pH敏感PAMAM树状大分子复合物胶束的制备及性质研究

目的利用聚乙二醇-聚磺胺二甲氧嘧啶(PEG-b-PSD)和PAMAM树状大分子制备具有pH敏感性的复合物胶束并对其制剂学性质进行研究。方法利用正负电荷的相互作用使PEG-b-PSD与PAMAM树状大分子在pH值为7.4条件下形成复合物胶束。考察正负电荷比、离子强度等对zeta电位、载药效果和粒径的影响。利用透射电镜观察制剂形态,考察制剂在不同pH缓冲液和血浆中的释放行为。结果采用正负电荷比为1∶1制备PAMAM/PEG-b-PSD复合物,制剂粒径为50 nm左右,形态为类球形,体外释放速率在pH值为6.5的PBS水溶液中要明显慢于在pH值为7.4的PBS水溶液和血浆中。结论 PEG-b-PSD与PAMAM利用正负电荷相互吸引的方式形成复合物,该复合物具有明显的pH值敏感性,适用于在低pH值部位定位释放药物。     

Contribution of hydrophobicity,DNA and proteins to the cytotoxicity of cationic PAMAM dendrimers

In most articles, cytotoxicity of cationic polyamidoamine (PAMAM) dendrimers toward red blood cells has been exclusively explained by their surface charge. We have focused on dendrimer hydrophobicity as a second possible factor that determines this cytotoxicity. Using PAMAM-NH₂ dendrimers from the 3rd to the 6th generations and PAMAM-NH₂-C₁₂(25%) dendrimer of the 4th generation bearing 25% acyl groups, these induced hemolysis that increased with their surface charge and hydrophobicity. Interaction of PAMAM-NH₂-C₁₂(25%) G4 dendrimer with blood proteins (γ-globulin, α-thrombin, human serum albumin) and calf thymus DNA (ctDNA) significantly reduced their cytotoxicity toward red blood cells.     

Stability and in vitro release profile of enalapril maleate from different commercially available tablets: possible therapeutic implications

Stability of enalapril maleate formulations can be affected when the product is exposed to higher temperature and humidity, with the formation of two main degradation products: enalaprilat and a diketopiperazine derivative. In this work, stability and drug release profiles of 20 mg enalapril maleate tablets (reference, generic and similar products) were evaluated. After 180 days of the accelerated stability testing, most products did not exhibit the specified amount of drug. Additionally, drug release profiles were markedly different from that of the reference product, mainly due to drug degradation. Changes in drug concentration and drug release profile of enalapril formulations are strong indicators of a compromised bioavailability, with possible interferences on the therapeutic response for this drug.     

Critical appraisal of commercially available suspending vehicles for extemporaneous compounding of cardiovascular medicines: physical and chemical stability mini review

Oral liquid formulations are compounded by pharmacists to meet the needs of patients when a suitable commercially available product is not available. To minimize the errors associated with measuring multiple excipients and to enhance the shelf-life of the medicines, commercially available suspending bases are commonly used. This review aims to compare the stability and shelf life of commercially available extemporaneous formulation to traditional formulation methods. Five (5) databases were searched (Pubmed, SCOPUS, Science direct, Embase, and EBSCOhost). Twelve articles, comprising of seven cardiovascular medications (amiodarone, captopril, carvedilol, furosemide, nifedipine, sotalol, and valsartan), met the study inclusion criteria and were reviewed. Chemical stability of the drugs was comparable between the two formulation methods except for furosemide, captopril, and valsartan. The traditional compounding method provided superior stability for furosemide (90?vs. 14?days) and captopril (50?vs. 14?days), while the commercial vehicles provided superior stability for valsartan (90?vs. 14?days). Physical stability tests indicated that sedimentation does occur with both formulation methods. Microbial studies within the data were lacking and further research can be undertaken in this area. This review highlights the importance of assessing the suitability of compounding ingredients prior to preparation of the formulation.     

