High-Dose Chemotherapy in Breast CancerLake, Diana; Hudis, Clifford
doi: 10.2165/00003495-200464170-00001pmid: 15329034
High-dose chemotherapy is based on the scientific hypothesis that escalating the dose of drug will overcome drug resistance and improve outcome. Autologous bone marrow transplantation and, more recently, peripheral stem cell transplantation used as a means to restore marrow, made this a viable treatment for patients with selected tumours such as haematological malignancies. The role in breast cancer is less certain.
Androgen Replacement TherapyGooren, Louis; Bunck, Mathijs
doi: 10.2165/00003495-200464170-00002pmid: 15329035
The major goal of androgen substitution is to replace testosterone at levels as close to physiological levels as is possible. For some androgen-dependent functions testosterone is a pro-hormone, peripherally converted to 5α-dihydrotestosterone (DHT) and 17β-estradiol (E2), of which the levels preferably should be within normal physiological ranges. Furthermore, androgens should have a good safety profile without adverse effects on the prostate, serum lipids, liver or respiratory function, and they must be convenient to use and patient-friendly, with a relative independence from medical services.
Amphotericin B Lipid ComplexGoldsmith, David; Perry, Caroline
doi: 10.2165/00003495-200464170-00004pmid: 15329037
▴ Amphotericin B lipid complex is a lipid formulation of amphotericin B, an antifungal drug with activity against Leishmania spp. Amphotericin B lipid complex appears to enhance uptake of amphotericin B by infected macrophages in patients with visceral leishmaniasis (VL).
▴ In randomised, open-label, dose-ranging studies, short-course treatment with once-daily amphotericin B lipid complex (5–15 mg/kg total cumulative dose over 5 days), administered by intravenous infusion, produced high rates of apparent (day 19) [93–100%] and definitive (6 months) [79–100%] cures in Indian patients with antimonial-resistant VL.
▴ Amphotericin B lipid complex appeared to be as effective as liposomal amphotericin B or the conventional deoxycholate formulation in a randomised, open-label study conducted in India in a mixed population of patients with previously untreated or antimonial-resistant VL.
▴ In patients with HIV infection and VL, amphotericin B lipid complex 3 mg/kg/day for 5 or 10 days appeared to be as effective as meglumine antimonate 20 mg/kg/day for 28 days in a small randomised pilot study in southern Europe.
▴ Amphotericin B lipid complex was generally well tolerated in patients with VL. Infusion-related reactions were the most common adverse events associated with amphotericin B lipid complex.
Delayed-Release Lansoprazole plus NaproxenCurran, Monique; Wellington, Keri
doi: 10.2165/00003495-200464170-00008pmid: 15329041
▴ A combination package containing delayed-release capsules of the proton pump inhibitor lansoprazole (15mg once daily) and tablets of the NSAID naproxen (375 or 500mg twice daily) has been approved for reducing the risk of NSAID-associated gastric ulcers in NSAID-requiring patients with a documented history of gastric ulcer.
▴ In a large, 12-week trial in NSAID (including naproxen)-requiring patients with a documented history of gastric ulcer, significantly more recipients of delayed-release lansoprazole 15mg once daily than placebo recipients were free from gastric ulcer (p < 0.001). At week 12, the percentages of patients who were free from gastric ulcer were 80% with lansoprazole 15mg and 51% with placebo.
▴ In a subgroup analysis of recipients of naproxen (89% received 750–1000 mg/day), the percentage of patients free from gastric ulcer after 12 weeks of treatment was significantly higher with delayed-release lansoprazole 15mg than with placebo (89% vs 33%; p < 0.001).
▴ In NSAID (including naproxen)-requiring patients with a documented history of gastric ulcer, the incidence of treatment-related adverse events in recipients of delayed-release lansoprazole 15mg once daily was low (7%), and similar to that in recipients of placebo (10%).