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Medicines, Volume 10, Issue 3 (March 2023) – 6 articles

Cover Story (view full-size image): Lack of reliable information hinders evaluation of suspected herb–drug interactions. This survey-based study analyzes real-life experiences with herb–drug interaction from the perspective of healthcare providers and laypersons. Interactions were evaluated against resources cited for the evaluation of potential supplement–drug interactions. Disproportionality analyses were performed using the FAERS, CFSAN, and CAERS databases. Secondary aims included exploring reasons for respondent use of dietary supplements and qualitative analysis of respondent’s perceptions of dietary supplement–drug interaction. While agreement among reported supplement–drug interactions with commonly cited resources via disproportionality analyses through FAERS was low, agreement using CAERS was high. View this paper

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8 pages, 316 KiB

Open AccessReview

Therapeutic Potential of Two Derivative Prescriptions of Rokumijiogan, Hachimijiogan and Bakumijiogan against Renal Damage in Nephrectomized Rats

by Chan Hum Park, Takashi Tanaka, Yoshie Akimoto, Jin Pyeong Jeon and Takako Yokozawa

Medicines 2023, 10(3), 24; https://doi.org/10.3390/medicines10030024 - 21 Mar 2023

Viewed by 1272

Abstract

Background: Hachimijiogan (HJG) and Bakumijiogan (BJG), two derivative prescriptions of Rokumijiogan (RJG), were selected to investigate their renoprotective potential in the 5/6 nephrectomized (5/6Nx) rat model. Methods: Rats were treated with HJG and BJG orally at 150 mg/kg body weight/day once daily for 10 weeks after resection of 5/6 of the renal volume, and their renoprotective effects were compared with 5/6Nx vehicle-treated and sham-operated control rats. Results: Improvements in renal lesions, glomerulosclerosis, tubulointerstitial injury, and arteriosclerotic lesions estimated by histologic scoring indices in the HJG-treated group were compared with those in the BJG-treated group. HJG- and BJG-treated groups ameliorated the renal function parameters. Elevated levels of renal oxidative stress-related biomarkers were reduced, while decreased antioxidant defence systems (superoxide dismutase and the glutathione/oxidized glutathione ratio) were increased in the HJG-treated group rather than the BJG-treated group. In contrast, BJG administration significantly reduced expression of the inflammatory response through oxidative stress. The HJG-treated group showed a decrease in inflammatory mediators through the JNK pathway. To gain a deeper understanding of their therapeutic action, the effects of the main components detected in HJG and BJG were evaluated using the LLC-PK₁ renal tubular epithelial cell line, which is the renal tissue most vulnerable to oxidative stress. Corni Fructus and Moutan Cortex-originated compositions afforded important protection against oxidative stress induced by peroxynitrite. Conclusions: From our described and discussed analyses, it can be concluded that RJG-containing prescriptions, HJG and BJG are an excellent medicine for chronic kidney disease. In the future, appropriately designed clinical studies in people with chronic kidney disease are necessary to evaluate the renoprotective activities of HJG and BJG. Full article

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7 pages, 285 KiB

Open AccessArticle

Health Technology Assessment of Different Glucosamine Formulations and Preparations Currently Marketed in Thailand

by Olivier Bruyère, Johann Detilleux and Jean-Yves Reginster

Medicines 2023, 10(3), 23; https://doi.org/10.3390/medicines10030023 - 08 Mar 2023

Cited by 1 | Viewed by 1345

Abstract

Objective: The aim of this study was to evaluate the cost-effectiveness of different glucosamine formulations and preparations used for the management of osteoarthritis in Thailand compared with placebo. Methods: We used a validated model to simulate the individual patient Utility score from aggregated data available from 10 different clinical trials. We then used the Utility score to calculate the quality-adjusted life year (QALY) over 3 and 6 months treatment period. We used the public costs of glucosamine products available in Thailand in 2019 to calculate the incremental cost-effectiveness ratio. We separated the analyses for prescription-grade crystalline glucosamine sulfate (pCGS) and other formulations of glucosamine. A cost-effectiveness cut-off of 3.260 USD/QALY was considered. Results: Irrespective of the glucosamine preparation (tablet or powder/capsule), the data show that pCGS is cost-effective compared with placebo over a 3 and 6 months. However, the other glucosamine formulations (e.g., glucosamine hydrochloride) never reached the breakeven point at any time. Conclusions: Our data show that pCGS is cost-effective for the management of osteoarthritis in the Thai context while other glucosamine formulations are not. Full article

11 pages, 311 KiB

Open AccessBrief Report

Evaluation of Nutritional Status in an Acute Geriatric Unit: Retrospective Study and Analysis of Frailty Syndrome

by Abrar-Ahmad Zulfiqar, Ibrahima Amadou Dembele and Emmanuel Andres

Medicines 2023, 10(3), 22; https://doi.org/10.3390/medicines10030022 - 08 Mar 2023

Viewed by 1057

Abstract

Introduction: The aim of our study is to evaluate the nutritional status of patients in an acute geriatric unit. Methods: Patients included in the study were hospitalized in an acute geriatric unit over a period of 6 months. The nutritional status of each patient was evaluated with anthropometric measurements (the BMI and MNA scales), and biological measurements (albumin). Frailty was evaluated using three scales: the Fried scale, the CFS and the modified SEGA scale. Results: A total of 359 patients were included, comprising 251 women (70%) with an average age of 85.28 years. The study showed that 102 elderly subjects were considered undernourished according to the BMI scale, 52 subjects were undernourished according to the MNA scale, and 50 subjects were undernourished according to their albumin levels. The relationships between undernutrition and frailty syndrome studied in our work show that elderly subjects who are undernourished according to the BMI and MNA scales are significantly frail according to Fried and Rockwood, whereas those who are undernourished according to their albumin levels are significantly frail according to Fried and the modified SEGA scale. Conclusion: The relationship between undernutrition and the frailty syndrome is close, and their joint screening is necessary, whether on an outpatient or in-hospital basis, in order to prevent negative events related to comorbidities and geriatric syndromes. Full article

