Schizophrenia is a severe and chronic psychiatric disorder with a lifetime prevalence of approximately 0.7%–1%worldwide[1].Aripiprazole is widely used for schizophrenia treatment,and known as a dopamine system stabil...Schizophrenia is a severe and chronic psychiatric disorder with a lifetime prevalence of approximately 0.7%–1%worldwide[1].Aripiprazole is widely used for schizophrenia treatment,and known as a dopamine system stabilizer due to its partial agonist activity as the dopamine-2(D2)and serotonin 5-hydroxytryptamine 1A(5-HT1A)receptors,as well as antagonist action at the 5-HT2A receptors[2].The investigational microsphere-based aripiprazole injection in this study is a novel long-acting formulation designed to optimize the release profile at the dose of 350 mg monthly.The objective of this study was to evaluate the pharmacokinetics,efficacy,and safety of the microsphere-based formulation,particularly the fluctuations in the peak-to-trough plasma concentration ratio.展开更多
Doping small amounts at the A-site or B-site of SmCrO3ceramics is a promising approach for modifying their microstructure,as well as their magnetic and dielectric properties.In this study,polycrystalline ceramics o...Doping small amounts at the A-site or B-site of SmCrO3ceramics is a promising approach for modifying their microstructure,as well as their magnetic and dielectric properties.In this study,polycrystalline ceramics of Sm1-xNixCrO3(x=0,0.05,and 0.20)and SmCr1-yNiyO3(y=0.05 and 0.20)were synthesized via a conventional solid-state reaction.X-ray diffraction validated that all the doped ceramics maintained an orthorhombic crystalline structure consistent with the Pbnm space group.Furthermore,X-ray photoelectron spectroscopy demonstrated the presence of Ni2+ions in the doped specimens.Notably,doping resulted in significant enhancement of low-temperature magnetic properties,particularly in samples doped at the A-site,such as Sm0.80Ni0.20CrO3.Compared with the pristine sample,the maximum magnetization of Sm0.80Ni0.20CrO3increased by approximately 60.9%and 93.5%in the zero-field cooling and field-cooling modes,respectively,in an external magnetic field of 100 Oe.Furthermore,the dielectric constants of the Ni-doped ceramics initially exceeded that of the pristine sample as the temperature increased.At equivalent doping ratios,A-site doping demonstrated superior performance over B-site doping,including higher magnetization,lower dielectric loss,and enhanced electrical quality factors.展开更多
In order to carry out the comprehensive reform of the professional master’s degree training mode of clinical pharmacy, we carried out interviews among 91 persons on the professional master’s degree of clinical pharm...In order to carry out the comprehensive reform of the professional master’s degree training mode of clinical pharmacy, we carried out interviews among 91 persons on the professional master’s degree of clinical pharmacy in Peking University School of Pharmaceutical Sciences and collected extensive feedback. We preliminaries explore the mode of Doctor of Pharmacy(Pharm. D.) Education, laying the foundation for Doctor’s education of professional clinical pharmacy in China. We conducted investigations and interviews among 91 clinical pharmacists and students of Peking University School of Pharmaceutical Sciences on the training of professional master’s degree and Pharm. D. education mode, which includes 67 postgraduates and 24 clinical pharmacists. Respondents put forward the problems of training mode and corresponding suggestions and opinions from different aspects during the investigation and interview. The results mainly divide into four aspects: curriculum setting, clinical practice, assessme nt system and teaching resources. Respondents put forward effective feedback on the above four aspects, which are beneficial to the comprehensive reform of the training mode of professional master degree in clinical pharmacy and preliminary exploration of Pharm. D. Education in China.展开更多
The purpose of the present study was to investigate the impact of genetic polymorphism on fluvastatin pharmacokinetics.In addition,we compared the fluvastatin pharmacokinetics differences between extended-release(ER)8...The purpose of the present study was to investigate the impact of genetic polymorphism on fluvastatin pharmacokinetics.In addition,we compared the fluvastatin pharmacokinetics differences between extended-release(ER)80 mg tablet and immediate-release(IR)40 mg capsule in terms of drug metabolism enzyme and transporter genetic polymorphisms.In this open-label,randomized,two-period,two-treatment,crossover study(n=24),effects of ABCG2,SLCO1B1,ABCB1,CYP2C9 and CYP3A5 polymorphisms on the pharmacokinetics of fluvastatin were analyzed.The administration dosage for IR 40 mg and ER 80 mg were twice and once daily,respectively,for total 7 d.Blood samples for pharmacokinetic evaluation were taken on the 1st and 7th d.The lower exposure following ER was observed.For ER tablets,SLCO1B1 T521C genotype correlated with AUC 0-24 of repeat doses(P=0.010).SLCO1B1 T521C genotype had no statistically significant effect on AUC 0-24 of IR capsule of fluvastatin after single or repeated doses.In vitro study demonstrated that when the concentration of fluvastatin was low(1μmol/l),transport velocity of fluvastatin by HEK293-OATP1B1 with SLCO1B1521TT(K m=11.4μmol/l)and with SLCO1B1521TCC(K m=15.1μmol/l)tend to be the same.It suggests that the increased effect of SLCO1B1 T521C genotype on ER formulation of fluvastatin was mainly caused by lower blood concentrations.We recommend that formulation should be incorporated into future pharmacogenomics studies.展开更多
