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Zhang P. et al., 2017, The Lancet

 

Utidelone, a genetically engineered epothilone analogue, has emerged as a potential treatment for breast cancer in phase 1 and 2 trials. This phase III multicentre, open- label, randomized controlled trial was planned to compare the efficacy and safety of utidelone-capecitabine combination versus capecitabine alone in 270 patients with metastatic breast cancer. Patients were randomly assigned (2:1) to a 21-day cycle of either utidelone (30 mg/m2 IV once per day on days 1–5) plus capecitabine (1000 mg/m2 orally twice per day on days 1–14), or capecitabine alone (1250 mg/m2 orally twice per day on days 1–14), until disease progression or unacceptable toxicity occurred. PFS (progression free survival) was assessed as the primary end- point. Median PFS in the combination group was 8·44 months (95% CI 7·95–9·92) compared with 4·27 months (3·22–5·68) in the capecitabine alone group. Peripheral neuropathy and Palmar-plantar erythrodysaesthesia were the most prominent grade 3 adverse event in the combination and monotherapy group respectively. 155 patients died (99 in combination therapy, 56 in monotherapy). All deaths, except one in each group were due to disease progression. This study has demonstrated that the combination was more efficacious compared to capecitabine alone, with mild toxicity and a longer PFS; thus making it an effective option for patients with metastatic breast cancer.

 

http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(17)30088-8/abstract

Pradeep A. R. et al, November 2016, Journal of Periodontology

 

Gingivitis, the early stage of periodontal disease, is an infection of the tissues that surround your teeth, and is caused by a buildup of plaque.Anantiplaqueagent with minimal side effects that can be used as an effective adjunct to mechanical plaque control is needed. Recently a randomized control trial was planned to evaluate the efficacy of triphala (TRP) mouthwash in reduction of plaque and gingivitis.  Ninety individuals with chronic generalized gingivitis were randomly assigned to three groups: placebo mouthwash; TRP mouthwash; chlorhexidine (CHX) mouthwash and were instructed to rinse with their respective mouthwash twice daily. 1) Plaque index (PI); 2) gingival index (GI); 3) oral hygiene index-simplified (OHI-S); and 4) microbiologic colony counts were recorded at different time intervals. A significant difference was noticed in all four parameters in group I compared with groups II and III. However, there were no significant differences found between groups II and III for any parameters at any time intervals. From these results it was concluded that TRP mouthwash was comparable with that of CHX mouthwash for improvement in gingivitis and therefore it can be considered a potential therapeutic agent in the treatment of gingivitis.

 

http://www.joponline.org/doi/10.1902/jop.2016.130406

Pradeep A. R. et al, November 2016, Journal of Periodontology

 

Since the discovery of antibiotics in the 1940s, research in this domain has been continuous, giving the world of an array of antibiotics. However, development of resistance to these antibiotics is a challenge that the researchers face on a daily basis. In a major breakthrough, scientists have discovered a fresh antibiotic, Teixobactin, produced by a screen of unculturable bacteria. Using a multichannel device, iChip, scientists cultured the unculturable bacteria in soil, screened the extracts obtained and identified Teixobactin. Further investigations into the activity spectrum and mechanism of action revealed that the antibiotic exhibited excellent activity against Gram- positive pathogens, including the drug- resistant strains; that expanded to difficult-to-treat enterococci, M. tuberculosis, C. difficle, B. anthracis and the very infamous, S. aureus MRSA. It inhibited cell wall synthesis, without affecting the DNA/ RNA and protein functions. To examine the development of resistance, Teixobactin was tested in a low dose against S. aureus and M. tuberculosis. Mutant strains did not develop, thus proposing a possible solution to antibiotic- resistance among pathogens. In vitro studies on cell lines showed no signs of apparent toxicity and in vivo efficacy studies in mouse models displayed superior efficacy. After decades of research channelled towards discovering antibiotics that do not allow for resistance development, discovery of Teixobactin has definitely given the research community hope to ‘unearth’ similar compounds.

