin-stimulated gastric acid secretion was better with intravenous esomeprazole 40 mg than with intravenous omeprazole 40 mg (single-dose study). Healing rates at 4 weeks were approximate, equals 80% in a well designed study in patients with erosive oesophagitis (n = 246) who received esomeprazole 40 mg once daily intravenously (by injection or infusion) or orally. Intravenous therapy was administered for the first week, after which all patients received oral esomeprazole. Intravenous esomeprazole was generally well tolerated in patients with erosive oesophagitis, with a tolerability profile similar to that of the oral formulation.

Administration, Oral↗

PubMed2004

Letrozole: a review of its use in postmenopausal women with breast cancer.

Letrozole (Femara), a nonsteroidal, third-generation aromatase inhibitor administered orally once daily, has shown efficacy in the treatment of postmenopausal women with early-stage or advanced, hormone-sensitive breast cancer. In early-stage disease, extending adjuvant endocrine therapy with letrozole (beyond the standard 5-year period of tamoxifen) improved disease-free survival; compared with placebo there was a 43% relative reduction in disease recurrences or new contralateral breast tumours at a median follow-up of 2.4 years. The results of 4 months' neoadjuvant treatment with letrozole or tamoxifen in postmenopausal women with untreated primary disease favour letrozole. In advanced breast cancer, letrozole was superior to tamoxifen as first-line treatment; time to disease progression was significantly longer (9.4 vs 6.0 months, p < 0.0001) and objective response rate was significantly greater with letrozole, but median overall survival was similar between groups. For second-line therapy of advanced breast cancer that had progressed on antiestrogen therapy, letrozole showed efficacy equivalent to that of anastrozole and similar to or better than that of megestrol acetate. Letrozole is generally well tolerated and has a similar tolerability profile to tamoxifen; the most common treatment-related adverse events were hot flushes, nausea and hair thinning. In patients with tumours that had progressed on antiestrogen therapy, letrozole was tolerated as least as well as, or better than, anastrozole or megestrol acetate. In the trial of extended adjuvant therapy, adverse events reported more frequently with letrozole than placebo were hot flushes, arthralgia, myalgia and arthritis. The long-term effects of letrozole on bone mineral density or lipid profile have not been determined and these parameters may require monitoring. In several pharmacoeconomic modelling studies from various public healthcare system perspectives, letrozole was considered a cost effective choice for first-line (vs tamoxifen) or second-line (vs megestrol acetate) treatment for advanced breast cancer in postmenopausal women. In conclusion, letrozole 2.5 mg/day is effective in the treatment of postmenopausal women with early-stage or advanced breast cancer. The efficacy, cost effectiveness and favourable tolerability profile of letrozole are reflected in current treatment guidelines recommending the drug as first-line therapy for advanced breast cancer. Letrozole is superior to tamoxifen for first-line treatment and is at least as effective as standard second-line treatments in disease that has progressed on antiestrogen therapy. For early-stage disease, letrozole is superior to tamoxifen in the neoadjuvant setting, and prolongs disease-free survival when administered after the standard 5-year period of adjuvant tamoxifen therapy.

Antineoplastic Agents↗

PubMed2004

Somatropin (Zorbtive): in short bowel syndrome.

A somatropin preparation (Zorbtive) produced by recombinant DNA technology has been evaluated in patients with short bowel syndrome. Somatropin is thought to enhance intestinal adaptation in this condition through direct or indirect effects on the intestine. In a randomised, double-blind study in patients with short bowel syndrome who were dependent on intravenous parenteral nutrition (IPN) [n = 41], recipients of subcutaneous somatropin alone or somatropin plus oral glutamine had significantly greater mean reductions from baseline in weekly total IPN volume than recipients of placebo plus glutamine. All patients received a special diet. In addition, significantly greater mean reductions from baseline in weekly total IPN calories and the mean frequency of IPN or supplemental lipid emulsion administration occurred in patients receiving somatropin alone or in combination with glutamine, compared with recipients of placebo plus glutamine. Adverse events were reported in 100% of patients with short bowel syndrome during treatment with somatropin with or without glutamine. However, a high proportion of patients also reported signs and symptoms before starting therapy or adverse events after therapy, suggesting that such patients experience numerous events attributable to their underlying condition or to complications of IPN.

Animals↗

PubMed2004

Budesonide/formoterol: a review of its use in asthma.