大豆异黄酮对2型糖尿病大鼠血清中SOD MDA GSH及NO的影响

目的研究大豆异黄酮对2型糖尿病大鼠血清中超氧化物歧化酶(SOD)、丙二醛(MDA)、还原型谷胱甘肽(GSH)及一氧化氮(NO)的影响。方法以高脂饲料喂养后的雄性SD大鼠腹腔注射小剂量链脲佐菌素(STZ)诱导2型糖尿病模型。将实验动物随机分为普食对照组、糖尿病对照组、大豆异黄酮250mg/kg、50mg/kg剂量干预组。检测各组喂养6周、10周的血糖水平,检测第10周后大鼠血清中SOD、MDA、GSH及NO的变化。结果与糖尿病对照组相比,大豆异黄酮250mg/kg剂量干预组大鼠血清中的SOD明显升高(P<0.05),MDA与NO明显下降(P<0.05);大豆异黄酮50mg/kg剂量干预组大鼠血清中GSH明显升高(P<0.05)。结论大豆异黄酮能改善2型糖尿病大鼠的抗氧化能力。     

Terpyridines and their complexes with first row transition metal ions: cytotoxicity, nuclease activity and self-assembly of biomacromolecules

Transition metal complexes with terpyridine ligands have attracted a widespread interest with respect to biomedical applications: [(tpy)PtCl]Cl and [(tpy)RuCl(3)] are potent anti-tumor agents with activities comparable to those of cisplatin and carboplatin. The Ru(II) complexes feature a high potential as reactive probes for DNA oxidation; whereas, luminescent Ir(III), Pt(II) or Eu(III) complexes have been utilized in biolabeling applications. Besides complexes based on heavy second or third row transition metal ions, remarkable results have been obtained with respect to the development of new types of metallodrugs, based on the naturally more abundant and intrinsically less toxic first row transition metal ions (e.g. Fe(II), Cu(I/II), Zn(II)). The perspective of these complexes in particular with respect to future biomedical applications in chemotherapy and cleavage of nucleic acids is evaluated in this review.     

Gallium(III) and iron(III) complexes of alpha-N-heterocyclic thiosemicarbazones: synthesis, characterization, cytotoxicity, and interaction with ribonucleotide reductase

A series of gallium(III) and iron(III) complexes with five different 4N-substituted alpha-N-heterocyclic thiosemicarbazones, viz., 2-acetylpyridine N,N-dimethylthiosemicarbazone (1), 2-acetylpyridine N-pyrrolidinylthiosemicarbazone (2), acetylpyrazine N,N-dimethylthiosemicarbazone (3), acetylpyrazine N-pyrrolidinylthiosemicarbazone (4), and acetylpyrazine N-piperidinylthiosemicarbazone (5), with the general formula [GaLCl2] (HL = 1 and 2) and [ML2][Y] (M = Ga, HL = 1-5, Y = PF6; M = Fe, HL = 1-5, Y = FeCl4 and PF6) were synthesized and characterized by elemental analysis, a number of spectroscopic methods (NMR, IR, UV-vis), mass spectrometry, and X-ray crystallography. The in vitro antitumor potency was studied in two human cancer cell lines (41M and SK-BR-3). The central metal ions exert pronounced effects in a divergent manner: gallium(III) enhances, whereas iron(III) weakens the cytotoxicity of the ligands. The capacity of ligand 1 and its Ga(III) and Fe(III) complexes to destroy the tyrosyl radical of the presumed target ribonucleotide reductase is reported.     

