Clinical therapeutics
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Clinical therapeutics · Mar 2015
Meta AnalysisEffect of the urinary tryptin inhibitor ulinastatin on cardiopulmonary bypass-related inflammatory response and clinical outcomes: a meta-analysis of randomized controlled trials.
Cardiopulmonary bypass (CPB) can cause systemic inflammatory responses and a series of subsequent complications that may harm patients. The aim of this study was to explore the effects of ulinastatin on inflammatory responses and clinical outcomes of CPB via a meta-analysis of published randomized controlled trials. ⋯ This meta-analysis found that changes in inflammatory cytokines occurred in a time-dependent manner and that the use of ulinastatin resulted in decreased duration of mechanical ventilation with CPB compared with placebo.
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Clinical therapeutics · Mar 2015
Randomized Controlled TrialEfficacy and tolerability of intranasal fentanyl spray in cancer patients with breakthrough pain.
The aims of this study were to explore the efficacy of intranasal fentanyl spray* (INFS) 400 μg to evaluate 12-week tolerability of the nasal mucosa and to explore safety data for all dose strengths of INFS in patients with cancer-related breakthrough pain (BTP). ⋯ INFS 400 μg is effective and nasal tolerability and overall safety profile is acceptable during 12 weeks of use. ClinicalTrials.gov identifier: NCT01429051.
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Clinical therapeutics · Mar 2015
Randomized Controlled TrialPharmacokinetics and pharmacodynamics of ticagrelor and prasugrel in healthy male Korean volunteers.
A combination of clopidogrel and aspirin is the standard treatment for patients with acute coronary syndrome and those undergoing percutaneous coronary intervention. Two novel antiplatelet agents, ticagrelor and prasugrel, have been shown to rapidly and more effectively inhibit the P2Y12 receptor compared with clopidogrel. The aim of this study was to evaluate and compare the pharmacokinetics (PK) and pharmacodynamics (PD) of ticagrelor and prasugrel in healthy male Korean volunteers. ⋯ Prasugrel 30 and 60 mg exhibited slightly stronger, more rapid, and sustainable platelet inhibitory effects compared with ticagrelor 180 mg. These differing effects should be considered when determining the efficacy and adverse effects of ticagrelor and prasugrel. ClinicalTrials.gov identifier: NCT01876797 and NCT02075268.
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Clinical therapeutics · Mar 2015
Effects of noninvasive positive pressure ventilation on oxygenation status and prognosis in patients with acute paraquat-induced lung injury.
The aim of this study was to evaluate the effects of noninvasive positive pressure ventilation (NIPPV) on oxygenation status and prognosis in patients with acute lung injury induced by paraquat (PQ) poisoning. ⋯ NIPPV may effectively improve oxygenation status in patients with acute PQ-induced lung injury, thereby relieving dyspnea and promoting the recovery of pulmonary function. PIinit and PImax may be important determinants of prognosis in acute PQ-induced lung injury. These findings need further verification in a large-scale, multicenter, randomized controlled study that combines other factors with a relatively long-term follow-up.
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Clinical therapeutics · Mar 2015
Observational StudyEffects of rivaroxaban versus warfarin on hospitalization days and other health care resource utilization in patients with nonvalvular atrial fibrillation: an observational study from a cohort of matched users.
Compared with warfarin, the new target-specific oral anticoagulant agents may have advantages, such as shorter hospital length of stay, in patients with nonvalvular atrial fibrillation (NVAF). The objective of the present study was to assess, among patients with NVAF, the effects of rivaroxaban versus warfarin on the number of hospitalization days and other health care resource utilization in a cohort of rivaroxaban users and matched warfarin users. ⋯ In this study conducted in clinical practice, the estimated mean numbers of hospitalization days, outpatient visits, and AF-related hospitalizations associated with rivaroxaban were significantly less than were those associated with warfarin in these patients with NVAF. The corresponding estimated difference in all-cause ED visits was not statistically significant.