Budesonide and formoterol have been combined in a single dry powder device, Symbicort Turbuhaler (budesonide/formoterol 160/9-640/18 microg/day), in an effort to simplify asthma management. The efficacy of budesonide/formoterol as maintenance therapy in patients with asthma has been examined in several randomised studies.Twice-daily budesonide/formoterol was significantly more effective than an equivalent or higher daily dose of budesonide alone or high-dose fluticasone propionate alone at improving peak expiratory flow (PEF) in adults with predominantly moderate persistent asthma. Symptom control and the risk of mild exacerbations were significantly improved versus budesonide alone. Moreover, budesonide/formoterol appeared to be as effective as concurrent therapy with equivalent dosages of budesonide and formoterol administered via separate inhalers in adults with moderate persistent asthma. Budesonide/formoterol administered once daily was as effective as twice-daily administration (equivalent daily doses) and more effective than once-daily budesonide in adults with moderate persistent asthma. Twice-daily budesonide/formoterol significantly improved PEF compared with budesonide in paediatric patients with asthma. Adjustable maintenance dosing with budesonide/formoterol was associated with significantly less study drug use than fixed dosing with budesonide/formoterol in adults with predominantly mild or moderate persistent asthma. In two of three studies (all longer than 4 months' duration), the risk of exacerbations was significantly lower with adjustable than with fixed dosing, but no difference was detected in four short-term studies. Symptom severity was maintained or improved in most patients receiving either treatment regimen. In adults with moderate-to-severe persistent asthma, adjustable maintenance dosing with budesonide/formoterol reduced the rate of exacerbations and reliever medication use compared with fixed dosing with salmeterol/fluticasone propionate. Budesonide/formoterol was well tolerated in both fixed and adjustable dosing regimens. In conclusion, in patients with persistent asthma symptoms despite treatment with inhaled corticosteroids, budesonide/formoterol administered via a single dry powder Turbuhaler device is an effective, well tolerated, convenient treatment option, which may have the potential for improved compliance. It appears to be as effective as treatment with budesonide and formoterol administered via separate inhalers and is more effective than budesonide monotherapy in improving PEF, controlling symptoms and preventing mild exacerbations. Adjustable maintenance dosing with budesonide/formoterol is associated with a lower overall dosage and appears to maintain control as effectively as fixed dosing.

Animals↗

PubMed2004

Inhaled salmeterol/fluticasone propionate: a review of its use in chronic obstructive pulmonary disease.

The salmeterol/fluticasone propionate dry powder inhaler (DPI) [Advair Diskus, Seretide Accuhaler] contains the long-acting beta2-adrenoceptor agonist salmeterol and the inhaled corticosteroid fluticasone propionate. In the US, twice-daily salmeterol/fluticasone propionate 50/250 microg is approved for use in adults with chronic obstructive pulmonary disease (COPD) associated with chronic bronchitis, and in the EU, the twice-daily 50/500 microg dosage is approved for use in patients with severe COPD, repeat exacerbations and significant symptoms despite bronchodilator therapy. In patients with moderate-to-severe COPD, twice-daily inhaled salmeterol/fluticasone propionate 50/250 or 50/500 microg for 24-52 weeks improves predose forced expiratory volume in 1 second (FEV1) significantly more than salmeterol monotherapy, improves postdose or postbronchodilator FEV1 significantly more than fluticasone propionate monotherapy and results in clinically significant improvements in health-related quality of life. Salmeterol/fluticasone propionate 50/500 microg significantly reduced annual COPD exacerbations, especially in severe COPD. Some corticosteroid-related adverse events were increased in recipients of fluticasone propionate with or without salmeterol versus salmeterol monotherapy or placebo; withdrawal from fluticasone propionate, including combination therapy, needs careful management to minimise COPD exacerbations. The DPI combining a corticosteroid and long-acting beta2-agonist provides benefits over monotherapy and may encourage patient compliance in COPD.

Administration, Inhalation↗

PubMed2004

Moxifloxacin: a review of its use in the management of bacterial infections.

Moxifloxacin (Avelox) is a fluoroquinolone antibacterial with a methoxy group in the C-8 position and a bulky C-7 side chain. Moxifloxacin is approved for use in the treatment of acute exacerbations of chronic bronchitis (AECB), community-acquired pneumonia (CAP), acute bacterial sinusitis and uncomplicated skin and skin structure infections (approved indications may differ between countries). Moxifloxacin has a broad spectrum of antibacterial activity, including activity against penicillin-resistant Streptococcus pneumoniae. It achieves good tissue penetration and has a convenient once-daily administration schedule, as well as being available in both intravenous and oral formulations in some markets. Moxifloxacin has good efficacy in the treatment of patients with AECB, CAP, acute bacterial sinusitis and uncomplicated skin and skin structure infections, and is generally well tolerated. Thus, moxifloxacin is an important option in the treatment of bacterial infections.

Anti-Bacterial Agents↗

PubMed2004

Duloxetine: in stress urinary incontinence.

