Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Combination therapy”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 289 records · Page 16Linked to original sources
PubMed2005

Goal-oriented treatment and combination therapy for pulmonary arterial hypertension.

Combination therapy may improve outcome in patients with severe pulmonary arterial hypertension (PAH). PAH patients were treated according to a goal-oriented therapeutic strategy. Patients who did not reach the treatment goals with monotherapy received combination treatment according to a predefined strategy, including bosentan, sildenafil and inhaled iloprost. Intravenous iloprost and lung transplantation were reserved for treatment failures. End points were overall survival, transplantation-free survival, and survival free from transplantation and intravenous prostanoid treatment. Between January 2002 and December 2004, 123 consecutive patients with PAH were treated according to the novel approach. Survival at 1, 2 and 3 yrs was 93.0, 83.1 and 79.9%, respectively, which was significantly better than the survival of a historical control group, as well as the expected survival. Compared to the historical control group, the use of combination treatment also significantly improved the combined end point of death, lung transplantation and need for intravenous iloprost treatment. In conclusion, a therapeutic approach utilising combinations of bosentan, sildenafil and inhaled iloprost in conjunction with a goal-oriented treatment strategy provides acceptable long-term results in patients with severe pulmonary arterial hypertension, and reduces the need for intravenous prostaglandin treatment and lung transplantation.

Administration, Inhalation↗
PubMed1997

Combination therapy using moclobemide with tricyclic and tetracyclic antidepressants to treat therapy-resistant depression.

In an open trial, a combination therapy with 300 mg moclobemide was instituted after adjustment to a classical tricyclic or tetracyclic antidepressant in a group of 23 previously therapy-resistant depressive inpatients (pretreatment with two biochemically different antidepressants over a period of at least 5 weeks with sufficient doses). In 13 patients (53.9%) a significant improvement on the Hamilton Depression Scale (24-item version) of at least 50% was achieved. The improvement in the BPRS was also significant. On the basis of the present findings, a combination therapy with the reversible MAO-inhibitor moclobemide represents an efficacious regimen for therapy-resistant depressions, with low side-effects. After this pilot study, further controlled studies are necessary.

Analysis of Variance↗
PubMedDate not supplied

Aiming at low disease activity in rheumatoid arthritis with initial combination therapy or initial monotherapy strategies: the BeSt study.

AIM: To evaluate the efficacy and safety of four different treatment strategies for patients with early rheumatoid arthritis (RA). METHODS: In the BeSt study, 508 patients with newly diagnosed (< 2 years) active RA were randomised to be treated according to four treatment strategies: 1. sequential monotherapy, 2. step up to combination therapy (both starting with methotrexate), 3. initial combination therapy with methotrexate, sulphasalazine, and a tapered high dose of prednisone, and 4. initial combination therapy with methotrexate and infliximab. Three-monthly therapy adjustments were dictated by calculation of the Disease Activity Score (DAS), with the goal to achieve and maintain a DAS <or= 2.4. Functional ability was measured every 3 months with the Health Assessment Questionnaire. Radiographs of hands and feet were assessed yearly, blinded for patient identity and treatment, and in random order, to measure joint damage progression (Sharp/van der Heijde score). RESULTS: After 2 years of treatment, 80% of all patients achieved the goal of DAS <or= 2.4, and 42% reached clinical remission (DAS < 1.6). Initial combination therapy, either with prednisone (group 3) or with infliximab (group 4), resulted in earlier improvement in functional ability, more continuous clinical remission (DAS < 1.6), and less joint damage progression than initial monotherapy (groups 1 and 2). Patients in groups 1 and 2 needed more therapy adjustments, including introduction of combination therapy with prednisone or infliximab, to achieve a DAS <or= 2.4, whereas many patients in groups 3 and 4 were able to taper their medication to sulphasalazine or methotrexate, respectively, monotherapy. The adverse events profile was comparable in all groups. The presence or absence of rheumatoid factor, HLA DR4, or anti-CCP was not associated with radiologic damage progression. CONCLUSION: In patients with early, active RA, remarkable clinical improvement and suppression of joint damage progression can be achieved with frequent, objectively steered treatment adjustments. The best chance for an early clinical and radiologic response lies with initial combination therapy with either methotrexate, sulphasalazine and prednisone or with methotrexate and infliximab, which can be tapered to DMARD monotherapy once low disease activity is achieved.