CYP3A4 plays a critical role in clopidogrel activation in the liver.The polymorphism of CYP3A4 may have an important effect on clopidogrel response in patients with cardio-cerebrovascular diseases.We conducted a syste...CYP3A4 plays a critical role in clopidogrel activation in the liver.The polymorphism of CYP3A4 may have an important effect on clopidogrel response in patients with cardio-cerebrovascular diseases.We conducted a systematic review and meta-analysis to evaluate the impact of CYP3A4 polymorphism on platelet reactivity after clopidogrel treatment and the outcomes of patients.A systematic literature search(up to 7th October,2019)was performed on the PubMed,EMBASE,Cochrane Library,clinicaltrials.gov,and Chinese databases,including China National Knowledge Infrastructure(CNKI)and Wan Fang Data.Cohort studies or case-control studies evaluated platelet reactivity and patients‟outcomes in different genotype patients.The Review Manager software was used for data analysis,and the NOS scale was used to assess the quality of included studies.A total of 18 articles were included in the Meta-analysis.The results showed the platelet reactivity after clopidogrel administration had no significant difference between CYP3A4 variant carriers and non-carriers.The occurrence of composite ischemic events or stent thrombosis had no significant difference between CYP3A4 variant carriers and non-carriers,either.In conclusion,there was no significant association between CYP3A4 polymorphism and clopidogrel response in patients with cardio-cerebrovascular diseases.展开更多
Background: Compound Salvia Pellet (T89), consisting of Danshen (salvia miltiorrhiza), Sanqi (panax notoginseng), and Borneol (Cinnamomum camphora), has been used worldwide for 14 years for chronic angina treatment. P...Background: Compound Salvia Pellet (T89), consisting of Danshen (salvia miltiorrhiza), Sanqi (panax notoginseng), and Borneol (Cinnamomum camphora), has been used worldwide for 14 years for chronic angina treatment. Purpose: A dose escalation study to determine the maximum tolerance dose (MTD) in Chinese population to support a proposed dose regimen change. Methods: Forty-six participants (age 18 to 45 yrs, male to female ratio = 1:1) were divided into a series of 6 patients cohorts, and sequentially assigned into one of the escalating dose groups, starting from 540 mg, the clinical doses, until 4 out of 6 subjects experience clinical Adverse Events (AEs) or when the pre-defined 3510 mg dose level is reached and completed. All doses were given orally as a single dose 2 hours after breakfast. Adverse events, vital signs, 12-lead ECG, clinical and laboratory parameters and medical evaluation were conducted as outcome measures. Results: Study completed at the highest pre-defined dose level of 3510 mg dose as never had 4/6 of subject experience AEs in any dose levels studied. All participants completed the study and data were included in the safety analysis. The only moderate AE observation (muscle damage) was observed at 2970 mg dose and was recovered without any medical treatment, and all other AEs (ECG, dizziness, muscle damage) were mild and may (5 cases) or may not (9 cases) be related to testing drug and were all self-resolved within 30 min after dose. Conclusion: Given as single oral dose, Compound Salvia Pellet is safe and well-tolerated up to the 3510 mg studied. The MTD value of Compound Salvia Pellet is unknown from this trial and must be higher than 3510 mg, 13 times higher than its current clinical dose.展开更多
The aim of this article was to report a case of toe nails disorder associated with metformin use in an elderly patient with type2diabetes. Two years ago, after receiving metformin 0.5 g three times daily for 6 months,...The aim of this article was to report a case of toe nails disorder associated with metformin use in an elderly patient with type2diabetes. Two years ago, after receiving metformin 0.5 g three times daily for 6 months, a 60-year-old Chinese man found his ten toe nails gradually thickened and yellowed (especially two thumbs). The symptoms improved and recovered after metformin discontinuance. Half year ago, metformin 0.5 g three times daily adopted again and toe nails disorder occurred again. Physician modified the therapy plan and replaced metformin with acarbose to control blood glucose level of this patient. According to the follow up 3 months after his discharge, ten toe nails recovered significantly and new parts of the nails were normal. Nail disorder was rarely reported in the worldwide, but the physicians should keep awareness of this adverse drug reaction (ADR), proper actions should be taken once it occurred to avoid unnecessary suffering of the patient.展开更多
