A systematic review of the safety of lisdexamfetamine dimesylate

BACKGROUND: Here we review the safety and tolerability profile of lisdexamfetamine dimesylate (LDX), the first long-acting prodrug stimulant for the treatment of attention-deficit/hyperactivity disorder (ADHD). METHODS: A PubMed search was conducted for English-language articles published up to 16 September 2013 using the following search terms: (lisdexamfetamine OR lisdexamphetamine OR SPD489 OR Vyvanse OR Venvanse OR NRP104 NOT review [publication type]). RESULTS: In short-term, parallel-group, placebo-controlled, phase III trials, treatment-emergent adverse events (TEAEs) in children, adolescents, and adults receiving LDX were typical for those reported for stimulants in general. Decreased appetite was reported by 25-39 % of patients and insomnia by 11-19 %. The most frequently reported TEAEs in long-term studies were similar to those reported in the short-term trials. Most TEAEs were mild or moderate in severity. Literature relating to four specific safety concerns associated with stimulant medications was evaluated in detail in patients receiving LDX. Gains in weight, height, and body mass index were smaller in children and adolescents receiving LDX than in placebo controls or untreated norms. Insomnia was a frequently reported TEAE in patients with ADHD of all ages receiving LDX, although the available data indicated no overall worsening of sleep quality in adults. Post-marketing survey data suggest that the rate of non-medical use of LDX was lower than that for short-acting stimulants and lower than or equivalent to long-acting stimulant formulations. Small mean increases were seen in blood pressure and pulse rate in patients receiving LDX. CONCLUSIONS: The safety and tolerability profile of LDX in individuals with ADHD is similar to that of other stimulants

Efficacy of lisdexamfetamine dimesylate throughout the day in children and adolescents with attention-deficit/hyperactivity disorder:results from a randomized, controlled trial

Lisdexamfetamine dimesylate (LDX) is a long-acting, prodrug stimulant therapy for patients with attention-deficit/hyperactivity disorder (ADHD). This randomized placebo-controlled trial of an optimized daily dose of LDX (30, 50 or 70 mg) was conducted in children and adolescents (aged 6–17 years) with ADHD. To evaluate the efficacy of LDX throughout the day, symptoms and behaviors of ADHD were evaluated using an abbreviated version of the Conners’ Parent Rating Scale-Revised (CPRS-R) at 1000, 1400 and 1800 hours following early morning dosing (0700 hours). Osmotic-release oral system methylphenidate (OROS-MPH) was included as a reference treatment, but the study was not designed to support a statistical comparison between LDX and OROS-MPH. The full analysis set comprised 317 patients (LDX, n = 104; placebo, n = 106; OROS-MPH, n = 107). At baseline, CPRS-R total scores were similar across treatment groups. At endpoint, differences (active treatment − placebo) in least squares (LS) mean change from baseline CPRS-R total scores were statistically significant (P < 0.001) throughout the day for LDX (effect sizes: 1000 hours, 1.42; 1400 hours, 1.41; 1800 hours, 1.30) and OROS-MPH (effect sizes: 1000 hours, 1.04; 1400 hours, 0.98; 1800 hours, 0.92). Differences in LS mean change from baseline to endpoint were statistically significant (P < 0.001) for both active treatments in all four subscales of the CPRS-R (ADHD index, oppositional, hyperactivity and cognitive). In conclusion, improvements relative to placebo in ADHD-related symptoms and behaviors in children and adolescents receiving a single morning dose of LDX or OROS-MPH were maintained throughout the day and were ongoing at the last measurement in the evening (1800 hours)

Rapidly re-computable EEG (electroencephalography) forward models for realistic head shapes