Adult↗
PubMed2004

Combination therapy for invasive mycoses: evaluation of past clinical trial designs.

BACKGROUND: Despite the availability of new antifungals, single-agent therapy frequently falls short of high cure rates. Combination therapy offers potentially higher cure rates, especially for resistant organisms. In vitro studies and experimental animal models have provided conflicting data. METHODS: Retrospective, randomized, controlled clinical studies were reviewed. RESULTS: Results indicate a clear advantage for polyene and flucytosine combination therapy in cryptococcal meningitis and a possible advantage for combination amphotericin B and fluconazole for candidemia. Unfortunately, the few studies published have been flawed by design problems that have compromised the determination of outcome. Study review allows investigators the opportunity to design future studies to ensure optimal evaluation of efficacy. CONCLUSION: Combination antifungal therapy is advantageous in cryptococcal diseases and may have a role in the treatment of invasive candidiasis. The greatest potential exists for combination therapy against aspergillosis and resistant fungi in patients with refractory mycotic disease who experience failure of monotherapy.

Antifungal Agents↗
PubMed2000

[Long-term results of combined therapy for primary osteosarcoma in extremities].

OBJECTIVE: To evaluate the survival rates, functional outcome, and complications between the combined and non-combined treatment of primary osteosarcoma of the extremities. METHOD: From 1977 through 1992, 170 patients with high-graded, nonmetastatic osteosarcoma were treated. Their average age at diagnosis was 21 years old (ranging from 6 to 52). Tumors were observed at distal femurs in 80 patients (47%), proximal tibia in 51 (30%), proximal humors in 10 and other locations in 22. Combined therapy (en bloc resection of tumor with preoperative and postoperative neoadjuvant chemotherapy) was given 104 patients and non-combined therapy (tumor resection only) to 66. Ninety-four patients underwent limb salvage surgery. In 76 patients who received amputations or disarticulations 33 received chemotherapy. RESULTS: The 5-and 10-year-survival rates were 61% and 53% in the combined therapy group and 28% and 26% in the non-combined therapy group. Local recurrence rate was 23% in limb salvage surgery group and 5.2% in amputation group. Functional evaluation of 80 patients showed that the patients who underwent salvage surgery had higher functional scores than those who had an amputation according to MSTS scoring system (1993). The average scores reached 71% in the salvage surgery group and 53% in the amputation group. CONCLUSIONS: In this study, long-term that combined therapy raised the survival rate of the patients with osteosarcoma. The ase of en bloc resection of bone tumor and reconstructive technique, has enable limb salvage procedures possible to produce excellent functional outcomes. The patients who well have responses to preoperative chemotherapy may have a higher survival rate.

Adolescent↗
PubMed2006

Efficacy and long-term follow up of combination therapy with interferon alpha and ribavirin for chronic hepatitis C in Korea.

Combination therapy with interferon alpha (IFN-alpha) and ribavirin for 24 or 48 weeks according to HCV genotype has improved the overall sustained virological response (SVR) rates to approximately 40%. The aim of this study was to investigate the long-term efficacy of combination therapy with IFN-alpha and ribavirin for chronic hepatitis C in Koreans. One hundred thirty-eight patients with chronic hepatitis C who received this combination therapy between 1995 and 2003 were analyzed retrospectively. All patients were treated with IFN-alpha 3-6 million units three times weekly in combination with 900-1200 mg/day of ribavirin for 24 weeks. The overall SVR rate was 41.3%. Patients were followed up for a median of 41 months (range, 12-105 months) after completion of therapy. In all of the SVR patients (57 patients), SVR was conserved during the follow-up period. None of the patients progressed to decompensated liver disease or hepatocellular carcinoma (HCC). However, 5 of the 81 non-SVR patients (6.2%) progressed to decompensated liver disease or HCC. In conclusion, combination therapy with IFN-alpha and ribavirin shows good long-term efficacy in patients with chronic hepatitis C in Korea, one of the highest endemic areas of hepatitis B virus (HBV) infection.

Adult↗
PubMed1979

[Factor analysis of the effectiveness of combined therapy in experimental leukemia].