In vitro evaluation of 9-(2-phosphonylmethoxyethyl)adenine ester analogues,a series of anti-HBV structures with improved plasma stability and liver release

Chronic hepatitis B virus (HBV) infection may lead to liver cirrhosis and hepatocellular carcinoma, but few drugs are available for its treatment. Acyclic nucleoside phosphonates (ANPs) have remarkable antivirus activities but are not easily absorbed from the gastrointestinal tract and accumulate in the kidneys, resulting in nephrotoxicity. Therefore, there is a need to find effective liver site-specific prodrugs. The dipivaloyloxymethyl ester of 9-(2-phosphonylmethoxyethyl)adenine (PMEA)—adefovir dipivoxil (ADV)—is a first-line therapy drug for chronic hepatitis B with a low therapeutic index because of renal toxicity and low hepatic uptake. In this study, a series of PMEA derivatives were synthesized to enhance plasma stability and liver release. The metabolic stability of ADV (Chemical I) and its two analogues (Chemicals II and III) was evaluated in rat plasma and liver homogenate in vitro. An ion-pair reverse-phase HPLC–UV method and a hybrid ion trap and high-resolution time-of-flight mass spectrometry (LC-IT-TOF-MS) were used to evaluate the degradation rate of the analogues and to identify their intermediate metabolites, respectively. Chemicals I and II were hydrolyzed by cleavage of the C–O bond to give monoesters. Sufficient enzymatic activation in the liver homogenate through a relatively simple metabolic pathway, in addition to a favorable stability profile in rat plasma, made Chemical II an optimal candidate. Next, six analogues based on the structure of Chemical II were synthesized and evaluated in plasma and liver homogenate. Compared to Chemical II, these compounds generated less active PMEA levels in rat liver homogenate. Therefore, chemical modification of Chemical II may lead to new promising PMEA derivatives with enhanced plasma stability and liver activation.     

Synthesis and biological activities of bisnaphthalimido polyamines derivatives: cytotoxicity, DNA binding, DNA damage and drug localization in breast cancer MCF 7 cells

New bisoxynaphthalimidopolyamines (BNIPOPut, BNIPOSpd and BNIPOSpm) were synthesized. Their cytotoxic properties were evaluated against breast cancer MCF 7 cells and compared with bisnaphthalimidopolyamines BNIPSpd and BNIPSpm. Among the bisoxynaphthalimido polyamines, BNIPOSpm and BNIPOSpd exhibited cytotoxic activity with an IC50 f 29.55 and 27.22 microM, respectively, while BNIPOPut failed to exert significant cytotoxicity after 48-h drug exposure. DNA binding was determined by midpoint of thermal denaturation (Tm) measurement, ethidium bromide displacement and DNA gel mobility. Both BNIPOSpm and BNIPOSpd exhibited strong binding affinities with DNA. BNIPOPut had the least effect. The results were compared with other cytotoxic bisnaphthalimido compounds (BNIPSpm and BNIPSpd) previously reported by us. Using the single cell gel electrophoresis assay, it was found that BNIPSpm and BNIPSpd caused substantial DNA damage to MCF 7 treated cells while BNIPOSpm showed no significant effect over a range of drug concentrations after 4-h drug exposure. However, after 12-h drug exposure, BNIPOSpm had induced significant DNA damage similar to that of BNIPSpm (after 4-h drug exposure). Fluorescence microscopic analysis revealed that at 1 microM drug concentration and after 6-h drug exposure, both BNIPSpm and BNIPSpd were located within the cell while the presence of BNIPOSpm, was not observed. Therefore, we conclude that BNIPSpd, BNIPSpm and BNIPOSpm induce DNA damage consistent with their rate of uptake into the cells.     

Inclusion complexes of tadalafil with natural and chemically modified β-cyclodextrins. I: Preparation and in-vitro evaluation

