The Experts below are selected from a list of 399 Experts worldwide ranked by ideXlab platform

Benedetta C Sallustio - One of the best experts on this subject based on the ideXlab platform.

Elliott M Antman - One of the best experts on this subject based on the ideXlab platform.

  • efficacy and safety of Perhexiline Maleate in refractory angina a double blind placebo controlled clinical trial of a novel antianginal agent
    Circulation, 1990
    Co-Authors: Patricia Cole, Andrew D Beamer, Noreen Mcgowan, Catherine Cantillon, K Benfell, Ralph A Kelly, L H Hartley, Thomas W Smith, Elliott M Antman
    Abstract:

    Despite large gains in the medical and surgical treatment of angina pectoris in the past two decades, many patients are refractory to conventional medical therapy and are unsuitable for a first or, more commonly, repeat coronary revascularization procedure. We evaluated the efficacy of Perhexiline Maleate, a drug with an antianginal mechanism of action in humans that is as yet unknown, by using a randomized double-blind placebo-controlled crossover design in 17 patients with refractory angina who continued to receive maximal antianginal therapy, typically including nitrates, a beta-blocker, and a calcium channel antagonist. In view of Perhexiline's potential for hepatic and neurological toxicity, plasma drug levels were monitored and maintained in the 150-600 ng/ml range. Sixty-three percent of patients were judged Perhexiline responders by objective exercise testing criteria, as compared with 18% of patients on placebo (p less than 0.05). By blinded review of subjective measures of anginal frequency and ...

  • Efficacy and safety of Perhexiline Maleate in refractory angina. A double-blind placebo-controlled clinical trial of a novel antianginal agent.
    Circulation, 1990
    Co-Authors: Patricia Cole, Andrew D Beamer, Noreen Mcgowan, Catherine Cantillon, K Benfell, Ralph A Kelly, Thomas W Smith, Louise Hartley, Elliott M Antman
    Abstract:

    Despite large gains in the medical and surgical treatment of angina pectoris in the past two decades, many patients are refractory to conventional medical therapy and are unsuitable for a first or, more commonly, repeat coronary revascularization procedure. We evaluated the efficacy of Perhexiline Maleate, a drug with an antianginal mechanism of action in humans that is as yet unknown, by using a randomized double-blind placebo-controlled crossover design in 17 patients with refractory angina who continued to receive maximal antianginal therapy, typically including nitrates, a beta-blocker, and a calcium channel antagonist. In view of Perhexiline's potential for hepatic and neurological toxicity, plasma drug levels were monitored and maintained in the 150-600 ng/ml range. Sixty-three percent of patients were judged Perhexiline responders by objective exercise testing criteria, as compared with 18% of patients on placebo (p less than 0.05). By blinded review of subjective measures of anginal frequency and severity, 65% of patients noted an improvement while on Perhexiline, whereas no patient identified the placebo phase with improvement. Side effects observed in 29% of patients were minor and related to transient elevations of blood levels of more than 600 ng/ml; no patient suffered hemodynamic or cardiac conduction abnormalities attributable to Perhexiline. With attention to the pharmacokinetics of Perhexiline's elimination in individual patients, this novel antianginal agent seems to be safe and effective and deserves further evaluation in patients already receiving maximal antianginal therapy who are not candidates for revascularization procedures.

Patricia Cole - One of the best experts on this subject based on the ideXlab platform.

  • efficacy and safety of Perhexiline Maleate in refractory angina a double blind placebo controlled clinical trial of a novel antianginal agent
    Circulation, 1990
    Co-Authors: Patricia Cole, Andrew D Beamer, Noreen Mcgowan, Catherine Cantillon, K Benfell, Ralph A Kelly, L H Hartley, Thomas W Smith, Elliott M Antman
    Abstract:

    Despite large gains in the medical and surgical treatment of angina pectoris in the past two decades, many patients are refractory to conventional medical therapy and are unsuitable for a first or, more commonly, repeat coronary revascularization procedure. We evaluated the efficacy of Perhexiline Maleate, a drug with an antianginal mechanism of action in humans that is as yet unknown, by using a randomized double-blind placebo-controlled crossover design in 17 patients with refractory angina who continued to receive maximal antianginal therapy, typically including nitrates, a beta-blocker, and a calcium channel antagonist. In view of Perhexiline's potential for hepatic and neurological toxicity, plasma drug levels were monitored and maintained in the 150-600 ng/ml range. Sixty-three percent of patients were judged Perhexiline responders by objective exercise testing criteria, as compared with 18% of patients on placebo (p less than 0.05). By blinded review of subjective measures of anginal frequency and ...