The effectiveness of the combined therapy of leukemia P-388 with cyclophosphane and diazane was studied. The pattern of administering these substances was selected with due consideration of the cyclospecificity of their action. In a number of cases considerable synergism was observed, resulting in a cure of 100% of animals. Estimation of the effectiveness and the degree of synergism was made by the method of fractionation analysis, which allowed delineating some trends for providing the optimum combined therapy.

Animals↗
PubMed2005

Erythrocyte ribavirin concentration for assessing hemoglobin reduction in interferon and ribavirin combination therapy.

BACKGROUND: Ribavirin-induced hemolytic anemia is one of the important adverse effects for the premature cessation of interferon and ribavirin combination therapy for hepatitis C virus clearance. To elucidate the mechanism of this matter, we examined the effects of plasma and erythrocyte ribavirin concentration on hemoglobin (Hb) reduction to assess hemolytic anemia in this combination therapy. METHOD: Nineteen patients, treated with the interferon alpha-2b and ribavirin combination therapy, were included. Plasma and erythrocyte ribavirin concentrations were monitored for the first 28 days of the combination therapy, in relation to changes in hematological parameters, Hb and hematocrit values. The initial dose of ribavirin was 11.5+/-1.5mg/kg/day. RESULTS: Steady-state plasma and erythrocyte ribavirin concentrations were 8.9+/-2.6 and 1218+/-270muM, respectively. Significant correlation was observed between erythrocyte ribavirin and Hb reduction (r=0.360, p<0.05), but not between plasma ribavirin and Hb reduction. The patients with higher levels of erythrocyte ribavirin (>/=1000muM) had greater Hb reduction compared to those with lower levels (<1000muM) (3.8+/-1.2g/dL versus 2.6+/-0.9g/dL, p<0.05). Nine cases out of 12 patients who developed anemia within the first 28 days of the combination therapy had higher levels of erythrocyte ribavirin (>/=1000muM). CONCLUSION: We confirmed that erythrocyte ribavirin was strongly associated with Hb reduction in interferon and ribavirin combination therapy.

Journal Article↗
PubMed2005

Pharmacologic principles for combination therapy.

This article discusses the pharmacologic basis for understanding the therapeutic actions of drugs, particularly for their use in combinations. The focus is on principles underlying combination therapy in general, including examples from diseases other than chronic obstructive pulmonary disease (COPD). Pharmacodynamic aspects of drug action are covered, with an emphasis on recent advances in the understanding of drug-receptor interactions and of drug agonism. Pharmacokinetics and drug-induced adaptive changes in receptors and cell signaling pathways are summarized, emphasizing their importance for potential combination therapies aimed at prolonging drug action. An organizational framework for three different approaches to combination therapy is then proposed; the molecular rationales for each approach are described together with classic examples from other diseases, and then their application to combination therapy in COPD is discussed. Finally, terminology for the independent and interactive effects of drug combinations is discussed, and approaches to the quantitative analysis and visual display of the effects of drug combinations are introduced. The basic principles reviewed here provide the pharmacologic foundation for subsequent articles in this issue that address the combinations in current use for COPD, and they point to novel strategies for potential future approaches to combination therapy in COPD.

Drug Interactions↗
PubMed2002

The combination therapy of Ephedra herb and Loxoprofen caused gastric lesions in mice.

The combination therapy of a Kampo formula and an analgesic-antipyretic agent is often used for the common cold in Japan. We investigated the effect of such a combination therapy, using the Ephedra herb, which is a common ingredient of Kakkon-to and Mao-to, and Loxoprofen, a nonsteroidal anti-inflammatory drug (NSAID), on fever induced in an experimental model of mice under strong stress. The combination therapy of Ephedra herb and Loxoprofen caused gastric mucosal lesions and loss of body weight. It is considered that this combination therapy should be avoided because of its adverse effects.

Animals↗
PubMed1996

[A study on combination therapy of Western and traditional Chinese medicine of acute viral myocarditis].