Artificial intelligence(AI)has emerged as a transformative force in healthcare,with applications spanning diagnostics to drug development.However,its integration into drug regulation remains nascent,with varying degre...Artificial intelligence(AI)has emerged as a transformative force in healthcare,with applications spanning diagnostics to drug development.However,its integration into drug regulation remains nascent,with varying degrees of adoption and implementation across different regulatory bodies worldwide.This review aims to provide a comprehensive overview of the current state of AI in drug regulation,encapsulating AI-related policies,initiatives,and its practical application in regulatory agencies globally.It further discusses the challenges and future prospects of AI in this field.The findings reveal that numerous agencies have launched action plans and initiatives to incorporate AI,aiming to streamline regulatory processes and enhance data-driven regulatory decision-making.Moreover,AI’s deployment in safety surveillance,workflow optimization,and regulatory science research is expanding,highlighting its increasing impact on drug regulation.Nonetheless,key challenges persist,such as data quality and reliability,technical limitations,talent shortage and the absence of standards.The review concludes that interdisciplinary collaboration is crucial to harness AI’s full potential in drug regulation and overcoming its current limitations.In the future,AI may become a pivotal catalyst in drug regulation,promising a new era of enhanced scrutiny,efficiency,and innovation that will benefit public health on a global scale.展开更多
Background:Since the launch of drug regulatory reform in 2015,China has substantially increased the availability of new cancer therapies.However,the efficacy evidence criteria for modified new anticancer drugs have no...Background:Since the launch of drug regulatory reform in 2015,China has substantially increased the availability of new cancer therapies.However,the efficacy evidence criteria for modified new anticancer drugs have not been evaluated.This cross-sectional study aimed to assess the pivotal trials supporting the indication approvals of innovative and modified new chemical anticancer drugs in China.Methods:The characteristics of indications,regulatory aspects,and pivotal trial designs were extracted and described.The primary efficacy endpoints of the pivotal clinical trials,including overall survival(OS)and progression-free survival(PFS),were quantitatively assessed by meta-analysis.Results:Between 2016 and 2022,77 cancer therapeutics for 107 indications were approved in China based on 128 pivotal trials.Among the 107 indications,64(59.8%)were classified as innovative anticancer drugs,and 43(40.2%)as modified new anticancer drugs.The study found that pivotal trials for innovative approvals tended to be single-arm trials,while modified approvals were more likely to employ randomized clinical trials with larger sample sizes and rigorous designs.Despite innovative drugs often receiving more expedited regulatory designations,there were no statistically significant differences in clinical benefit of OS or PFS outcomes between innovative and modified approvals.Conclusions:These results suggest that the current regulatory framework may prioritize the speed of approval for innovative drugs over the strength of supporting evidence.These findings align with the strategic trends of pharmaceutical companies and regulatory inclinations that aim to expedite the approval of innovative anticancer drugs with a high unmet need,thereby accelerating patients’accessibility to treatment.展开更多
Thank you for your thorough review and insightful comments on our research[1].Your observations are highly pertinent and provide valuable insights for our continued examination of China’s evolving anticancer drug reg...Thank you for your thorough review and insightful comments on our research[1].Your observations are highly pertinent and provide valuable insights for our continued examination of China’s evolving anticancer drug regulatory framework.展开更多
Integrins are considered the main cell-adhesion transmembrane receptors that play multifaceted roles as extracellular matrix(ECM)-cytoskeletal linkers and transducers in biochemical and mechanical signals between cell...Integrins are considered the main cell-adhesion transmembrane receptors that play multifaceted roles as extracellular matrix(ECM)-cytoskeletal linkers and transducers in biochemical and mechanical signals between cells and their environment in a wide range of states in health and diseases.Integrin functions are dependable on a delicate balance between active and inactive status via multiple mechanisms,including protein-protein interactions,conformational changes,and trafficking.Due to their exposure on the cell surface and sensitivity to the molecular blockade,integrins have been investigated as pharmacological targets for nearly 40 years,but given the complexity of integrins and sometimes opposite characteristics,targeting integrin therapeutics has been a challenge.To date,only