Dustri Online Services

Search Results

Books: 0	Journals: 1	Articles: 2

Original

Efficacy of H2 receptor antagonists for prevention of upper gastrointestinal bleeding during dual-antiplatelet therapy

Takeo Yasu, Noriko Sato, Yosuke Kurokawa, Shigeru Saito and Masaru Shoji

Price
42.00 $

Add to Cart

Price

42.00 $

Volume 51 p. 854 - 860

Abstract

International Journal of Clinical Pharmacology and Therapeutics, Vol. 51 – No. 11/2013 (854-860)

Efficacy of H2 receptor antagonists for prevention of upper gastrointestinal bleeding during dual-antiplatelet therapy

Takeo Yasu¹,²,³, Noriko Sato⁴, Yosuke Kurokawa², Shigeru Saito⁵ and Masaru Shoji³

¹Department of Pharmacy, Shonan Kamakura General Hospital, Kanagawa, ²Department of Pharmacy, The Research Hospital, The Institute of Medical Science, The University of Tokyo, ³Department of Pharmacodynamics, Meiji Pharmaceutical University, Tokyo, ⁴Department of Pharmacy, Hayama Heart Center, and ⁵Department of Cardiology and Catheterization Laboratory and Heart Center, Shonan Kamakura General Hospital, Kanagawa, Japan
Proton pump inhibitors (PPI) are frequently used to prevent upper gastrointestinal bleeding (UGIB) in patients receiving dual-antiplatelet therapy (DAPT) with aspirin and clopidogrel. However, the concomitant therapy of PPI and DAPT has been associated with a decreased effect of the antiplatelet drugs and an increased risk of major adverse cardiovascular events (MACE). It has been suggested that histamine H2 receptor antagonists (H2RA) can be used as alternatives to PPI to prevent UGIB during DAPT without an increase in the risk of MACE. We tested this hypothesis in a retrospective cohort study including patients without a prior history of upper gastrointestinal events. We examined the incidence of UGIB and MACE in 296 patients treated with H2RA (H2RA group) and 447 patients not treated with H2RA (control group) during DAPT with aspirin and clopidogrel after drug-eluting stent implantation. The patients treated with PPI were excluded. In the 1-year follow-up, UGIB occurred in 2 patients (0.7%) in the H2RA group and 12 (2.7%) in the control group. The incidence of UGIB was significantly different between the two groups (p = 0.049 in log-rank test). MACE occurred in 31 patients (10.5%) in the H2RA group and in 54 patients (12.1%) in the control group, and the incidence was not significantly different (p = 0.447 in logrank test). Thus, H2RA may be effective safe alternatives to PPI during DAPT in patients without a prior history of upper gastrointestinal events.Correspondence to:
Takeo Yasu, MSc
The Research Hospital
The Institute of Medical Science
The University of Tokyo
4-6-1, Shirokanedai, Minatoku, Tokyo 108-8639, Japan
Email: [email protected]

Original

Nadir lymphocytopenia as a risk factor of bloodstream infection during molecular targeting pharmacotherapy in multiple myeloma

Yukihiro Shimizu, Hiroaki Inoue, Shigeru Hishinuma, and Masaru Shoji

Price
42.00 $

Add to Cart

Price

42.00 $

Volume 57 (2019) p. 542 - 551

Abstract

International Journal of Clinical Pharmacology and Therapeutics, Vol. 57 – No. 11/2019 (542-551)

Nadir lymphocytopenia as a risk factor of bloodstream infection during molecular targeting pharmacotherapy in multiple myeloma

Yukihiro Shimizu¹#², Hiroaki Inoue¹, Shigeru Hishinuma², and Masaru Shoji²

¹Department of Pharmacy, National Defense Medical College Hospital, Tokorozawa, Saitama, and ²Department of Pharmacodynamics, Meiji Pharmaceutical University, Kiyose, Tokyo, Japan
Objective: Molecular targeting pharmacotherapy (MTP) with proteasome inhibitors and immunomodulatory drugs has led to a remarkable improvement in the effectiveness of multiple myeloma (MM) therapy. However, the effect of MTP on the occurrence of infections in patients with MM remains unclear. We aimed to identify the incidence of and risk factors for bloodstream infection (BSI) in patients with MM undergoing MTP.

Materials and methods: We conducted a retrospective cohort study. We reviewed the medical records of 108 inpatients with MM at the National Defense Medical College Hospital between January 2010 and January 2017. Univariate and multivariate analyses were conducted to identify risk factors for BSI.

Results: The incidence of BSI in patients with MM receiving MTP (n = 188) was 6.9%, which was significantly lower than the 52.6% in patients receiving cytotoxic chemotherapy (n = 57). We found that the most important risk factor for BSI in patients receiving MTP was lymphocytopenia at nadir (< 200/µL). In contrast, the risk factor for BSI in patients receiving cytotoxic chemotherapy was the number of regimens performed.

Conclusion: Our study suggests that the incidence of BSI is lower in patients with MM receiving MTP than in those receiving cytotoxic chemotherapy and that lymphocytopenia at nadir may be a risk factor for BSI in patients with MM receiving MTP. Since previous clinical trials with MTP showed that the frequency of myelosuppression and infections was high in the Japanese population, these findings might provide novel insights into MTP for Japanese patients with MM. Correspondence to:
 Shigeru Hishinuma, PhD,
Department of  Pharmacodynamics
Meiji Pharmaceutical University
2-522-1 Nosio, Kiyose, Tokyo 204-8588, Japan
Email: [email protected]

Shopping Overview

Shopping Overview
Type	Qtty	Discount	VAT	Price
Your basket is empty

View Cart

Search Results

Shopping Overview

Send us an E-Mail