Solution of the EEG source localization (inverse) problem utilizing model-based methods typically requires a significant number of forward model evaluations. For subspace based inverse methods like MUSIC [6], the total number of forward model evaluations can often approach an order of 10{sup 3} or 10{sup 4}. Techniques based on least-squares minimization may require significantly more evaluations. The observed set of measurements over an M-sensor array is often expressed as a linear forward spatio-temporal model of the form: F = GQ + N (1) where the observed forward field F (M-sensors x N-time samples) can be expressed in terms of the forward model G, a set of dipole moment(s) Q (3xP-dipoles x N-time samples) and additive noise N. Because of their simplicity, ease of computation, and relatively good accuracy, multi-layer spherical models [7] (or fast approximations described in [1], [7]) have traditionally been the 'forward model of choice' for approximating the human head. However, approximation of the human head via a spherical model does have several key drawbacks. By its very shape, the use of a spherical model distorts the true distribution of passive currents in the skull cavity. Spherical models also require that the sensor positions be projected onto the fitted sphere (Fig. 1), resulting in a distortion of the true sensor-dipole spatial geometry (and ultimately the computed surface potential). The use of a single 'best-fitted' sphere has the added drawback of incomplete coverage of the inner skull region, often ignoring areas such as the frontal cortex. In practice, this problem is typically countered by fitting additional sphere(s) to those region(s) not covered by the primary sphere. The use of these additional spheres results in added complication to the forward model. Using high-resolution spatial information obtained via X-ray CT or MR imaging, a realistic head model can be formed by tessellating the head into a set of contiguous regions (typically the scalp, outer skull, and inner skull surfaces). Since accurate in vivo determination of internal conductivities is currently not currently possible, the head is typically assumed to consist of a set of contiguous isotropic regions, each with constant conductivity

Toward a global description of the nucleus-nucleus interaction

Extensive systematization of theoretical and experimental nuclear densities and of optical potential strengths exctracted from heavy-ion elastic scattering data analyses at low and intermediate energies are presented.The energy-dependence of the nuclear potential is accounted for within a model based on the nonlocal nature of the interaction.The systematics indicate that the heavy-ion nuclear potential can be described in a simple global way through a double-folding shape,which basically depends only on the density of nucleons of the partners in the collision.The poissibility of extracting information about the nucleon-nucleon interaction from the heavy-ion potential is investigated.Comment: 12 pages,12 figure

A common genetic variant of a mitochondrial RNA processing enzyme predisposes to insulin resistance

Mitochondrial energy metabolism plays an important role in the pathophysiology of insulin resistance. Recently, a missense N437S variant was identified in the MRPP3 gene, which encodes a mitochondrial RNA processing enzyme within the RNase P complex, with predicted impact on metabolism. We used CRISPR-Cas9 genome editing to introduce this variant into the mouse Mrpp3 gene and show that the variant causes insulin resistance on a high-fat diet. The variant did not influence mitochondrial gene expression markedly, but instead, it reduced mitochondrial calcium that lowered insulin release from the pancreatic islet β cells of the Mrpp3 variant mice. Reduced insulin secretion resulted in lower insulin levels that contributed to imbalanced metabolism and liver steatosis in the Mrpp3 variant mice on a high-fat diet. Our findings reveal that the MRPP3 variant may be a predisposing factor to insulin resistance and metabolic disease in the human population

Gradijentna HPLC analiza raloksifen hidroklorida i primjena u kontroli kvalitete

A rapid, sensitive and selective method for the determination of raloxifene hydrochloride (RLX) in pure drug and in tablets was developed using gradient high performance liquid chromatography (HPLC). The devised method involved separation of RLX on a reversed phase Hypersil ODS column and determination with UV detection at 284 nm. The standard curve was linear (R = 0.999) over the concentration range of 50-600 μg mL1 with a detection limit of 0.04 μg mL1 and a quantification limit of 0.16 μg mL1. Intra-day and inter-day precision and accuracy of the method were established according to the current ICH guidelines. Intra-day RSD values at three QC levels (250, 450 and 550 μg mL1) were 0.20.5% based on the peak area. The intra-day relative error (er) was between 0.2 and 0.5%. The developed method was successfully applied to the determination of RLX in tablets and the results were statistically compared with those obtained by a literature method. Accuracy, evaluated by means of the spike recovery method, was excellent with percent recovery in the range 97.7103.2 with precision in the range 1.62.2%. No interference was observed from the conformulated substances. The method was economical in terms of the time taken and the amount of solvent used.Koristeći gradijentnu tekućinsku kromatografiju visoke učinkovitosti razvijena je brza, osjetljiva i selektivna metoda za određivanje raloksifen hidroklorida (RLX), čiste supstancije i u tabletama. U radu je primijenjena reverzno-fazna kolona Hypersil ODS te UV detekcija pri 284 nm. Standardna krivulja bila je linearna (R = 0,999) u koncentracijskom području 50600 μg mL1. Granica detekcije bila je 0,04 μg mL1 a granica određivanja 0,16 μg mL1. Repetabilnost, intermedijalna preciznost i ispravnost ispitivane su prema važećim ICH uputama. Mjerenjem površine ispod pika na tri koncentracijske razine (250, 450 i 550 μg mL1) procijenjena je repetabilnost na 0,20,5%. Relativna pogreška procijenjena unutar jednog dana (er) bila je između 0,2 i 0,5%. Razvijena metoda uspješno je primijenjena za određivanje RLX u tabletama. Rezultati su statistički uspoređeni s rezultatima dobivenim prema ranije objavljenoj metodi. Analitički povrat bio je u rasponu 97,7103,2 uz preciznost od 1,6 do 2,2%. Nije primijećena interferencija pomoćnih tvari. Metoda je ekonomična s obzirom na utrošeno vrijeme i količine upotrebljenog otapala