seven drugs targeting integrins have been successfully marketed,including abciximab,eptifibatide,tirofiban,natalizumab,vedolizumab,lifitegrast,and carotegrast.Currently,there are approximately 90 kinds of integrin-based therapeutic drugs or imaging agents in clinical studies,including small molecules,antibodies,synthetic mimic peptides,antibody-drug conjugates(ADCs),chimeric antigen receptor(CAR)T-cell therapy,imaging agents,etc.A serious lesson from past integrin drug discovery and research efforts is that successes rely on both a deep understanding of integrin-regulatory mechanisms and unmet clinical needs.Herein,we provide a systematic and complete review of all integrin family members and integrin-mediated downstream signal transduction to highlight ongoing efforts to develop new therapies/diagnoses from bench to clinic.In addition,we further discuss the trend of drug development,how to improve the success rate of clinical trials targeting integrin therapies,and the key points for clinical research,basic research,and translational research.展开更多
The outbreak and spread of coronavirus disease 2019(COVID-19)highlighted the importance and urgency of the research and development of therapeutic drugs.Very early into the COVID-19 pandemic,China has begun developing...The outbreak and spread of coronavirus disease 2019(COVID-19)highlighted the importance and urgency of the research and development of therapeutic drugs.Very early into the COVID-19 pandemic,China has begun developing drugs,with some notable progress.Herein,we summarizes the anti-COVID-19 drugs and promising drug candidates originally developed and researched in China.Furthermore,we discussed the developmental prospects,mechanisms of action,and advantages and disadvantages of the anti-COVID-19 drugs in development,with the aim to contribute to the rational use of drugs in COVID-19 treatment and more effective development of new drugs against severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)and the variants.Neutralizing antibody is an effective approach to overcome COVID-19.However,drug resistance induced by rapid virus mutation will likely to challenge neutralizing antibodies.Taking into account current epidemic trends,small molecule drugs have a crucial role in fighting COVID-19 due to their significant advantage of convenient administration and affordable and broad-spectrum.Traditional Chinese medicines,including natural products and traditional Chinese medicine prescriptions,contribute to the treatment of COVID-19 due to their unique mechanism of action.Currently,the research and development of Chinese anti-COVID-19 drugs have led to some promising achievements,thus prompting us to expect even more rapidly available solutions.展开更多
Dear Editor,The integrinαvβ3 receptor is a promising target for anticancer therapy.1,2 However,there are no effective marketed treatments targetingαvβ3.One possible limitation of Arginine-Glycine-Aspartic(RGD)-mim...Dear Editor,The integrinαvβ3 receptor is a promising target for anticancer therapy.1,2 However,there are no effective marketed treatments targetingαvβ3.One possible limitation of Arginine-Glycine-Aspartic(RGD)-mimeticαvβ3 antagonists has been shown to cause partial agonism,which could induce major conformational changes that trigger paradoxical cell adhesion and angiogenesis.展开更多
Previous studies have shown that low platelet count combined with high plasma total homocysteine(tHcy)increased stroke risk and can be lowered by 73% with folic acid.However,the combined role of other platelet activat...Previous studies have shown that low platelet count combined with high plasma total homocysteine(tHcy)increased stroke risk and can be lowered by 73% with folic acid.However,the combined role of other platelet activation parameters and the methylenetetrahydrofolate reductase(MTHFR)C677T genotypes on stroke risk and folic acid treatment benefit remain to be examined.This study aimed to investigate if platelet activation parameters and MTHFR genotypes jointly impact folic acid treatment efficacy in first stroke prevention.Data were derived from the China Stroke Primary Prevention Trial.This study includes a total of 11,185 adult hypertensive patients with relevant platelet activation parameters and MTHFR genotype data.When simultaneously considering both platelet activation parameters(plateletcrit,platelet count,mean platelet volume,platelet distribution width)and MTHFR genotypes,patients with both low plateletcrit(Q1)and the TT genotype had the highest stroke incidence rate(5.6%)in the enalapril group.This subgroup significantly benefited from folic acid treatment,with a 66% reduction in first stroke(HR:0.34;95%CI:0.14-0.82;p=0.016).Consistently,the subgroup with low plateletcrit(Q1)and the CC/CT genotype also benefited from folic acid treatment(HR:0.40;95%CI:0.23-0.70;p=0.001).In Chinese hypertensive adults,low plateletcrit can identify those who may greatly benefit from folic acid treatment,in particular,those with the TT genotype,a subpopulation known to have the highest stroke risk.展开更多
基金supported by the National Science and Technology Major Project of China(Grant No.:2017ZX09201004-016).
