Abstract:
WHAT IS KNOWN AND OBJECTIVE:Alzheimer's disease (AD) is the most common cause of dementia among the elderly. The exact cause of the disease is not clearly known, and no existing therapies are able to prevent disease progression. Identification of the possible "impaired brain insulin signalling in AD" enriched the scope for "the repurposing of diabetic drugs in AD management." Among the different classes of diabetic drugs, pioglitazone (PIO), a PPARγ agonist classed as an insulin sensitizer, is of the highest interest for AD management. The drug is reported to have direct action on multiple targets involved in AD, independent of insulin signalling. Even though PIO has appeared to be a potent molecule in preclinical trials, limited success was observed in the clinical stage. The tentative reasons for the limited therapeutic success in the clinical stage are not clear. The main focus of the review is to discuss various factors that might limit the therapeutic success of PIO in clinical trials and possible approaches to overcome those limitations. METHOD:The research articles, review articles, and patents containing information regarding the clinical and preclinical trials of PIO in AD have been reviewed thoroughly using the keywords related to diabetic drugs in AD, PIO for AD management and mechanism of PIO in AD. Literature search was conducted on PubMed, SCOPUS and EMBASE. RESULTS AND DISCUSSION:Previous studies have indicated that the blood-brain barrier (BBB) is the biggest challenge to delivering PIO to the brain. Therefore, to attain a therapeutic concentration in the brain, a higher dose is needed, which is also supported by preclinical investigations in AD; however, in clinical studies, scientists have used the usual diabetic doses. This dose is inadequate to attain a therapeutic concentration in the brain and appears to be the primary reason for the limited success of PIO in clinical trials. The stage of drug intervention and the nature of the study population are also influential factors for the therapeutic response. WHAT IS NEW AND CONCLUSION:The insufficient concentration of the drug reaching the brain appears to be the crucial factor that limits the therapeutic success of PIO in AD management. Since the administration of higher doses cannot be recommended due to safety issues, the current situation demands the use of novel tools to ensure a therapeutic concentration reaches the brain.
journal_name
J Clin Pharm Therjournal_title
Journal of clinical pharmacy and therapeuticsauthors
Jojo GM,Kuppusamy Gdoi
10.1111/jcpt.12808subject
Has Abstractpub_date
2019-06-01 00:00:00pages
337-348issue
3eissn
0269-4727issn
1365-2710journal_volume
44pub_type
杂志文章,评审abstract:WHAT IS KNOWN AND OBJECTIVE:Polypharmacy has a significant impact on patients' health with overall expenditure on over-the-counter (OTC) medicines representing a substantial burden in terms of cost of treatment. The aim of this study, which was conducted within the framework of a European Project funded by the European...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章,多中心研究
doi:10.1111/jcpt.12601
更新日期:2018-02-01 00:00:00
abstract:OBJECTIVE:A large number of structurally and functionally diverse compounds act as substrates or modulators of p-glycoprotein (p-gp). Some of them possess multiple drug resistance (MDR)-reversing activity, but only a small number of them have entered clinical study. In order to uncover the factors which exert a signifi...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章,评审
doi:10.1046/j.1365-2710.2003.00487.x
更新日期:2003-06-01 00:00:00
abstract:WHAT IS KNOWN AND OBJECTIVE:The CHOP regimen with rituximab (R-CHOP) remains the standard for chemotherapy in patients with aggressive non-Hodgkin's lymphoma (NHL). The cardiotoxicity of doxorubicin appears to be a key problem in clinical practice. We studied the cardiotoxicity of CHOP/R-CHOP regimen in a retrospective...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1111/jcpt.12124
更新日期:2014-04-01 00:00:00
abstract:OBJECTIVE:To probe the pharmacokinetic basis for the use of levofloxacin for complicated skin and skin-structure infections (SSSIs) at a once-daily dosage of 750 mg by investigating its penetration into skin tissue. METHOD:Ten healthy volunteers were administered three oral, once-daily 750 mg doses of levofloxacin, an...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 临床试验,杂志文章
doi:10.1046/j.1365-2710.2002.00396.x
更新日期:2002-04-01 00:00:00
abstract:WHAT IS KNOWN AND OBJECTIVE:The use of prophylactic antibiotics in clean operations was routine in China before 2011. Along with the appeal for using antibiotics rationally by WHO in 2011, China launched a national special rectification scheme on clinical use of antibiotics from April that year. The scheme, aimed at ac...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1111/jcpt.12275
更新日期:2015-08-01 00:00:00
abstract:BACKGROUND:The anti-craving drug, naltrexone, is used as a pharmacotherapeutic adjunct in the treatment of alcohol dependence. In addictive disorders, compliance issues remain central. There are limited data on compliance with naltrexone treatment regimens within formalized rehabilitation programs and even less data th...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1046/j.1365-2710.2001.00326.x