Duloxetine is an orally administered, balanced, dual serotonin and norepinephrine (noradrenaline) reuptake inhibitor that increases neural input to the urethral sphincter, thereby relieving the symptoms of stress urinary incontinence (SUI). Duloxetine 40 mg twice daily for 12 weeks reduced the median incontinence episode frequency (IEF) to a significantly greater extent than placebo in women with predominant symptoms of SUI. In most studies, Incontinence Quality of Life (I-QOL) questionnaire total scores were significantly improved compared with placebo. In a dose-escalation study in women with severe SUI scheduled for continence surgery, duloxetine 80-120 mg/day for 8 weeks significantly reduced IEF and increased I-QOL total scores compared with placebo, and caused 20% of recipients to reconsider their willingness to undergo surgery. Duloxetine or duloxetine plus pelvic floor muscle training (PFMT) were more effective in reducing the median IEF than PFMT alone or no treatment in women with SUI. Mean I-QOL total scores suggested that combination therapy was more effective than either therapy alone. Nausea was the most frequent adverse event and was the main cause for discontinuing duloxetine therapy.

Adrenergic Uptake Inhibitors↗

PubMed2004

Eplerenone : a review of its use in left ventricular systolic dysfunction and heart failure after acute myocardial infarction.

Eplerenone (Inspra) is a selective aldosterone blocker. Oral eplerenone is approved for use in patients with left ventricular (LV) systolic dysfunction and clinical evidence of heart failure following acute myocardial infarction (MI) in the US and in European countries (e.g. the UK and The Netherlands). The addition of eplerenone to standard medical therapy significantly improved mortality and morbidity in patients with LV systolic dysfunction and clinical evidence of heart failure following acute MI in the large, well designed EPHESUS (Eplerenone Post-acute myocardial infarction Heart failure Efficacy and SUrvival Study) trial. The beneficial effects of eplerenone on all-cause mortality and cardiovascular mortality were seen within 30 days of randomisation. Eplerenone was generally well tolerated. Although a higher incidence of hyperkalaemia occurred with eplerenone than with placebo, the incidence of hypokalaemia was significantly lower with eplerenone treatment. Thus, the addition of eplerenone to standard medical therapy is an important new strategy for further improving mortality and morbidity in post-MI patients with LV systolic dysfunction and heart failure.

Animals↗

PubMed2004

Peginterferon-alpha-2a (40kD) plus ribavirin: a review of its use in hepatitis C Virus And HIV co-infection.

Pegylated interferon plus ribavirin is the standard first-line treatment in patients with chronic hepatitis C virus (HCV) mono-infection. Although the optimal anti-HCV regimen is not established in the more difficult-to-treat population with HIV-HCV co-infection, much of the data in this clinical setting have been derived from studies evaluating peginterferon-alpha-2a (40kD) [Pegasys] plus ribavirin (Copegus), most notably the APRICOT (AIDS Pegasys Ribavirin International Co-Infection Trial) and the ACTG (AIDS Clinical Trial Group) A5071 study. In particular, results of APRICOT - the largest study conducted to date with a pegylated interferon plus ribavirin in patients with HIV-HCV co-infection - indicate that a substantial proportion of patients will achieve sustained virological response (SVR) at week 72 when these drugs are administered for 48 weeks in an appropriate dosage regimen. In general, the tolerability profile of peginterferon-alpha-2a plus ribavirin in APRICOT was similar to that previously reported in patients with HCV mono-infection.

Antiviral Agents↗

PubMed2004

Paroxetine controlled release.

A controlled-release (CR) formulation of the SSRI paroxetine has been developed. This CR formulation delays the release of paroxetine until the tablet has passed through the stomach; the drug is then released over 4-5 hours. In well designed placebo-controlled trials in patients with major depressive disorder (including a study in the elderly), social anxiety disorder or premenstrual dysphoric disorder (PMDD), paroxetine CR was consistently superior to placebo with regards to primary endpoints (i.e. mean Hamilton Rating Scale for Depression total score [major depressive disorder], Liebowitz social anxiety scale total score and Clinical Global Impressions-Global Improvement score [social anxiety disorder] and Visual Analogue Scale-Mood score [PMDD]). The duration of treatment was 12 weeks or, in PMDD, over three menstrual cycles (intermittent or continuous administration). Paroxetine CR also demonstrated efficacy in three well designed studies in patients with panic disorder with or without agoraphobia. Paroxetine CR was generally well tolerated in clinical trials, with an adverse-event profile typical of SSRIs, although recipients of paroxetine CR experienced significantly less nausea than recipients of immediate-release paroxetine in the first week of treatment.

Animals↗

PubMed2004

Ropinirole: for the treatment of restless legs syndrome.