UNLABELLED: To investigate the combination therapy of Western and traditional Chinese medicine on treatment of acute viral myocarditis, 48 patients were randomly divided into 2 groups. The 1st group consisted of 30 patients, receiving the combination therapy of Western and traditional Chinese medicine, including Astragalus membranaceus, taurine, coenzyme Q10 and antiarrhythmics, while the 2nd group consisted of 18 patients, receiving the conventional therapy, including glucose-insulin-potassium (GIK), coenzyme Q10 and also antiarrhythmics. RESULTS: The efficacy of combination therapy of western and traditional Chinese medicine was better than that of conventional therapy in improving the clinical manifestation, negative converting positive EVsRNA in peripheral leukocytes and controlling the premature beats. CONCLUSION: The combination therapy of western and traditional Chinese medicine was an effective method in treating acute viral myocarditis.

Acute Disease↗
PubMed2006

A pilot study to evaluate a new combination therapy for gastric ulcer: Helicobacter pylori eradication therapy followed by gastroprotective treatment with rebamipide.

BACKGROUND AND AIM: Controversies remain over the need for antiulcer treatment following 1-week eradication triple therapy for Helicobacter pylori-positive peptic ulcers. The usefulness of combination therapy for gastric ulcers in Japanese patients, which consists of H. pylori eradication followed by gastroprotective therapy with rebamipide, was therefore evaluated. METHODS: The study was conducted in 52 H. pylori-positive patients with an endoscopically-proven open gastric ulcer. All patients received 1-week triple therapy (lansoprazole, amoxicillin and clarithromycin) followed by 7-week rebamipide therapy. After completion of the combination therapy, all patients underwent evaluation of ulcer healing by endoscopy, gastric ulcer symptoms and H. pylori eradication by rapid urease test and (13)C-urea breath test. RESULTS: The ulcer healing rates were 85.7% (36/42) at 8 weeks, 83.3% (30/36) in eradicated patients and 100% (6/6) in non-eradicated patients. The overall gastrointestinal symptom-free rate improved from 19.0% at baseline to 88.1% at 8 weeks. H. pylori was effectively eradicated in 85.7% (36/42) of patients. CONCLUSIONS: The results suggested that the combination therapy for open gastric ulcer was safe, well-tolerated and effective. However, data from a double-blind placebo-controlled study is necessary to confirm these findings.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed1998

[Medication use in diabetes mellitus (VI). Economics and effectiveness of insulin and sulfonyl-urea combination therapy compared with conventional two daily doses].

BACKGROUND: To compare the cost and effectiveness of bedtime intermediate-acting insulin and daytime-sulfonylurea (SU) combination therapy versus the conventional two-daily-dose insulin treatment. SUBJECTS, MATERIAL AND METHODS: A pharmacoeconomical analysis of cost minimization. To prove a similar effectiveness a transversal prospective study was carried out. Patients recently converted to insulin due to oral hypoglycaemic agents failure were recruited. Entry criteria were: age > 40 years-old, more than 3 and 1 years of diagnosed diabetes and follow-up, respectively, current BMI between 20-40 kg/m2, baseline HbA1c > 8.5% and fasting C-peptide > 0.3 nmol/l. BMI, HbA1c, hypoglycaemic crisis, insulin and SU (glicazide and glibenclamide) daily dose were recorded, estimating the cost of both therapies. RESULTS: Sixty-five patients (23 male), 32 in combined therapy (mean daily dose of insulin 19.5 U and 2.4 SU tb t.i.d.) and 33 patients with a two-insulin-injection regimen (38.4 U) were treated during a follow-up period of 2.4 years. The two groups exhibited similar mean age (67.8/67.7y), known diabetes duration (15.9/15.1y), BMI (28.9/28.8/kg/m2), previous HbA1c (8.9/9.1%) and fasting C-peptide (1.6/1.2 nmol/l). No statistical differences in BMI increase (1/1.4 kg/m2), neither in mean HbA1c (7.8/7.9%) nor severe hypoglycaemic crisis (0.03/0.17 episodes/year) were evidenced. Patients in combined therapy reported a lower number of mild hypoglycaemic crisis (0.7/1.9 episodes/month; p < 0.01) and the daily cost was significantly lower (94.5/134.3 ptas./day; p < 0.0001). CONCLUSIONS: Both therapies, two-insulin-injection regimen and insulin and sulfonylurea combination therapy were similarly effective in having an acceptable glycaemic control with similar risk for weight gain or severe hypoglycaemia. Combined therapy was more cost-effective and well-tolerated, thus, comfort and a lower risk of mild hypoglycaemic episodes were evidenced.

