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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]

Abstract

International Journal of Clinical Pharmacology and Therapeutics, Vol. 54 – No. 6/2016 (471-473)

Vincristine-induced paralytic ileus during induction therapy of treatment protocols for acute lymphoblastic leukemia in adult patients

Takeo Yasu¹, Nobuhiro Ohno², Toyotaka Kawamata², and Yosuke Kurokawa¹

¹Department of Pharmacy, and ²Department of Hematology/Oncology, The Research Hospital, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
Vincristine (VCR) is an important drug used in the treatment of acute lymphoblastic leukemia (ALL). VCR-induced neurotoxicity can manifest as peripheral neuropathy, constipation, or paralytic ileus. While there are some case reports describing VCR-induced paralytic ileus (VIPI) in pediatric ALL, there are fewer publication on adult ALL patients. Therefore, we retrospectively investigated VIPI during induction therapy of treatment protocols for ALL in 19 adult patients. The incidence of VIPI was 32%. VIPI was significantly increased in patients receiving concomitant itraconazole (ITCZ) (p = 0.04). We recommend avoidance of the combination of VCR and ITCZ.Correspondence to:
Takeo Yasu, PhD
The Research Hospital
The Institute of Medical Science
The University of Tokyo
4-6-1, Shirokanedai, Minato-ku, Tokyo 108-8639, Japan
Email: [email protected]

Abstract

International Journal of Clinical Pharmacology and Therapeutics, Vol. 54 – No. 12/2016 (1009-1011)

The efficacy of febuxostat 10 mg for the prevention of hyperuricemia associated with tumor lysis syndrome (TLS) in Japanese patients with non-Hodgkin’s lymphoma 

Takeo Yasu, Shunsuke Kobayashi, Mai Horii, Yosuke Kurokawa

Department of Pharmacy, The Research Hospital, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
Tumor lysis syndrome (TLS) is a life-threatening oncologic emergency. The control of serum uric acid level (UA) is important for prevention of TLS. Febuxostat has demonstrated its superiority over allopurinol in decreasing UA level. We retrospectively evaluated the efficacy of febuxostat 10 mg in prevention of hyperuricemia associated with TLS (HU-TLS) in 12 patients with non-Hodgkin’s lymphoma (NHL). Mean UA levels were found to significantly decrease (p = 0.003). HU-TLS was prevented in all patients. Thus, febuxostat 10 mg is effective in prevention of HU-TLS. Future study is need to determine whether the incidence of HU-TLS change with dosage of febuxostat. Correspondence to:
Takeo Yasu, PhD 
The Research Hospital
The Institute of Medical Science
The University of Tokyo
4-6-1, Shirokanedai, Minato-ku,
Tokyo 108-8639, Japan 
Email: yasutakeo-tky@ umin.ac.jp

Abstract

International Journal of Clinical Pharmacology and Therapeutics, Vol. 55 – No. 10/2017 (807-810)

Hypersensitivity reaction to β-lactam antibiotics in patients with adult T-cell leukemia/lymphoma treated with mogamulizumab 

Takeo Yasu¹, Yoichi Imai², Nobuhiro Ohno², Kaoru Uchimaru³, Yosuke Kurokawa¹, and Arinobu Tojo²

¹Department of Pharmacy, ²Department of Hematology/Oncology,  The Institute of Medical Science, and ³Laboratory of Tumor Cell Biology, Department of Computational Biology and Medical Sciences,  Graduate School of Frontier Sciences, The University of Tokyo, Tokyo, Japan
Mogamulizumab (MOG) is a humanized anti-CCR4 monoclonal antibody that is highly cytotoxic for adult T-cell leukemia/lymphoma (ATL) cells. Most non-hematological adverse events are cutaneous adverse reactions in ATL patients. We reviewed the medical records of 24 patients with CCR4-positive aggressive ATL who had received MOG treatment. The incidence of MOG-induced cutaneous adverse reactions (MCARs) was 25% (6 patients). Four patients with MCAR had an interesting clinical course, compared with MCARs reported in previous reports. The factors causing MCAR were suspected to be cefepime, cefozopran, and piperacillin/tazobactam. We consider that hypersensitivity reaction to β-lactam antibiotics is involved in a significant proportion of MCARs. Correspondence to:
Takeo Yasu, PhD 
Department of Pharmacy
The Institute of Medical Science
The University of Tokyo
4-6-1, Shirokanedai, Minato-ku, Tokyo 108-8639, Japan
Email:  yasutakeo-tky@ umin.ac.jp

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