摘要Schizophrenia is a severe and chronic psychiatric disorder with a lifetime prevalence of approximately 0.7%–1%worldwide[1].Aripiprazole is widely used for schizophrenia treatment,and known as a dopamine system stabilizer due to its partial agonist activity as the dopamine-2(D2)and serotonin 5-hydroxytryptamine 1A(5-HT1A)receptors,as well as antagonist action at the 5-HT2A receptors[2].The investigational microsphere-based aripiprazole injection in this study is a novel long-acting formulation designed to optimize the release profile at the dose of 350 mg monthly.The objective of this study was to evaluate the pharmacokinetics,efficacy,and safety of the microsphere-based formulation,particularly the fluctuations in the peak-to-trough plasma concentration ratio.
基金financially supported by the National Natural Science Foundation of China(Nos.12034002 and 12375283)。
摘要Doping small amounts at the A-site or B-site of SmCrO3ceramics is a promising approach for modifying their microstructure,as well as their magnetic and dielectric properties.In this study,polycrystalline ceramics of Sm1-xNixCrO3(x=0,0.05,and 0.20)and SmCr1-yNiyO3(y=0.05 and 0.20)were synthesized via a conventional solid-state reaction.X-ray diffraction validated that all the doped ceramics maintained an orthorhombic crystalline structure consistent with the Pbnm space group.Furthermore,X-ray photoelectron spectroscopy demonstrated the presence of Ni2+ions in the doped specimens.Notably,doping resulted in significant enhancement of low-temperature magnetic properties,particularly in samples doped at the A-site,such as Sm0.80Ni0.20CrO3.Compared with the pristine sample,the maximum magnetization of Sm0.80Ni0.20CrO3increased by approximately 60.9%and 93.5%in the zero-field cooling and field-cooling modes,respectively,in an external magnetic field of 100 Oe.Furthermore,the dielectric constants of the Ni-doped ceramics initially exceeded that of the pristine sample as the temperature increased.At equivalent doping ratios,A-site doping demonstrated superior performance over B-site doping,including higher magnetization,lower dielectric loss,and enhanced electrical quality factors.
摘要In order to carry out the comprehensive reform of the professional master’s degree training mode of clinical pharmacy, we carried out interviews among 91 persons on the professional master’s degree of clinical pharmacy in Peking University School of Pharmaceutical Sciences and collected extensive feedback. We preliminaries explore the mode of Doctor of Pharmacy(Pharm. D.) Education, laying the foundation for Doctor’s education of professional clinical pharmacy in China. We conducted investigations and interviews among 91 clinical pharmacists and students of Peking University School of Pharmaceutical Sciences on the training of professional master’s degree and Pharm. D. education mode, which includes 67 postgraduates and 24 clinical pharmacists. Respondents put forward the problems of training mode and corresponding suggestions and opinions from different aspects during the investigation and interview. The results mainly divide into four aspects: curriculum setting, clinical practice, assessme nt system and teaching resources. Respondents put forward effective feedback on the above four aspects, which are beneficial to the comprehensive reform of the training mode of professional master degree in clinical pharmacy and preliminary exploration of Pharm. D. Education in China.
基金This study was supported by grants from the National Key R&D Program of China(No.2016YFC0904900)National Natural Science Foundation(No.81673509 and No.81573504)of China+1 种基金Natural Science Foundation of Beijing Municipality(No.7171012)National Science and Technology Major Projects for“Major New Drugs Innovation and Development”of China(No.2017ZX09304028 and No.2017ZX09101001).
摘要The purpose of the present study was to investigate the impact of genetic polymorphism on fluvastatin pharmacokinetics.In addition,we compared the fluvastatin pharmacokinetics differences between extended-release(ER)80 mg tablet and immediate-release(IR)40 mg capsule in terms of drug metabolism enzyme and transporter genetic polymorphisms.In this open-label,randomized,two-period,two-treatment,crossover study(n=24),effects of ABCG2,SLCO1B1,ABCB1,CYP2C9 and CYP3A5 polymorphisms on the pharmacokinetics of fluvastatin were analyzed.The administration dosage for IR 40 mg and ER 80 mg were twice and once daily,respectively,for total 7 d.Blood samples for pharmacokinetic evaluation were taken on the 1st and 7th d.The lower exposure following ER was observed.For ER tablets,SLCO1B1 T521C genotype correlated with AUC 0-24 of repeat doses(P=0.010).SLCO1B1 T521C genotype had no statistically significant effect on AUC 0-24 of IR capsule of fluvastatin after single or repeated doses.In vitro study demonstrated that when the concentration of fluvastatin was low(1μmol/l),transport velocity of fluvastatin by HEK293-OATP1B1 with SLCO1B1521TT(K m=11.4μmol/l)and with SLCO1B1521TCC(K m=15.1μmol/l)tend to be the same.It suggests that the increased effect of SLCO1B1 T521C genotype on ER formulation of fluvastatin was mainly caused by lower blood concentrations.We recommend that formulation should be incorporated into future pharmacogenomics studies.