Body Mass Index↗
PubMed1989

[Clinical evaluation of a combination therapy with aztreonam and clindamycin for severe infections in leukemia and related disorders].

A combination of aztreonam (AZT) and clindamycin (CLDM) was evaluated for severe infections associated with leukemia and related disorders. AZT is a monobactam antibiotic which has strong bactericidal effect against Gram-negative bacteria including Pseudomonas aeruginosa. CLDM which has strong antibacterial spectrum against Gram-positive and anaerobic bacteria, was chosen as a partner of AZT in order to complement the weak points of AZT. Fifty six patients were treated with the combination therapy. Among them, 51 patients were evaluable for the effectiveness. Five patients were excluded from the evaluation because 3 patients were subjected to additional therapy with other agents such as amikacin, miconazole and pulse therapy of a large dose of methylprednisolone, one had a fever episode apparently due to primary disease, and the remaining one was discontinued of the combination therapy of administration due to mild nausea after 3 days. Excellent responses were obtained in 17 (33.3%) patients and good responses in 20 (39.2%) patients, with a total rate of effectiveness of 72.5%. One patient with whom the combination therapy was stopped due to nausea, was included in the final evaluation of side effects. Side effects were observed in 2 patients of 50 and 40 years of ages (2/52, 3.8%), both of whom suffered with nausea. In the 50 years patient of acute myeloblastic leukemia, nausea occurred in a slight degree in 3 hours after the combined regimen was started. But, it disappeared during the continuation of the combination therapy. In the 40 years patient of acute myelomonocytic leukemia, mild nausea occurred after 3 day administration of the combined regimen. It disappeared soon after the cessation of the treatment. These results indicated that a combination of AZT and CLDM was an effective and safe regimen for the treatment of severe infections in patients with hematological disorders.

Adult↗
PubMed2003

[Change of blood parameters in liver failure patients with severe hepatitis after combined therapy].

OBJECTIVE: To determine the feasibility, security and clinical effects of the combination of plasma exchange(PE) and high-flow hemodiafiltration (HDF) in the treatment of liver failure caused by severe hepatitis. METHODS: Fifty-eight treatments with combined therapy were taken in 26 patients with severe hepatitis. The changes of clinical symptom, liver function, plasma thrombinogen activity and ammonia were observed to determine the clinical effects. The feasibility and security were determined by therapy related adverse reactions and tolerance of the patients. RESULTS: After the treatment, the clinical symptoms such as conscious disturbance, jaundice, inertia, abdominal distention were taken better turn. The serum bilirubin decreased [(190.8+/-93.6) micromol/L] and PTA increased [(19.7+/-8.9)%]. The major adverse reaction was hypersensitive to plasma, no severe hemorrhage, shock and superinfection happened. All patients tolerated the combined therapy. CONCLUSION: The combined therapy is a safe treatment and can significantly improve the symptoms, blood parameters and recently mortality in hepatic failure patients with severe hepatitis. The therapy is worth to spread.

Adult↗
PubMed2004

Adequate timing of ribavirin reduction in patients with hemolysis during combination therapy of interferon and ribavirin for chronic hepatitis C.

BACKGROUND: Hemolytic anemia is one of the major adverse events of the combination therapy of interferon and ribavirin. Because of ribavirin-related hemolytic anemia, dose reduction is a common event in this therapy. In this clinical retrospective cohort study we have examined the suitable timing of ribavirin reduction in patients with hemolysis during combination therapy. METHODS: Thirty-seven of 160 patients who had HCV-genotype 1b, had high virus load, and received 24-week combination therapy developed anemia with hemoglobin level <10 g/dl or anemia-related signs during therapy. After that, these 37 patients were reduced one tablet of ribavirin (200 mg) per day. After reduction of ribavirin, 27 of 37 patients could continue combination therapy for a total of 24 weeks (group A). However, 10 of 37 patients with reduction of ribavirin could not continue combination therapy because their <8.5 g/dl hemoglobin values decreased to or anemia-related severe side effects occurred (group B). We assessed the final efficacy and safety after reduction of ribavirin in groups A and B. RESULTS: A sustained virological response (SVR) was 29.6% (8/27) in group A and 10% (1/10) in group B, respectively. A 34.4% (12/27) of SVR + biological response in group A was higher than 10% (1/10) in group B ( P = 0.051), with slight significance. With respect to hemoglobin level at the time of ribavirin reduction, a rate of continuation of therapy in patients with > or =10 g/dl hemoglobin was higher than that in patients with <10 g/dl ( P = 0.036). CONCLUSIONS: Reduction of ribavirin at hemoglobin level > or =10 g/dl is suitable in terms of efficacy and side effects.