更新日期:2001-02-01 00:00:00
abstract:WHAT IS KNOWN AND OBJECTIVE:There are no clinical reports that have compared topiroxostat, a selective xanthine oxidase inhibitor, with allopurinol in serum urate-lowering efficacy. The aim of this study was to compare the efficacy and safety of topiroxostat and allopurinol in Japanese hyperuricemic patients with or wi...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1111/jcpt.12391
更新日期:2016-06-01 00:00:00
abstract::The extent and factors that influence drug use were studied in two rural cohorts of Finnish men. The men aged between 65 and 84 years belonged to the Finnish study population of the 25-year follow-up of the 'Seven Countries Study'. Of the original 1,711 men in 1959, 766 were still alive in 1984. The participation rate...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2710.1990.tb00365.x
更新日期:1990-04-01 00:00:00
abstract::When designing studies of the optimal use of antimicrobial drugs, it is important to define at an early stage, which outcome parameters to use. It must be clear to which category a parameter to be measured belongs: the structure, the process or a clinical outcome. Attention must be paid to the measurement scales as we...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1046/j.0269-4727.2003.00518.x
更新日期:2003-12-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Morphine hydrochloride, a major analgesic drug, is being increasingly administered using portable disposable infusion devices. The objective of this study was to investigate the stability of morphine in such a system at two concentrations (2.50 and 5.00 mg/ ml) over a 30-day period. METHOD:Hig...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1046/j.1365-2710.1997.10475104.x
更新日期:1997-08-01 00:00:00
abstract:WHAT IS KNOWN AND OBJECTIVE:Bevacizumab is a monoclonal antibody that targets vascular endothelial growth factor (VEGF) that has activity in several types of malignancies. One of the uncommon adverse effects is spontaneous bowel perforation. In patients who have undergone cystectomy, a loop of small bowel is often used...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2710.2012.01343.x
更新日期:2012-10-01 00:00:00
abstract::Standard meta-analytical and pharmacoeconomic techniques were used to study the clinical effectiveness and the cost-effectiveness ratio of the prophylactic (or pre-emptive) administration of G-CSF to patients with small cell lung cancer treated with conventional myelosuppressive cytotoxic chemotherapy. In the first pa...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章,meta分析
doi:10.1111/j.1365-2710.1996.tb00001.x
更新日期:1996-04-01 00:00:00
abstract::An information package was developed for general practitioners (GPs) involved in the management of home parenteral nutrition (HPN) patients. The booklet covered five major sections: background information; HPN training; complications of HPN; arrangements for a particular patient; and hospital management of HPN. This s...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2710.1988.tb00210.x
更新日期:1988-12-01 00:00:00
abstract:WHAT IS KNOWN AND OBJECTIVE:It is well known that medication reconciliation at discharge is a key strategy to ensure proper drug prescription and the effectiveness and safety of any treatment. Different types of interventions to reduce reconciliation errors at discharge have been tested, many of which are based on the ...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1111/jcpt.12365
更新日期:2016-04-01 00:00:00
abstract:OBJECTIVE:A population analysis of the kinetics of valproic acid (VPA) in children with epilepsy was performed in order to characterize the covariates which influence VPA clearance (CL). METHODS:A total of 770 steady-state serum concentration samples was analysed. These were collected during VPA therapy from 255 child...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1046/j.1365-2710.1999.00202.x
更新日期:1999-02-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:The application of population pharmacokinetics (PopPK) appears increasingly in drug labelling. The current study was to examine the use of PopPK in dose recommendation in drug-product labels. METHOD:PopPK information was identified in the data sheets included in the physician desk reference (P...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2710.2007.00799.x
更新日期:2007-02-01 00:00:00
abstract:WHAT IS KNOWN AND OBJECTIVE:To assess the equivalent efficacy of two or more treatments, clinical relevance must be adequately established, but there appears to be some confusion between clinical relevance and differences in absolute risk reduction or effect size, which quantifies the size of the difference between two...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1111/jcpt.12243
更新日期:2015-04-01 00:00:00
abstract:WHAT IS KNOWN AND OBJECTIVE:Ceftriaxone is a third-generation cephalosporin with broad-spectrum antibacterial activity. Ceftriaxone-associated urolithiasis and post-renal acute renal failure (PARF) in adults is exceedingly rare and perhaps underappreciated. We report one such case to increase appreciation of this risk ...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type:
doi:10.1111/jcpt.12358
更新日期:2016-06-01 00:00:00
abstract:WHAT IS KNOWN AND OBJECTIVE:Far more patients are now surviving cancer than ever before because of major advances in the diagnosis and treatment of primary and metastatic malignancy. Adjuvant chemotherapeutic drug and combination regimens have contributed to the success. However, persistent residual adverse effects inv...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章,评审
doi:10.1111/j.1365-2710.2010.01208.x
更新日期:2011-08-01 00:00:00
abstract:BACKGROUND:Patients' own medications (POM) are medications that patients have obtained in the community setting and bring to the hospital when admitted. The practice of using POMs has not been well studied. OBJECTIVE:To identify benefits, risks and other impacts on the use of POM in hospitals. METHODS:A systematic se...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章,评审
doi:10.1111/j.1365-2710.2006.00773.x
更新日期:2006-12-01 00:00:00
abstract::Caffeine elimination was studied in 73 patients admitted to an intensive care unit, 33 of whom had liver disease. Mean plasma clearance of caffeine in patients with no liver disease (1.30 +/- 0.79 ml/kg/min) was significantly higher than in patients with liver disease (0.39 +/- 0.23 ml/kg/min). Mean half-life of caffe...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 临床试验,杂志文章
doi:10.1111/j.1365-2710.1995.tb00621.x
更新日期:1995-02-01 00:00:00
abstract:WHAT IS KNOWN AND OBJECTIVE:Serum sialic acid is a recently investigated potential risk-marker for cardiovascular complications. There is a known association between sialic acid and cardiovascular complications in diabetes mellitus. We aimed to investigate the effect of antidiabetic drugs on the serum concentration of ...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2710.2009.01145.x
更新日期:2010-12-01 00:00:00
abstract:WHAT IS KNOWN AND OBJECTIVE:Amlodipine overdose is common; however, the dose and timing of intravenous lipid emulsion (ILE) therapy as a management strategy remain debatable. CASE DESCRIPTION:A 73-year-old man received a single bolus (1.5 mL/kg) of ILE therapy following massive ingestion of multiple drugs, including a...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type:
doi:10.1111/jcpt.13018
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:Personal imports of unapproved drugs are made by physicians and patients in Japan. Such imports require submission of a request for an import certificate from the Regional Bureau of Health and Welfare (RBHW). So far, there have been few reports on personal imports of drugs in Japan. OBJECTIVE:To assess the ...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2710.2008.00941.x
更新日期:2008-10-01 00:00:00
abstract:WHAT IS KNOWN AND OBJECTIVE:Despite the widespread use of proton pump inhibitors (PPIs), little is known about the appropriateness of treatment according to the indications reported by patients and their involvement in the process of treatment discontinuation. In patients who are unlikely to benefit, the medication sho...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1111/jcpt.12371
更新日期:2016-04-01 00:00:00
abstract:WHAT IS KNOWN AND OBJECTIVE:Cytochrome P450 1A2 (CYP1A2), CYP2B6 and inducible nitric oxide synthase (iNOS) are involved in the metabolism and action of many important therapeutic drugs, and genetic variants have been associated with interethnic differences in response to treatment, including chemotherapy. METHODS:Eig...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1111/jcpt.12351
更新日期:2016-02-01 00:00:00
abstract:WHAT IS KNOWN AND OBJECTIVE:Niacin commonly causes cutaneous flushing, which is partially alleviated by laropiprant, a selective antagonist of prostaglandin D2 at the DP1 receptor. Here we report an unusually high incidence of exanthematous eruption associated with the use of the extended-release (ER) niacin/laropipran...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1111/jcpt.12096
更新日期:2013-12-01 00:00:00
abstract::We examined a total of 192 samples, including eight different brands of shaving cream and eight brands of shampoo, for their total aerobic bacterial, coliforms and fungal counts. Shaving creams were more heavily contaminated with bacteria than shampoos. Viable bacterial were not recovered from 57% and 10% of shampoos ...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2710.1989.tb00218.x
更新日期:1989-02-01 00:00:00
abstract:OBJECTIVE:To establish the role of patient characteristics in estimating doses of digoxin for neonates using routine therapeutic drug monitoring data. METHOD:The steady-state blood level data (n = 129) after repetitive oral administration in 71 hospitalized neonates were analysed using Nonlinear Mixed Effects Modellin...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2710.2007.00833.x
更新日期:2007-08-01 00:00:00
abstract:WHAT IS KNOWN AND OBJECTIVE:Admixtures of levobupivacaine, fentanyl and epinephrine are increasingly used in epidural pain management. Neither the compatibility nor the stability of levobupivacaine with fentanyl and epinephrine is known and therefore we examined the chemical, physical and microbiological stability of l...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1111/jcpt.12035
更新日期:2013-04-01 00:00:00