Expert opinion on investigational drugs
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Expert Opin Investig Drugs · Aug 2008
ReviewCarbamylated erythropoietin to treat neuronal injury: new development strategies.
Carbamylated erythropoietin (CEPO) is a modified erythropoietin molecule not affecting hematocrit. It is a potentially important pharmacological agent that may be applied to the treatment of several diseases affecting central and peripheral system neurons. ⋯ Use of CEPO in treating diseases such as stroke and traumatic brain and spinal cord injuries is important because these conditions affect millions of patients every year. Extensive preclinical studies support further clinical studies of CEPO for acute ischemic stroke. However, further studies are required for testing CEPO in patients with many other indications.
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Expert Opin Investig Drugs · Jun 2008
ReviewIncretin mimetics and dipeptidyl peptidase 4 inhibitors in clinical trials for the treatment of type 2 diabetes.
Exenatide is an incretin mimetic, while sitagliptin and vildagliptin are incretin enhancers used as adjunctive therapy in patients with type 2 diabetes failing oral agents. Sitagliptin and vildagliptin can also be used as monotherapy in patients with type 2 diabetes uncontrolled by diet. ⋯ Exenatide, sitagliptin and vildagliptin are useful add-on therapy for type 2 diabetes that is suboptimally controlled on oral agents, particularly when there is concern about weight gain and hypoglycemia, or when postprandial hyperglycemia is the major cause of inadequate glycemic control. Sitagliptin and vildagliptin may be used as monotherapy in patients who cannot tolerate metformin or SU, and sitagliptin may be used as alternative to metformin in renal insufficiency.
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Rivaroxaban is a small molecule, direct Factor Xa inhibitor and may be a potentially attractive alternative to vitamin K antagonists. Rivaroxaban is being investigated for the prevention and treatment of venous and arterial thrombosis. A broad search of Medline, clinicaltrials.gov and the annual proceedings of the American Society of Hematology and the International Society on Thrombosis and Hemostasis was conducted. ⋯ Additionally, rivaroxaban is being evaluated for the treatment of pulmonary embolism, secondary prevention after acute coronary syndromes and the prevention of stroke and non-central nervous system embolism in patients with non-valvular atrial fibrillation. The drug may have its greatest impact in providing a much-needed and attractive alternative to warfarin. Further data (especially large Phase III trials) are required.
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Expert Opin Investig Drugs · May 2008
ReviewVernakalant--a promising therapy for conversion of recent-onset atrial fibrillation.
This paper reviews the pharmacology, electrophysiology, efficacy and safety of intravenous and oral vernakalant hydrochloride (RSD-1235), a novel antiarrhythmic drug that has relative atrial selectivity by blocking potassium channels that are present in the atria and not the ventricle. In addition, this drug has important rate-dependent sodium channel blocking properties. ⋯ Intravenous vernakalant has the potential to be an important agent in the conversion of atrial fibrillation and oral vernakalant may be a useful drug for the suppression of atrial fibrillation recurrences.
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Expert Opin Investig Drugs · Mar 2008
ReviewBrivaracetam: a new drug in development for epilepsy and neuropathic pain.
Epilepsy is a neurological disorder with a worldwide prevalence estimated to be 0.5-1.0% of the population. Many potent antiepileptic drugs (AED) have been used for treatment but still about 30% of patients are resistant to current AEDs. Some AEDs are also used for the treatment of neuropathic pain. ⋯ Brivaracetam represents a new mechanism of action being a ligand of synaptic vesicle protein 2A. It is undergoing Phase III evaluation after a successful Phase II programme in which was effective as an adjunctive treatment in partial-onset epilepsy (50 mg/day). It is well tolerated, without serious adverse side effects.