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001-es BibID:	BIBFORM015816
Első szerző:	Gerlag, Danielle M.
Cím:	Preclinical and clinical investigation of a CCR5 antagonist, AZD5672, in patients with rheumatoid arthritis receiving methotrexate / Gerlag, D. M., Hollis, S., Layton, M., Vencovsky, J., Szekanecz, Z., Braddock, M., Tak, P. P., The ESCAPE Study Group
Dátum:	2010
ISSN:	1529-0131 (Electronic)
Megjegyzések:	To investigate both the preclinical effects of blocking the chemokine receptor CCR5 and the clinical effects of this approach on the signs and symptoms of rheumatoid arthritis (RA) in patients with active disease. METHODS: Preclinical evaluations of AZD5672, a small-molecule antagonist of CCR5, were performed, including studies of ligand binding and chemotaxis. The pharmacokinetics of AZD5672 were assessed in both single- and multiple-dose studies in healthy volunteers. A randomized, placebo-controlled, phase IIb study was conducted in patients with active RA receiving methotrexate. Treatment arms were AZD5672 (20, 50, 100, or 150 mg orally, once daily), matched placebo, or open-label etanercept (50 mg subcutaneously, once weekly). The primary end point was the proportion of patients achieving a 20% improvement response on the American College of Rheumatology improvement criteria (ACR20) at week 12. Secondary end points included the ACR20 over time, as well as 50% (ACR50) and 70% (ACR70) improvement responses, changes in individual components of the ACR improvement criteria, and disease activity measured with the Disease Activity Score based on the 28-joint count. RESULTS: AZD5672 was a highly potent and selective antagonist of CCR5, displaying nonproportional steady-state pharmacokinetics while inhibiting internalization of CCR5 in an ex vivo macrophage inflammatory protein 1beta stimulation assay in which AZD5672 was evaluated over the 20-150-mg dose range. In the phase IIb study testing this dose range in patients with RA (n = 371 patients randomized to received treatment), AZD5672 was generally well tolerated, with no unexpected adverse events. There was no statistically significant difference in the proportion of patients achieving an ACR20 response at week 12 between those receiving any dose of AZD5672 and those receiving placebo; etanercept was significantly more efficacious than AZD5672 and placebo. CONCLUSION: Despite a clear rationale for targeting CCR5, this clinical study showed that AZD5672, administered orally, did not have any clinical benefit, suggesting that CCR5 antagonism alone is unlikely to be a viable therapeutic strategy in RA.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban Antirheumatic Agents/therapeutic use Arthritis, Rheumatoid/drug therapy Benzeneacetamides/therapeutic use Chi-Square Distribution Double-Blind Method Drug Therapy, Combination Female Humans Male Methotrexate/therapeutic use Receptors, CCR5/antagonists & inhibitors Sulfonamides/*therapeutic use Treatment Outcome
Megjelenés:	Arthritis and Rheumatism. - 62 : 11 (2010), p. 3154-3160. -
További szerzők:	Hollis, Sally Layton, Mark Vencovsky, Jiri Szekanecz Zoltán (1964-) (reumatológus, belgyógyász, immunológus) Braddock, Martin Tak, Paul P. The ESCAPE Study Group
Internet cím:	DOI elektronikus változat Intézményi repozitóriumban (DEA) tárolt változat
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001-es BibID:	BIBFORM035120
035-os BibID:	PMID:21978977
Első szerző:	Szekanecz Zoltán (reumatológus, belgyógyász, immunológus)
Cím:	Chemokine and chemokine receptor blockade in arthritis, a prototype of immune-mediated inflammatory diseases / Z. Szekanecz, A. E. Koch, P. P. Tak
Dátum:	2011
ISSN:	0300-2977
Megjegyzések:	Chemokines and chemokine receptors have been implicated in inflammatory cell recruitment and angiogenesis underlying the pathogenesis of rheumatoid arthritis (RA) and other inflammatory rheumatic diseases. Numerous CXC, CC, C and CX3C chemokines and their receptors have been detected in the arthritic synovium and numerous strategies, including biologics, peptide and other small molecule inhibitors of chemokines and their receptors have given promising results in preclinical studies performed in animal models of arthritis. However, most recent human RA trials using antibodies and synthetic compounds have failed. Reasons for negative results of these RA trials include overlapping actions of multiple chemokines, dose-dependency, both antagonistic and agonistic effects of chemokines, chemokine degradation by proteases, as well as effects of anti-inflammatory, regulatory cells. Recent studies have suggested that CCR1 may still be a good target and previous trials may have failed because of the need of sustained CCR1 occupancy throughout the treatment. Therefore, modulation of receptor occupancy may be a feasible option to increase the efficacy of chemokine receptor targeting.PMID:21978977
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban Rheumatoid arthritis chemokines chemokine receptors targeting külföldön készült közlemény
Megjelenés:	Netherlands Journal of Medicine. - 69 : 9 (2011), p. 356-366. -
További szerzők:	Koch, Alisa E. Tak, Paul P.
Internet cím:	Intézményi repozitóriumban (DEA) tárolt változat Szerző által megadott URL
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