The aim of this work was to investigate the inclusion complexation between tadalafil, a practically insoluble selective phosphodiesterase-5 inhibitor (PDE5), and two chemically modified β-cyclodextrins: hydroxypropyl-β-cyclodextrin (HP-β-CD) and heptakis-[2,6-di-O-methyl]-β-cyclodextrin (DM-β-CD), in comparison with the natural β-cyclodextrin (β-CD) in order to improve the solubility and the dissolution rate of the drug in an attempt to enhance its bioavailability. Inclusion complexation was investigated in both the solution and the solid state. The UV spectral shift method indicated guest–host complex formation between tadalafil and the three cyclodextrins (CDs). The phase solubility profiles with all the used CDs were classified as A_p-type, indicating the formation of higher order complexes. The complexation efficiency values (CE), which reflect the solubilizing power of the CDs towards the drug, could be arranged in the following order: DM-β-CD > HP-β-CD > β-CD. Solid binary systems of tadalafil with CDs were prepared by kneading and freeze-drying techniques at molar ratios of 1:1, 1:3 and 1:5 (drug to CD). Physical mixtures were prepared in the same molar ratios for comparison. Physicochemical characterization of the prepared systems at molar ratio of 1:5 was studied using differential scanning calorimetry (DSC), X-ray diffractometry (XRD), and Fourier-transform infrared spectroscopy (FTIR). The results showed the formation of true inclusion complexes between the drug and both HP-β-CD and DM-β-CD using the freeze-drying method at molar ratio of 1:5. In contrast, crystalline drug was detectable in all other products. The dissolution of tadalafil from all the prepared binary systems was carried out to determine the most appropriate CD type, molar ratio, and preparation technique to prepare inclusion complexes to be used in the development of tablet formulation for oral delivery of tadalafil. The dissolution enhancement was increased on increasing the CD proportion in all the prepared systems. Both the CD type and the preparation technique played an important role in the performance of the system. Irrespective of the preparation technique, the systems prepared using HP-β-CD and DM-β-CD yielded better performance than the corresponding ones prepared using β-CD. In addition, the freeze-drying technique showed superior dissolution enhancement than other methods especially when combined with the β-CD derivatives.     

In vitro digestion,antioxidant and antiacetylcholinesterase activities of two species of Ruta: Ruta chalepensis and Ruta montana

Context: Ruta genus (Rutaceae) is abundantly used and described in the most ancient systematic records of medical practice of the Mediterranean world. In Tunisia, this genus is represented by two medicinal and aromatic shrubs: Ruta chalepensis L. and Ruta montana L.

Objective: This study investigates the antioxidant and acetylcholinesterase inhibition (AChE) activities before and after in vitro gastrointestinal metabolism of leaf decoction of R. chalepensis and R. montana.

Materials and methods: We study, in vitro, the effect of the gastrointestinal juices gastric (1.75?mL) or pancreatic (2.5?mL) juices, on the biological activity by the measurement of the antioxidant activity and AChE inhibition during 4?h of decoction extract obtained from the leaves of the two species of Ruta.

Results: The results showed that the ability to inhibit the AChE enzyme was similar; being the greatest inhibitory activity exhibited by the ethanol extract (IC_50?=_?12?±?1.1?μg/mL) obtained from leaves of R. chalepensis.

Conclusion: In conclusion, we showed that there was no appreciable degradation and that the activity was kept constant after gastric and pancreatic juice digestion.     

Assessment of the safety, tolerability, and PK/PD properties of two new formulations of subcutaneously administered IFN-beta1a: a double-blind, placebo-controlled comparison with the currently available formulation