(This article belongs to the Special Issue Frailty Syndrome in the Elderly: A Real Challenge for Our Society)

8 pages, 855 KiB

Open AccessBrief Report

Effect of Dexamethasone on Abiraterone Pharmacokinetics in Mice: Determined by LC/MS Analysis

by Subrata Deb, Mohamed Ben-Eltriki, Hans Adomat, Mei Y. Chin and Emma S. Tomlinson Guns

Medicines 2023, 10(3), 21; https://doi.org/10.3390/medicines10030021 - 06 Mar 2023

Cited by 1 | Viewed by 1757

Abstract

Background: Abiraterone acetate is a cytochrome P450 17A1 (CYP17A1) inhibitor that is indicated for use in both castration-resistant and castration-sensitive prostate cancer patients. To manage the mineralocorticoid effects of CYP17A1 inhibition, a glucocorticoid such as dexamethasone is co-administered with abiraterone. The goal of the present study was to understand the effect of dexamethasone on the disposition of abiraterone. Methods: Adult male CD-1 mice were treated with either dexamethasone (80 mg/kg/day) or vehicle for three consecutive days, followed by the administration of a single dose of abiraterone acetate (180 mg/kg) as an oral gavage. Blood samples were collected by tail bleeding at timepoints between 0 to 24 h. Subsequently, abiraterone was extracted from the mouse serum using a neutral pH condition and serum abiraterone levels were determined using a liquid chromatography–mass spectrometry assay. Results: Our results demonstrated that dexamethasone lowered the maximum plasma concentration and area under the curve parameters by approximately five- and ten-fold, respectively. Similar effects were also observed on the plasma half-life and oral clearance parameters. This is the first report of dexamethasone effect on abiraterone disposition in vivo. Conclusions: We conclude that dexamethasone has the potential to reduce the plasma abiraterone level and thus compromise its CYP17A1 inhibitory ability in the procancerous androgen biosynthesis pathway. Thus, use of a higher abiraterone dose may be warranted when used alongside dexamethasone. Full article

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16 pages, 1209 KiB

Open AccessArticle

Everyday Evaluation of Herb/Dietary Supplement–Drug Interaction: A Pilot Study

by Joao Victor Souza-Peres, Kimberly Flores, Bethany Umloff, Michelle Heinan, Paul Herscu and Mary Beth Babos

Medicines 2023, 10(3), 20; https://doi.org/10.3390/medicines10030020 - 28 Feb 2023

Viewed by 2069

Abstract

A lack of reliable information hinders the clinician evaluation of suspected herb–drug interactions. This pilot study was a survey-based study conceived as a descriptive analysis of real-life experiences with herb–drug interaction from the perspective of herbalists, licensed health-care providers, and lay persons. Reported dietary supplement–drug interactions were evaluated against the resources most commonly cited for the evaluation of potential supplement–drug interactions. Disproportionality analyses were performed using tools available to most clinicians using data from the U.S. Federal Adverse Event Reporting System (FAERS) and the US Center for Food Safety and Applied Nutrition (CFSAN) Adverse Event Reporting System (CAERS). Secondary aims of the study included exploration of the reasons for respondent use of dietary supplements and qualitative analysis of respondent’s perceptions of dietary supplement–drug interaction. While agreement among reported supplement–drug interactions with commonly cited resources for supplement–drug interaction evaluation and via disproportionality analyses through FAERS was low, agreement using data from CAERS was high. Full article

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19 pages, 2416 KiB

Open AccessArticle

Clinical Benefit of Autologous Platelet-Rich Plasma Infusion in Ovarian Function Rejuvenation: Evidence from a Before-After Prospective Pilot Study

by Athanasios Garavelas, Panagiotis Mallis, Efstathios Michalopoulos and Eros Nikitos

Medicines 2023, 10(3), 19; https://doi.org/10.3390/medicines10030019 - 27 Feb 2023

Cited by 4 | Viewed by 4761

Abstract

Background: The intraovarian administration of autologous platelet-rich plasma (PRP) acts beneficially for the stimulation of follicle production in women presenting different forms of ovarian dysfunction. This pilot study aimed to evaluate and provide significant data regarding the efficacy of PRP to rejuvenate the ovaries. Methods: A total of 253 women aged 22–56 years, were divided into five groups, based on their status. All participants signed for informed consent for the current study. Blood sampling, preparation of PRP and intraovarian infusion of the latter were performed on all participants. The evaluation of PRP efficacy, a two-month follow-up detecting the levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2) and anti-mullerian hormone (AMH), was performed for all participants. For women with advanced ages (>48 years), the restoration and regularity of the menstrual cycle were additionally evaluated. Results: After the two-month follow-up, the majority of the participants presented improvement in their hormonal profiles. Additionally, 17% of the women in this pilot study successfully conceived. The restoration of the menstrual cycle was detected in 15% of the women with advanced ages. Conclusions: Intraovarian infusion of autologous PRP exhibited remarkable evidence and promising results to restore ovarian insufficiency. Full article

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