基金National Natural Science Foundation of China(Grant No.81803497)。
摘要CYP3A4 plays a critical role in clopidogrel activation in the liver.The polymorphism of CYP3A4 may have an important effect on clopidogrel response in patients with cardio-cerebrovascular diseases.We conducted a systematic review and meta-analysis to evaluate the impact of CYP3A4 polymorphism on platelet reactivity after clopidogrel treatment and the outcomes of patients.A systematic literature search(up to 7th October,2019)was performed on the PubMed,EMBASE,Cochrane Library,clinicaltrials.gov,and Chinese databases,including China National Knowledge Infrastructure(CNKI)and Wan Fang Data.Cohort studies or case-control studies evaluated platelet reactivity and patients‟outcomes in different genotype patients.The Review Manager software was used for data analysis,and the NOS scale was used to assess the quality of included studies.A total of 18 articles were included in the Meta-analysis.The results showed the platelet reactivity after clopidogrel administration had no significant difference between CYP3A4 variant carriers and non-carriers.The occurrence of composite ischemic events or stent thrombosis had no significant difference between CYP3A4 variant carriers and non-carriers,either.In conclusion,there was no significant association between CYP3A4 polymorphism and clopidogrel response in patients with cardio-cerebrovascular diseases.
摘要Background: Compound Salvia Pellet (T89), consisting of Danshen (salvia miltiorrhiza), Sanqi (panax notoginseng), and Borneol (Cinnamomum camphora), has been used worldwide for 14 years for chronic angina treatment. Purpose: A dose escalation study to determine the maximum tolerance dose (MTD) in Chinese population to support a proposed dose regimen change. Methods: Forty-six participants (age 18 to 45 yrs, male to female ratio = 1:1) were divided into a series of 6 patients cohorts, and sequentially assigned into one of the escalating dose groups, starting from 540 mg, the clinical doses, until 4 out of 6 subjects experience clinical Adverse Events (AEs) or when the pre-defined 3510 mg dose level is reached and completed. All doses were given orally as a single dose 2 hours after breakfast. Adverse events, vital signs, 12-lead ECG, clinical and laboratory parameters and medical evaluation were conducted as outcome measures. Results: Study completed at the highest pre-defined dose level of 3510 mg dose as never had 4/6 of subject experience AEs in any dose levels studied. All participants completed the study and data were included in the safety analysis. The only moderate AE observation (muscle damage) was observed at 2970 mg dose and was recovered without any medical treatment, and all other AEs (ECG, dizziness, muscle damage) were mild and may (5 cases) or may not (9 cases) be related to testing drug and were all self-resolved within 30 min after dose. Conclusion: Given as single oral dose, Compound Salvia Pellet is safe and well-tolerated up to the 3510 mg studied. The MTD value of Compound Salvia Pellet is unknown from this trial and must be higher than 3510 mg, 13 times higher than its current clinical dose.
摘要The aim of this article was to report a case of toe nails disorder associated with metformin use in an elderly patient with type2diabetes. Two years ago, after receiving metformin 0.5 g three times daily for 6 months, a 60-year-old Chinese man found his ten toe nails gradually thickened and yellowed (especially two thumbs). The symptoms improved and recovered after metformin discontinuance. Half year ago, metformin 0.5 g three times daily adopted again and toe nails disorder occurred again. Physician modified the therapy plan and replaced metformin with acarbose to control blood glucose level of this patient. According to the follow up 3 months after his discharge, ten toe nails recovered significantly and new parts of the nails were normal. Nail disorder was rarely reported in the worldwide, but the physicians should keep awareness of this adverse drug reaction (ADR), proper actions should be taken once it occurred to avoid unnecessary suffering of the patient.
摘要Artificial intelligence(AI)has emerged as a transformative force in healthcare,with applications spanning diagnostics to drug development.However,its integration into drug regulation remains nascent,with varying degrees of adoption and implementation across different regulatory bodies worldwide.This review aims to provide a comprehensive overview of the current state of AI in drug regulation,encapsulating AI-related policies,initiatives,and its practical application in regulatory agencies globally.It further discusses the challenges and future prospects of AI in this field.The findings reveal that numerous agencies have launched action plans and initiatives to incorporate AI,aiming to streamline regulatory processes and enhance data-driven regulatory decision-making.Moreover,AI’s deployment in safety surveillance,workflow optimization,and regulatory science research is expanding,highlighting its increasing impact on drug regulation.Nonetheless,key challenges persist,such as data quality and reliability,technical limitations,talent shortage and the absence of standards.The review concludes that interdisciplinary collaboration is crucial to harness AI’s full potential in drug regulation and overcoming its current limitations.In the future,AI may become a pivotal catalyst in drug regulation,promising a new era of enhanced scrutiny,efficiency,and innovation that will benefit public health on a global scale.