Anemia, Hemolytic↗
PubMed2003

[Optimal dosing schedule in combination therapy with irinotecan and doxifluridine in a human colorectal cancer xenograft model].

A combination therapy with CPT-11 and 5-FU/LV has been recently established as a first-line therapy for metastatic colorectal cancer. However, severe adverse effects have also been reported from this combination therapy, and a modality to reduce the adverse effects is desired. 5'-DFUR, a pro-drug of 5-FU, shows less myelotoxicity than 5-FU, and thus it may be a better partner to combine with CPT-11. However, since each drug has the possibility of inducing diarrhea, there is concern about their use in combination therapy. Therefore, in the present study, our aim was to establish an optimal schedule in murine models, which shows no increase in diarrhea but maintains potent antitumor activity. In non-tumor bearing mice, CPT-11 was given i.v. at 100 mg/kg/day q2d x 3, and 5'-DFUR was given p.o. at 172 mg/kg/day daily for 14 days. Each of these doses caused diarrhea in the single treatment. CPT-11 was administered simultaneously or sequentially with 5'-DFUR. With the simultaneously administered schedule, the diarrhea appeared stronger than that found in the CPT-11 single or in the 5'-DFUR single treatment groups. On the other hand, with the sequentially administered schedule the diarrhea was not much stronger than that found in the single agent treatment groups. When CPT-11 and 5'-DFUR administrations were separated by three-day intervals, the diarrhea was not augmented at all. In mice bearing human colorectal cancer COLO 205, the antitumor activity of CPT-11 in the combination with 5'-DFUR was additive in all of the examined schedules. The efficacy in the sequential schedule was the same as in the simultaneous schedule. These results suggest that a sequential administration schedule of CPT-11 and 5'-DFUR would be more tolerable than and equally efficacious to the simultaneous administration schedule. Clinical study of this sequential administration in combination therapy is warranted.

Animals↗
PubMed1994

[Clinical evaluation of combination therapy of sulbactam/cefoperazone and aminoglycoside in respiratory tract infections].

We compared clinical efficacy and safety of sulbactam/cefoperazone (SBT/CPZ) with those of SBT/CPZ combined with aminoglycoside (amikacin (AMK), tobramycin (TOB), etc.) in treatment of respiratory tract infections in patients with underlying respiratory diseases, with cancer, or with acute exacerbation of chronic respiratory infections. Clinical evaluations of monotherapy with SBT/CPZ in a total of 30 patients showed excellent results in 5, good results in 17. Clinical effects of combined therapy of SBT/CPZ plus different aminoglycosides in a total of 33 patients were excellent in 18, good in 5. The efficacy rates (excellent plus good) were 73.3% in the monotherapy and 69.7% in the combined therapy. AMK was used concomitantly with SBT/CPZ in 16 of 33 patients. Clinical effects of SBT/CPZ plus AMK were excellent in 10, good in 3, and the efficacy rate was 81.3%. Bacteriological effects were evaluable against 11 strains in the monotherapy group, and against 17 strains in the combined therapy group. The eradication rates were 54.5% in the monotherapy group, and 81.3% in the combination therapy group. Diarrhea was observed in a patient who received the monotherapy. Abnormal laboratory test results were observed on in 5 patients who received the monotherapy, and in 4 patients who received one of the combined therapies. All abnormalities disappeared after the completion or discontinuation of therapies. We considered SBT/CPZ combined with an aminoglycoside is a useful chemotherapy for respiratory tract infections in patients with underlying diseases and acute exacerbation of chronic respiratory tract infections.

Adult↗