Clinical therapeutics
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Clinical therapeutics · Mar 2012
The influence of sparse data sampling on population pharmacokinetics: a post hoc analysis of a pharmacokinetic study of morphine in healthy volunteers.
Intensive sampling of patients for drugs with complex pharmacokinetic profiles is difficult to perform in the clinic or hospitalized patient setting. We seek to address whether sparse sampling can obtain pharmacokinetic parameter values similar to those with traditional modeling from a post hoc analysis of 2 previous clinical trials. ⋯ This post hoc analysis suggests that intensive sampling for discerning complex, 3-compartment pharmacokinetic models, such as morphine, may not be necessary. Sparse sampling achieved accurate model structure recognition and parameter identification for predicting concentrations of very complex drug-dosage regimens.
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Clinical therapeutics · Mar 2012
ReviewPazopanib for the treatment of metastatic renal cell carcinoma.
Renal cell carcinoma (RCC) is the most common cancer in the kidneys. Until 2005, treatment options were limited to immunotherapy. Since that time, there have been numerous targeted therapy agents approved with improved efficacy toward RCC. Pazopanib is a multi-tyrosine kinase inhibitor that was approved by the US Food and Drug Administration in October 2009 and by the European Medicines Agency in June 2010 for the treatment of metastatic RCC. ⋯ Pazopanib is reportedly effective in the treatment of metastatic RCC. Although there are currently no direct comparisons between pazopanib and other tyrosine kinase inhibitors, the data suggest that pazopanib may be a first-line option in the treatment of RCC. The only Phase III trial of pazopanib suggests improvement of progression-free survival in RCC as well as tolerability in the selected population.
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Clinical therapeutics · Mar 2012
A retrospective database analysis of neuropathic pain and oral antidiabetic medication use and adherence among Texas adults with type 2 diabetes enrolled in Medicaid.
Adherence to oral antidiabetic (OAD) medications is essential in achieving glycemic control and slowing the progression of diabeties-related complications such as neuropathic pain. OAD medication adherence has been suboptimal and adding neuropathic pain medications may negatively affect adherence. However, little is known about adherence to neuropathic pain medications by patients with diabetes and how this may be related to OAD medication adherence. ⋯ Overall, these data suggest that mean adherence to both PDPN and OAD medications was suboptimal (MPR <80%). Patients who were adherent to PDPN medications were more adherent to OAD medications in the post-index period, but OAD medication adherence was independent of the type of PDPN medication used. OAD adherence decreased from pre- to post-index (ie, when patients were prescribed PDPN medications), which may indicate an opportunity for practitioners to emphasize the importance of OAD adherence in reducing the progression to neuropathy.