基金supported by the Beijing Natural Science Foundation(L234038)the National Natural Science Foundation of China(no.82274015).
摘要Background:Since the launch of drug regulatory reform in 2015,China has substantially increased the availability of new cancer therapies.However,the efficacy evidence criteria for modified new anticancer drugs have not been evaluated.This cross-sectional study aimed to assess the pivotal trials supporting the indication approvals of innovative and modified new chemical anticancer drugs in China.Methods:The characteristics of indications,regulatory aspects,and pivotal trial designs were extracted and described.The primary efficacy endpoints of the pivotal clinical trials,including overall survival(OS)and progression-free survival(PFS),were quantitatively assessed by meta-analysis.Results:Between 2016 and 2022,77 cancer therapeutics for 107 indications were approved in China based on 128 pivotal trials.Among the 107 indications,64(59.8%)were classified as innovative anticancer drugs,and 43(40.2%)as modified new anticancer drugs.The study found that pivotal trials for innovative approvals tended to be single-arm trials,while modified approvals were more likely to employ randomized clinical trials with larger sample sizes and rigorous designs.Despite innovative drugs often receiving more expedited regulatory designations,there were no statistically significant differences in clinical benefit of OS or PFS outcomes between innovative and modified approvals.Conclusions:These results suggest that the current regulatory framework may prioritize the speed of approval for innovative drugs over the strength of supporting evidence.These findings align with the strategic trends of pharmaceutical companies and regulatory inclinations that aim to expedite the approval of innovative anticancer drugs with a high unmet need,thereby accelerating patients’accessibility to treatment.
摘要Thank you for your thorough review and insightful comments on our research[1].Your observations are highly pertinent and provide valuable insights for our continued examination of China’s evolving anticancer drug regulatory framework.
基金This research was funded by National High Level Hospital Clinical Research Funding(Scientific and Technological Achievements Transformation Incubation Guidance Fund Project of Peking University First Hospital)(Nos.2022CX11 and 2022RT01)National Key R&D Program of China(No.2020YFC2008304)National Natural Science Foundation of China(Nos.81973320 and 81903714).Thanks to Pharmacodia database for retrieving clinical trial data.
摘要Integrins are considered the main cell-adhesion transmembrane receptors that play multifaceted roles as extracellular matrix(ECM)-cytoskeletal linkers and transducers in biochemical and mechanical signals between cells and their environment in a wide range of states in health and diseases.Integrin functions are dependable on a delicate balance between active and inactive status via multiple mechanisms,including protein-protein interactions,conformational changes,and trafficking.Due to their exposure on the cell surface and sensitivity to the molecular blockade,integrins have been investigated as pharmacological targets for nearly 40 years,but given the complexity of integrins and sometimes opposite characteristics,targeting integrin therapeutics has been a challenge.To date,only seven drugs targeting integrins have been successfully marketed,including abciximab,eptifibatide,tirofiban,natalizumab,vedolizumab,lifitegrast,and carotegrast.Currently,there are approximately 90 kinds of integrin-based therapeutic drugs or imaging agents in clinical studies,including small molecules,antibodies,synthetic mimic peptides,antibody-drug conjugates(ADCs),chimeric antigen receptor(CAR)T-cell therapy,imaging agents,etc.A serious lesson from past integrin drug discovery and research efforts is that successes rely on both a deep understanding of integrin-regulatory mechanisms and unmet clinical needs.Herein,we provide a systematic and complete review of all integrin family members and integrin-mediated downstream signal transduction to highlight ongoing efforts to develop new therapies/diagnoses from bench to clinic.In addition,we further discuss the trend of drug development,how to improve the success rate of clinical trials targeting integrin therapies,and the key points for clinical research,basic research,and translational research.
基金This study was supported by National Natural Science Foundation of China(NSFC,Grant No.81803614).
摘要The outbreak and spread of coronavirus disease 2019(COVID-19)highlighted the importance and urgency of the research and development of therapeutic drugs.Very early into the COVID-19 pandemic,China has begun developing drugs,with some notable progress.Herein,we summarizes the anti-COVID-19 drugs and promising drug candidates originally developed and researched in China.Furthermore,we discussed the developmental prospects,mechanisms of action,and advantages and disadvantages of the anti-COVID-19 drugs in development,with the aim to contribute to the rational use of drugs in COVID-19 treatment and more effective development of new drugs against severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)and the variants.Neutralizing antibody is an effective approach to overcome COVID-19.However,drug resistance induced by rapid virus mutation will likely to challenge neutralizing antibodies.Taking into account current epidemic trends,small molecule drugs have a crucial role in fighting COVID-19 due to their significant advantage of convenient administration and affordable and broad-spectrum.Traditional Chinese medicines,including natural products and traditional Chinese medicine prescriptions,contribute to the treatment of COVID-19 due to their unique mechanism of action.Currently,the research and development of Chinese anti-COVID-19 drugs have led to some promising achievements,thus prompting us to expect even more rapidly available solutions.