OBJECTIVE: Application-site disorders are well-known adverse events (AEs) associated with subcutaneous (s.c.) injection. With high-dose, high-frequency interferon (IFN)-beta1a (Rebif) these AEs are generally mild but may lead to the discontinuation of some patients. The objective of this study was to compare the safety, tolerability, and the pharmacokinetic (PK) and pharmacodynamic (PD) profiles of two new formulations of Rebif (Rebif New Formulation: RNF1 and RNF2) with the current formulation (hereafter referred to as R) and placebo. METHODS: In this double-blind, placebo-controlled, parallel-group, Phase I study, healthy volunteers of both sexes were randomized 1:1:1:1 to receive a single 0.5 ml s.c. dose of RNF1, RNF2, R or placebo (normal saline). The three active treatments contained 44 microg IFN-beta1a. During the 24-hour post-dose period, safety and tolerability assessments were conducted and blood samples were taken at regular intervals for PK and PD analyses. Pain intensity on injection was measured using the short-form McGill questionnaire and a 100 mm visual analogue scale (VAS). Further safety assessments were performed and blood samples taken at 24-hour intervals until Day 7 post-dose, with a final post-study visit 10- 14 days after dosing. RESULTS: A total of 48 subjects (22 men, 26 women) were recruited and allocated equally to each treatment (12 subjects per group). AEs were reported by 10 subjects in each active treatment group and by 3 subjects in the placebo group. All AEs were consistent with the known safety profile of R. The number of treatment-emergent AEs was lower in the RNF2 group than the RNF 1 or R groups (21, 31 and 33 events, respectively). Redness at the injection site was mostly mild and occurred in fewer subjects in the RNF2 group (n = 3) than the RNF 1 or R groups (n = 7 and n = 4, respectively). Injection site pain was reported by 1 subject in the RNF2 group, compared with 4, 6 and 3 subjects, respectively, in the RNF1, R and placebo groups. The worst pain intensity, as measured by VAS, was lower in the RNF2 and RNFI groups than either the R or placebo groups. There was considerable intersubject variability in the PK and PD profiles of the three formulations of IFN-beta1a. Nevertheless, the PK and PD characteristics of RNF2 were similar to those of R. CONCLUSIONS: The results from this study suggest that RNF2 may offer improved tolerability compared with the current formulation of R, but retains comparable pharmacokinetic and pharmacodynamic characteristics.     

花椒挥发油微乳凝胶的制备及其对不同油水分配系数药物的体外释放研究

目的制备花椒挥发油微乳凝胶,探究微乳凝胶中花椒挥发油的稳定性及不同油水分配系数(log P)药物的体外释放行为。方法首先以凝胶基质的外观、成型性、黏稠度为评价指标,筛选凝胶基质种类及用量,以花椒挥发油为油相的微乳制备为花椒挥发油微乳凝胶,并通过GC指纹图谱相似度评价花椒挥发油在微乳凝胶中的稳定性。然后,采用改良Franz扩散池法考察花椒挥发油微乳凝胶中不同log P值药物的体外释放行为。结果优选得到的凝胶基质及用量为1%的卡波姆940,基于此制备的微乳凝胶中花椒挥发油稳定性较好,模型药蛇床子素、川芎嗪、阿魏酸、葛根素及京尼平苷的24 h累积释放率分别为(1.28±0.16)%、(85.90±4.57)%、(43.82±5.34)%、(46.87±5.26)%、(88.60±5.46)%。结论微乳凝胶能增强花椒挥发油在制剂中的稳定性,且对亲水性及小分子亲脂性成分释放能力强,可作为花椒挥发油在今后临床应用的优良剂型,为富含挥发油的中药外用制剂开发和临床应用提供指导。     

Interaction of aliphatic N-hydroxylamines with microsomal cytochrome P450: nature of the different derived complexes and inhibitory effects on monoxygenases activities.

Primary N-hydroxylamines, RR′R″CNHOH, produce difference spectra of liver microsomes from variously pretreated rats with peaks around 420 nm and troughs around 392 nm which are interpreted as the result of the hydroxylamines binding to cytochrome P450-Fe (III) through their oxygen atom. The hydroxylamines interact with dithionite-or NADPH-anaerobically reduced micro-somes giving peaks around 423 nm. In the presence of NADPH, oxygen and microsomes, all the hydroxylamines of the type RR'CHNHOH lead to 455 nm difference spectra which should correspond to cytochrome P450-Fe (II)-RR′CHNO complexes. These hydroxylamines also act as strong inhibitors of aniline hydroxylase, P-nitroanisole-O-demethylase and 7-ethoxycoumarin-O-dealkylase activities of PB-pretreated rat liver microsomes. In most cases, they are better inhibitors than metyrapone or SKF 525A. These inhibitory effects of hydroxylamines are related to their ability to lead to 455 nm absorbing complexes; For instance, 1-hydroxylamino-2phenyl-ethane exhibits the best apparent Ks for the 455 nm absorbing complex formation and is also the best inhibitor of microsomal $\text{7-}\text{ethoxycoumarin}\text{-O-}\text{dealkylase}\text{(}\text{I}{}_{50}\text{= 0.5 μ}\text{M}\text{)}$.     