The ENIGMA Stroke Recovery Working Group: Big data neuroimaging to study brain–behavior relationships after stroke

The goal of the Enhancing Neuroimaging Genetics through Meta‐Analysis (ENIGMA) Stroke Recovery working group is to understand brain and behavior relationships using well‐powered meta‐ and mega‐analytic approaches. ENIGMA Stroke Recovery has data from over 2,100 stroke patients collected across 39 research studies and 10 countries around the world, comprising the largest multisite retrospective stroke data collaboration to date. This article outlines the efforts taken by the ENIGMA Stroke Recovery working group to develop neuroinformatics protocols and methods to manage multisite stroke brain magnetic resonance imaging, behavioral and demographics data. Specifically, the processes for scalable data intake and preprocessing, multisite data harmonization, and large‐scale stroke lesion analysis are described, and challenges unique to this type of big data collaboration in stroke research are discussed. Finally, future directions and limitations, as well as recommendations for improved data harmonization through prospective data collection and data management, are provided

Određivanje donepezil hidroklorida u humanoj plazmi i ljekovitim oblicima pomoću HPLC s detekcijom fluorescencije

A sensitive, isocratic reversed-phase high performance liquid chromatographic method involving fluorescence detection was developed for the determination of donepezil hydrochloride in tablets and in human plasma. Pindolol was successfully used as an internal standard. Good chromatographic separation was achieved by using analytical column C18. The system operated at room temperature using a mobile phase consisting of methanol, phosphate buffer (0.02 mol L1) and triethyl amine (pH 3.5) (55: 45: 0.5 V/V/V) at a flow rate 0.9 mL min1. The analyte and internal standard were extracted from human plasma via liquid-liquid extraction. The proposed method was validated for selectivity, linearity, accuracy and precision. The calibration curve was linear over the range of 5-2000 ng mL1 of donepezil with detection limit of 1.5 ng mL1. Intra- and inter-day relative standard deviations were less than 2.5 %. The method was found to be suitable for the quality control of donepezil hydrochloride in bulk drug as well as in human plasma.Ovaj rad opisuje HPLC metodu određivanja donepezil hidroklorida (DP) u tabletama i u ljudskoj plazmi u nano području. Postavljena je osjetljiva metoda izokratične HPLC s fluorescencijskom detekcijom. Kao unutarnji standard upotrebljen je pindolol. Dobro kromatografsko odjeljivanje postignuto je primjenom analitičke kolone C18. Radna temperatura bila je sobna, a kao mobilna faza upotrebljena je smjesa metanola, fosfatnog pufera (0,02 mol L1) i trietilamina (pH 3,5) (55:45:0.5 V/V/V). Analit i unutarnji standard su ekstrahirani iz ljudske plazme ekstrakcijom tekuće-tekuće. Predložena metoda je validirana s obzirom na selektivnost, područje linearnosti, ispravnost i preciznost. Kalibracijska funkcija bila je linearna u području od 5-2000 ng mL1 donepezila, a granica detekcije iznosila je 2 ng mL1. Relativna standardna devijacija za repetabilnost i intermedijarnu preciznost bila je manja od 2,5 %. Metoda je primjenljliva u kontroli kvalitete ljekovitih formulacija s DP-om i u praćenju DP-a u ljudskoj plazmi