 

http://www.nature.com/nature/journal/v517/n7535/full/nature14098.html

https://veedacr.com/2016-year-in-review/

Ling L. et al, 2015, Nature

 

Since the discovery of antibiotics in the 1940s, research in this domain has been continuous, giving the world of an array of antibiotics. However, development of resistance to these antibiotics is a challenge that the researchers face on a daily basis. In a major breakthrough, scientists have discovered a fresh antibiotic, Teixobactin, produced by a screen of unculturable bacteria. Using a multichannel device, iChip, scientists cultured the unculturable bacteria in soil, screened the extracts obtained and identified Teixobactin. Further investigations into the activity spectrum and mechanism of action revealed that the antibiotic exhibited excellent activity against Gram- positive pathogens, including the drug- resistant strains; that expanded to difficult-to-treat enterococci, M. tuberculosis, C. difficle, B. anthracis and the very infamous, S. aureus MRSA. It inhibited cell wall synthesis, without affecting the DNA/ RNA and protein functions. To examine the development of resistance, Teixobactin was tested in a low dose against S. aureus and M. tuberculosis. Mutant strains did not develop, thus proposing a possible solution to antibiotic- resistance among pathogens. In vitro studies on cell lines showed no signs of apparent toxicity and in vivo efficacy studies in mouse models displayed superior efficacy. After decades of research channelled towards discovering antibiotics that do not allow for resistance development, discovery of Teixobactin has definitely given the research community hope to ‘unearth’ similar compounds.

 

http://www.nature.com/nature/journal/v517/n7535/full/nature14098.html

https://veedacr.com/2016-year-in-review/

 

Mosquirix(RTS,S/ AS01) is a protein- based recombinant malaria vaccine, recently approved by the EMA. It is the first licensed vaccine, to be used for a parasitic disease. Developed by GlaxoSmithKline Vaccines, Belgium, in collaboration with the Walter Reed Army Institute of Researchand funded in part by PATH Malaria Vaccine Initiative (MVI) and with support from the Bill & Melinda Gates Foundation, it is considered as landmark achievement in the campaign against malaria. Mosquirix remains the first malaria vaccine to have completed Phase III trials, enrolling 15000 infants and young children from seven countries in sub- Saharan Africa. Efficacy was shown to range between 26- 50% in infants and children. Another set of preliminary studies indicated an efficacy of 86.7% in healthy, malaria- naive adults.

On November 2017, WHO announced the roll- out of the vaccine in pilot projects in three countries of sub-Saharan Africa. This WHO- coordinated programme is aimed to assess the vaccine’s efficacy in real- life settings. The programme will also evaluate the feasibility of delivery of the 4 required doses, the impact of the vaccines on the lives and the safety of the vaccine with respect to scheduled use.

https://www.ncbi.nlm.nih.gov/pubmed/25913272

https://www.ncbi.nlm.nih.gov/pubmed/27296848

http://www.who.int/mediacentre/news/releases/2016/funding-malaria-vaccine/en/

Thabit H. et al., Lancet Diabetes Endocrinology,  2017

 

An open- label, parallel- group, randomized controlled trial was conducted by Thabit H et al. to assess the safety and efficacy of fully closed-loop insulin delivery (so-called artificial pancreas), as compared to the standard subcutaneous insulin therapy in patients with type 2 diabetes mellitus. During the one year study period, 40 patients aged 18 years and above, from general ward were randomized to receive closed- loop insulin delivery (using a model-predictive control algorithm to direct subcutaneous delivery of rapid-acting insulin analogue without meal-time insulin boluses) or the conventional subcutaneous insulin delivery. The primary outcome i.e.; time spent in the target glucose concentration range of 5.6-10.0 mmol/L during the 72 hour study period; was 59·8% (SD 18·7) in the closed-loop group and 38·1% (16·7) in the control group (difference 21·8% [95% CI 10·4–33·1]; p=0·0004). No episodes of severe hypoglycaemia or hyperglycaemia with ketonaemia were observed in either group. Thus, closed- loop insulin delivery without meal-time boluses is safe and efficacious in insulin-treated adults with type 2 diabetes in the general ward.

 

https://www.ncbi.nlm.nih.gov/pubmed/27836235