Study of serum interaction with a cationic nanoparticle: Implications for in vitro endocytosis, cytotoxicity and genotoxicity

We used well-characterized and positively charged nanoparticles (NP⁺) to investigate the importance of cell culture conditions, specifically the presence of serum and proteins, on NP⁺ physicochemical characteristics, and the consequences for their endocytosis and genotoxicity in bronchial epithelial cells (16HBE14o-). NP⁺ surface charge was significantly reduced, proportionally to NP⁺/serum and NP⁺/BSA ratios, while NP⁺ size was not modified. Microscopy studies showed high endocytosis of NP⁺ in 16HBE14o-, and serum/proteins impaired this internalization in a dose-dependent manner. Toxicity studies showed no cytotoxicity, even for very high doses of NP⁺. No genotoxicity was observed with classic comet assay while primary oxidative DNA damage was observed when using the lesion-specific repair enzyme, formamidopyrimidine DNA-glycosylase (FPG). The micronucleus test showed NP⁺ genotoxicity only for very high doses that cannot be attained in vivo. The low toxicity of these NP⁺ might be explained by their high exocytosis from 16HBE14o- cells. Our results confirm the importance of serum and proteins on nanoparticles endocytosis and genotoxicity.     

Toxicity and cytotoxicity of nigrin b, a two-chain ribosome-inactivating protein from Sambucus nigra : comparison with ricin

Nigrin b, a lectin isolated from the bark of elderberry (Sambucus nigra L.), has structure and enzymatic activity similar to that of ricin and other type 2 ribosome-inactivating proteins (RIPs), and yet is much less toxic to cells and animals. In an attempt to explain this difference, we studied (1) the cytotoxicity of both lectins at 18 and 37 °C, and in the presence of substances interfering with intracellular routing, and (2) the binding of nigrin b to, and its uptake and degradation by HeLa cells, in parallel with ricin. As compared with the latter, (1) less nigrin b was bound and more was degraded by cells, with a resulting lower concentration remaining inside the cells, and (2) there is evidence for a different intracellular routing followed by the two lectins. These results may explain at least partly the different cytotoxicity and consequently the lower toxicity to mice of nigrin b compared with ricin. Received: 5 September 1996 / Accepted: 30 October 1996     

Biphasic release of indomethacin from HPMC/pectin/calcium matrix tablet: II. Influencing variables, stability and pharmacokinetics in dogs

The pectin/calcium interaction, which is the basis for biphasic release of indomethacin from the HPMC/pectin/calcium chloride matrix tablet, is susceptible to influence of a variety of variables that is supposed to be encountered by the oral route. In this study, the effect of influencing variables on biphasic release characteristics, the stability and the pharmacokinetics of the hybrid matrix tablet were investigated. An increasing tendency of the overall release rate was observed from pH 1.2 to 7.4. The power law correlation n values increased with pH, while the release lag time or 10% release time (T_0.1) decreased at pH 6.8 and 7.4. Ionic strength in the release media also influenced the biphasic release significantly at sodium chloride levels of over 0.5%. Obvious increase in overall release rate was observed at sodium chloride level of 0.9% with an n value of 1.20 and a T_0.1 of 3.4 h. At sodium chloride levels of over 2%, the pectin/calcium interaction was disrupted resulting in very fast release of indomethacin. Release in gradient pH media was similar to that in pH 6.8 citrate buffer. When pectinase (Pectinex Ultra SP-L) was added into the release medium in 22.2 pg/ml or over, obvious triggering on drug release was observed. The stress testing showed increased release at extreme relative humidity of 92.5%. Both accelerated testing for 6 m and long-term testing for 12 m affirmed fine stability, especially in release characteristics. Pharmacokinetic study in dogs gave T_max/C_max of 4 h/604 ng/ml and 3 h/1662 ng/ml for HPMC/pectin/calcium and HPMC/pectin tablet, respectively. The plasma indomethacin level of the calcium-containing tablet was maintained at a much lower level for 3 h with a MRT of 7.13 h, longer than 3.97 and 5.61 h for indomethacin crude drug and HPMC/pectin tablet, confirming delayed absorption. The AUC of the HPMC/pectin/calcium tablet was lower than that of the HPMC/pectin tablet and indomethacin crude drug showing incomplete absorption. It is concluded that the HPMC/pectin/calcium matrix tablet is potentially useful for colon-specific drug delivery.     

