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Our results show that the hydrophilicity of colloidal silica affects surface coverage, ranging from 6% to over 80%. Binary mixtures with hydrophobic additives, D10 and D17, generated smaller silica aggregates with a wider spread on the surface of host particles. For Retalac® conditioned at 20% RH, HR values changed from 1.30 (acceptable flow) to 1.17 (good flow). For Avicel® PH-102, conditioned at 60% RH, HR values changed from 1.22 (fair flow) to less than 1.10 (excellent flow).In recent years, transdermal preparations have emerged as one of the most promising modes of administration. Asunaprevir in vitro In particular, dissolving microneedles have attracted extensive attention because of their painlessness, safety, high delivery efficiency and easily operation for patients. This article mainly reviews the preparation methods, the types of matrix polymer materials, the content of dissolving microneedles performance testing, and the applications of dissolving microneedles. It is expected to lay a solid knowledge foundation for the in-depth study of the dissolving microneedles.Bupivacaine and ketorolac are commonly used in combination to reduce perioperative pain. This study aimed to develop and characterize an injectable system that offers simultaneous and prolonged release of bupivacaine and ketorolac. Formulations were prepared using poloxamer 407 with increasing concentrations of poloxamer 188 and sodium chloride. Small Angle X-ray Scattering (SAXS) experiments demonstrated that the poloxamers form gels with a cubic lattice arrangement regardless of the matrix composition, whereas the system porosity is driven by poloxamers concentration. Drug loading slightly reduced the intermicellar spacing. Fourier transform infrared spectroscopy and thermal analysis suggested electrostatic interactions between the loaded drugs and poloxamers. Mechanical and rheological studies confirmed the formulations exhibit Newtonian-like flow at room temperature followed by a transition to a viscous gel at body temperature. Importantly, the developed formulations demonstrated steady and sustained release of both bupivacaine and ketorolac over two weeks. Sodium chloride reduced the initial burst release over the first six hours for BH, from 8.6 ± 0.18% to 1.6 ± 0.11%, and KT, from 7.7 ± 0.27% to 1.5 ± 0.10%. Hence, poloxamer-based thermoresponsive gelling systems are promising delivery platforms for the sustained delivery of bupivacaine and ketorolac, with potential clinical benefits for managing perioperative pain.

Existing criteria to improve the probability of capturing dermatomyositis (DM) include muscle biopsy but little is known about whether less invasive diagnostic procedures may be just as useful.

We aimed to determine whether skin biopsy, electromyography, or magnetic resonance imaging of the involved muscle could be done in lieu of muscle biopsy.

Two hundred and seventy-five patients were reviewed to investigate the presence of cutaneous and muscle disease, their timing in relation to diagnosis, and results of skin biopsies, muscle biopsies, magnetic resonance imaging, and electromyography.

Of the cases with findings consistent with DM on muscle biopsy, 65% were in agreement with diagnostic features on electromyography or magnetic resonance imaging. Results of skin and muscle biopsies supported DM in 67% of patients who underwent both procedures.

A limited number of patients had muscle biopsies.

In the presence of DM-specific skin findings, less invasive procedures may be sufficient to diagnose DM and guide its management.

In the presence of DM-specific skin findings, less invasive procedures may be sufficient to diagnose DM and guide its management.

No studies evaluating the rapidity of response to biological therapies are available for Crohn’s disease (CD). The aim of this study was to evaluate rapidity of onset of clinical response and impact on quality of life (QoL) of adalimumab therapy in adult anti-TNF-naïve patients with moderately-to-severely active CD.

RAPIDA was an open-label, single-arm, prospective, multicenter clinical trial. Adult patients with moderately-to-severely active luminal CD, anti-TNF-naïve, and unresponsive to conventional therapy were treated with adalimumab. Clinical disease activity, QoL and inflammatory biomarkers were measured at day 4, and weeks 1, 2, 4, and 12 after treatment initiation.

Eighty-six patients were included in the intention-to-treat (ITT) analyses. Clinical disease activity was reduced from a median of 9.0 points to 6.0 points at day 4. Clinical response (≥ 3-point reduction in the Harvey-Bradshaw Index, HBI) was achieved by 61.6% (d4) and 75.6% (w1) of patients in the ITT population (median 2.5 days) and with non-responder imputation (NRI), by 55.8% and 53.4%, respectively. The proportion of patients in clinical remission (HBI<5) at weeks 2 and 4 in the ITT population was 54.7% and 62.8%, respectively (median 7.0 days), and 38.4% and 45.3% in the NRI population. All QoL scores significantly improved and inflammatory biomarkers significantly decreased from day 4 onwards (p<0.0001).

Rapid clinical response and remission, improvement in QoL and fatigue, and a reduction of inflammatory biomarkers were achieved with adalimumab as early as day 4 in adult anti-TNF-naïve patients with moderately-to-severely active CD.

Rapid clinical response and remission, improvement in QoL and fatigue, and a reduction of inflammatory biomarkers were achieved with adalimumab as early as day 4 in adult anti-TNF-naïve patients with moderately-to-severely active CD.

Nonadherence to medication is common in patients with inflammatory bowel disease (IBD) and can result in disease complications, therapy escalation, and the need for corticosteroids. The aim of this study was to assess the adherence to self-administered subcutaneous biologic medications prescribed for IBD and to identify the risk factors for nonadherence.

A retrospective cohort study on IBD patients initiated on subcutaneous biologic therapy between January 2016 and July 2019 was performed. Medical records were retrospectively reviewed for collection of demographic and IBD data. Medication possession ratios (mMPRs) during the first 12 months of treatment and at the end of the follow-up period (global, 42 months) were calculated. Nonadherence was defined as an mMPR of <90%. Multiple regression analysis was performed to assess the risk factors for nonadherence to therapy.

A total of 154 patients (84 male and 70 female; mean age at biologic treatment initiation, 36±14 years; Crohn’s disease, n=118; ulcerative colitis, n=31; indeterminate colitis, n=5) were included; 121 received adalimumab (ADA) and 33 received ustekinumab (UST); 63% were naive to anti-TNF therapy, while 16.