基金This research was funded by National High Level Hospital Clinical Research Funding(Scientific and Technological Achievements Transformation Incubation Guidance Fund Project of Peking University First Hospital)(No.2022CX11,No.2022RT01)National Key R&D Program of China(No.2020YFC2008304)National Natural Science Foundation of China(No.81973320 and No.81903714).Thanks to Dr.Qian Wang in the State Key Laboratory of Natural and Biomimetic Drugs,Peking University for the experimental assistance of SPR.Thanks to K2 Oncology Co.Ltd.for experimental assistance with patient-derived organoids.
摘要Dear Editor,The integrinαvβ3 receptor is a promising target for anticancer therapy.1,2 However,there are no effective marketed treatments targetingαvβ3.One possible limitation of Arginine-Glycine-Aspartic(RGD)-mimeticαvβ3 antagonists has been shown to cause partial agonism,which could induce major conformational changes that trigger paradoxical cell adhesion and angiogenesis.
基金supported by the National Nature Science Foundation of China(82330021,82061160372,82270771)the National Key Research and Development Program(2020YFC2004405)+13 种基金the Shenzhen Key Laboratory of Precision Prevention and Control of Major Chronic Diseases and Metabolic Research(ZDSYS20220606100801004)the Central Military Commission Key Project of Basic Research for Application(BWJ21J003)the Regional Joint Funding Key Project of Guangdong Basic Research and Basic Research for Application(2021B1515120083)the Key Project of Sustainable Development Science and Technology of Shenzhen Science and Technology Innovation Committee(KCXFZ20211020163801002)Shenzhen Science and Technology Program(ZDSYS20220606100801004,SGDX20230116092459009)Shenzhen Medical Research Fund(B2302020)Shenzhen Key Medical Discipline Construction Fund(SZXK002)the Sun Yat-sen University-Shenzhen TAILORED Medical Ltd.Postgraduate joint training base,the Futian District Public Health Scientific Research Project of Shenzhen(FTWS2022001)Department of Cardiology,Joint Laboratory of Guangdong-Hong Kong-Macao Universities for Nutritional Metabolism and Precise Prevention and Control of Major Chronic Diseases,the Eighth Affiliated Hospital of Sun Yat-sen University,Shenzhen,the Chinese Association of Integrative Medicine-Shanghai Hutchison Pharmaceuticals Fund(HMPE202202)China Heart House-Chinese Cardiovascular Association HX fund(2022-CCA-HX-090)the Shenzhen Key Medical Discipline Construction Fund(SZXK002)to H.HShenzhen Medical Research Fund(A2302013)to Zhengzhipeng ZhangThe fifth“333”high-level talent training project of Jiangsu Province(BRA2019247)Medical Research Project of Jiangsu Provincial Health Commission in 2020(ZDA2020018).
摘要Previous studies have shown that low platelet count combined with high plasma total homocysteine(tHcy)increased stroke risk and can be lowered by 73% with folic acid.However,the combined role of other platelet activation parameters and the methylenetetrahydrofolate reductase(MTHFR)C677T genotypes on stroke risk and folic acid treatment benefit remain to be examined.This study aimed to investigate if platelet activation parameters and MTHFR genotypes jointly impact folic acid treatment efficacy in first stroke prevention.Data were derived from the China Stroke Primary Prevention Trial.This study includes a total of 11,185 adult hypertensive patients with relevant platelet activation parameters and MTHFR genotype data.When simultaneously considering both platelet activation parameters(plateletcrit,platelet count,mean platelet volume,platelet distribution width)and MTHFR genotypes,patients with both low plateletcrit(Q1)and the TT genotype had the highest stroke incidence rate(5.6%)in the enalapril group.This subgroup significantly benefited from folic acid treatment,with a 66% reduction in first stroke(HR:0.34;95%CI:0.14-0.82;p=0.016).Consistently,the subgroup with low plateletcrit(Q1)and the CC/CT genotype also benefited from folic acid treatment(HR:0.40;95%CI:0.23-0.70;p=0.001).In Chinese hypertensive adults,low plateletcrit can identify those who may greatly benefit from folic acid treatment,in particular,those with the TT genotype,a subpopulation known to have the highest stroke risk.