Inclusion complex of a new propiconazole derivative with β-cyclodextrin: NMR, ESI–MS and preliminary pharmacological studies

A novel inclusion complex of the propiconazole nitrate (NO₃PCZ) with β-cyclodextrin (β-CD) was prepared by treatment of propiconazole (PCZ) with an acidic nitrating agent. The formation of NO₃PCZ and its inclusion complex with β-CD has been studied by NMR, ESI–MS, TGA, DSC methods. Using the undecoupled signal in the HMBC correlation spectra, almost identical coupling constants of CH from trizolic ring of PCZ and NO₃PCZ compounds (¹J(HC)3=207 Hz, ¹J(CH)5=214 Hz, for PCZ; ¹J(HC)3=208 Hz and ¹J(CH)5=215 Hz, for NO₃PCZ) were determined, confirming that the geometry of the heterocyclic skeleton is identical in both the forms. The 1:1 stoichiometry of the complex was determined by ESI–MS and was confirmed using Scott's equation in DMSO and Higuchi and Connors equation in water. The solubility curve obtained for NO₃PCZ in presence of β-CD in distilled water was constructed, resulting in a solubility diagram of AL type. Solubility of NO₃PCZ in water was determined by DLS studies. The results showed that NO₃PCZ was encapsulated within the β-CD cavity with a binding constant of 330 M-1 in DMSO and 975 M-1 in water. Preliminary pharmacological studies showed higher antifungal activities for NO₃PCZ and its inclusion complex, compared with its PCZ analog. The acute toxicity of the complex is smaller than the pure or modified drug, recommending the inclusion complex as future promising therapeutic agents.     

Efficacy and safety of tapentadol prolonged release formulation in the treatment of elderly patients with moderate-to-severe chronic osteoarthritis knee pain: a pooled analysis of two double-blind,randomized, placebo-, and active-controlled trials

Objective: To compare efficacy and safety of tapentadol prolonged release (PR) vs oxycodone controlled release (CR) in younger patients (<65?years of age) and in elderly patients (≥65 and ≥75 years of age) in the treatment of moderate-to-severe chronic osteoarthritis (OA) knee pain.

Methods: Data from two double-blind, randomized, placebo-, and oxycodone CR-controlled phase 3 trials were pooled and stratified by age. Primary efficacy end-points were change from baseline in average pain intensity at week 12 (US end-point) and over the entire maintenance period (non-US end-point).

Results: A total of 1357 patients <65?years, 653 patients ≥65?years, and 176 patients ≥75?years of age were assessed. The comparison between tapentadol PR and oxycodone CR showed numerically better pain relief under tapentadol PR for both primary end-points in all three age groups. More favorable improvements were also observed for patient global impression of change, the Short Form-36 physical component score, and EuroQoL-5Dimensions health status index. In the elderly, incidences of dizziness and somnolence were comparable between active treatments, but incidences of nausea, vomiting, and constipation were considerably lower under tapentadol PR. Treatment completion rates were lowest under oxycodone CR;?>?50% of elderly oxycodone CR patients named side-effects as the main reason for discontinuation.

Conclusions: Tapentadol PR was effective in the treatment of moderate-to-severe chronic OA pain in elderly and younger patients. Compared to oxycodone CR, the overall and the gastrointestinal tolerability profile in particular were better in all tapentadol PR groups, regardless of age.