Ropinirole is a non-ergoline dopamine agonist that exhibits a high affinity for D(2) and D(3) receptors but little or no affinity for D(1)-like and non-dopaminergic receptors. Symptoms of restless legs syndrome (RLS) [measured using the International Restless Legs scale and Clinical Global Impression-Global Improvement Scale scores] significantly improved with ropinirole compared with placebo in large, randomised, double-blind trials. Ropinirole reduced periodic leg movements and improved sleep efficiency relative to baseline and placebo in several trials (two of which were randomised, double-blind and relatively large) in patients with RLS. Ropinirole was generally well tolerated in patients with RLS; adverse events were generally mild to moderate in nature and consistent with those expected of dopamine agonists. Few patients receiving ropinirole withdrew from therapy because of adverse events, the most predominant of which were nausea and headache.

Antiparkinson Agents↗

PubMed2004

Adalimumab: a review of its use in rheumatoid arthritis.

Adalimumab (Humira) is a recombinant, fully human IgG1 monoclonal antibody that binds specifically to tumor necrosis factor (TNF)-alpha, thereby neutralizing the activity of the cytokine. Subcutaneous adalimumab has been investigated in well designed trials in patients with active rheumatoid arthritis despite treatment with disease-modifying antirheumatic drugs (DMARDs). Patients receiving adalimumab 40mg every other week in combination with methotrexate (Anti-TNF Research Study Program of the Monoclonal Antibody Adalimumab [ARMADA] and DE019 trials) or standard antirheumatic therapy (Safety Trial of Adalimumab in Rheumatoid Arthritis [STAR] trial) for 24-52 weeks had significantly higher American College of Rheumatology (ACR) 20, ACR50, and ACR70 response rates than patients receiving placebo plus methotrexate or standard antirheumatic therapy. In ARMADA, an ACR20 response was achieved in 25%, 52%, and 67% of adalimumab plus methotrexate recipients at weeks 1, 4, and 24, respectively. In ARMADA and DE019, improvements in the individual components of the ACR response were significantly greater with adalimumab 40mg every other week plus methotrexate than with placebo plus methotrexate. Monotherapy with adalimumab 40mg every other week was associated with significantly higher ACR20, ACR50, and ACR70 response rates than placebo, as well as significantly greater improvements in the individual components of the ACR response. ACR responses were sustained with adalimumab according to the results of extension studies in which patients received adalimumab in combination with methotrexate (up to 30 months) or as monotherapy (up to 5 years). In both concomitant therapy and monotherapy trials, adalimumab was associated with significantly greater improvements from baseline in health-related quality of life (HR-QOL) measures than placebo; adalimumab also retarded the radiographic progression of structural joint damage to a significant extent compared with placebo. Adalimumab was generally well tolerated as both concomitant therapy and monotherapy. In ARMADA, there were no significant differences between adalimumab and placebo (in combination with methotrexate) in the incidence of adverse events; however, in STAR, the incidence of injection site reactions, rash, and back pain was significantly higher with adalimumab than with placebo (in combination with standard antirheumatic therapy). No cases of tuberculosis were reported in either trial.In conclusion, subcutaneous adalimumab in combination with methotrexate or standard antirheumatic therapy, or as monotherapy, is effective in the treatment of adults with active rheumatoid arthritis who have had an inadequate response to DMARDs. Adalimumab has a rapid onset of action and sustained efficacy. The drug also retards the progression of structural joint damage, improves HR-QOL, and is generally well tolerated. Thus, adalimumab is a valuable new option for the treatment of DMARD-refractory adult rheumatoid arthritis.

Adalimumab↗

PubMed2004

Valsartan: a review of its use in patients with heart failure and/or left ventricular systolic dysfunction after myocardial infarction.

Valsartan (Diovan) is an oral angiotensin II-receptor antagonist with specificity for the angiotensin II type 1 receptor subtype. It demonstrates antihypertensive activity and slows the progression of chronic heart failure (CHF). Recently it has been evaluated in comparison with an ACE inhibitor regimen in patients with heart failure or left ventricular systolic dysfunction (LVSD) after an acute myocardial infarction (MI), a population known to be at high risk of subsequent death or other major cardiovascular events. In the VALIANT (VALsartan In Acute myocardial iNfarcTion) trial, valsartan was as effective as captopril at reducing mortality and cardiovascular morbidity in patients who developed heart failure and/or LVSD after surviving an MI. It was also generally well tolerated in this population. Treatment with a combination of valsartan plus captopril provided no additional therapeutic benefit over treatment with captopril and was less well tolerated. Valsartan has a potential role as a new treatment for high-risk patients in the post-MI setting.

Angiotensin II Type 1 Receptor Blockers↗