  • Efficacy and safety of Perhexiline Maleate in refractory angina. A double-blind placebo-controlled clinical trial of a novel antianginal agent.
    Circulation, 1990
    Co-Authors: Patricia Cole, Andrew D Beamer, Noreen Mcgowan, Catherine Cantillon, K Benfell, Ralph A Kelly, Thomas W Smith, Louise Hartley, Elliott M Antman
    Abstract:

    Despite large gains in the medical and surgical treatment of angina pectoris in the past two decades, many patients are refractory to conventional medical therapy and are unsuitable for a first or, more commonly, repeat coronary revascularization procedure. We evaluated the efficacy of Perhexiline Maleate, a drug with an antianginal mechanism of action in humans that is as yet unknown, by using a randomized double-blind placebo-controlled crossover design in 17 patients with refractory angina who continued to receive maximal antianginal therapy, typically including nitrates, a beta-blocker, and a calcium channel antagonist. In view of Perhexiline's potential for hepatic and neurological toxicity, plasma drug levels were monitored and maintained in the 150-600 ng/ml range. Sixty-three percent of patients were judged Perhexiline responders by objective exercise testing criteria, as compared with 18% of patients on placebo (p less than 0.05). By blinded review of subjective measures of anginal frequency and severity, 65% of patients noted an improvement while on Perhexiline, whereas no patient identified the placebo phase with improvement. Side effects observed in 29% of patients were minor and related to transient elevations of blood levels of more than 600 ng/ml; no patient suffered hemodynamic or cardiac conduction abnormalities attributable to Perhexiline. With attention to the pharmacokinetics of Perhexiline's elimination in individual patients, this novel antianginal agent seems to be safe and effective and deserves further evaluation in patients already receiving maximal antianginal therapy who are not candidates for revascularization procedures.

John D Horowitz - One of the best experts on this subject based on the ideXlab platform.

Sandra Gemma - One of the best experts on this subject based on the ideXlab platform.

  • r and s Perhexiline Maleate enantioselective synthesis and functional studies on schistosoma mansoni larval and adult stages
    Bioorganic Chemistry, 2020
    Co-Authors: Alessandra Guidi, Prasanth A Saraswati, Nicola Relitti, Roberto Gimmelli, Fulvio Saccoccia, Carmina Sirignano, Orazio Taglialatelascafati, Giuseppe Campiani, Giovina Ruberti, Sandra Gemma
    Abstract:

    Abstract Schistosomiasis is a neglected tropical disease mainly affecting the poorest tropical and subtropical areas of the world with the impressive number of roughly 200 million infections per year. Schistosomes are blood trematode flukes of the genus Schistosoma causing symptoms in humans and animals. Organ morbidity is caused by the accumulation of parasite eggs and subsequent development of fibrosis. If left untreated, schistosomiasis can result in substantial morbidity and even mortality. Praziquantel (PZQ) is the most effective and widely used compound for the treatment of the disease and in prevention control programs in the last 30 years. Unfortunately, it has no effect on juvenile immature schistosomes and cannot prevent re-infection or interfere with the schistosome life cycle; moreover drug-resistance represents a serious threat. The search for an alternative or complementary treatment is urgent and drug repurposing could accelerate a solution. The anti-anginal drug Perhexiline Maleate (PHX) has been previously shown to be effective on larval, juvenile, and adult stages of S. mansoni and to impact egg production in vitro. Since PHX is a racemic mixture of R-(+)- and S-(-)-enantiomers, we designed and realized a stereoselective synthesis of both PHX enantiomers and developed an analytical procedure for the direct quantification of the enantiomeric excess also suitable for semipreparative separation of PHX enantiomers. We next investigated the impact of each enantiomer on viability of newly transformed schistosomula (NTS) and worm pairs of S. mansoni as well as on egg production and vitellarium morphology by in vitro studies. Our results indicate that the R-(+)-PHX is mainly driving the anti-schistosomal activity but that also the S-(-)-PHX possesses a significant activity towards S. mansoni in vitro.

  • (+)-(R)- and (-)-(S)-Perhexiline Maleate: Enantioselective synthesis and functional studies on Schistosoma mansoni larval and adult stages.
    Bioorganic Chemistry, 2020
    Co-Authors: Alessandra Guidi, Nicola Relitti, Roberto Gimmelli, Fulvio Saccoccia, Carmina Sirignano, Giuseppe Campiani, Giovina Ruberti, A. Prasanth Saraswati, Orazio Taglialatela-scafati, Sandra Gemma
    Abstract:

    Abstract Schistosomiasis is a neglected tropical disease mainly affecting the poorest tropical and subtropical areas of the world with the impressive number of roughly 200 million infections per year. Schistosomes are blood trematode flukes of the genus Schistosoma causing symptoms in humans and animals. Organ morbidity is caused by the accumulation of parasite eggs and subsequent development of fibrosis. If left untreated, schistosomiasis can result in substantial morbidity and even mortality. Praziquantel (PZQ) is the most effective and widely used compound for the treatment of the disease, in prevention and control programs in the last 30 years. Unfortunately, it has no effect on juvenile immature schistosomes and cannot prevent reinfection or interfere with the schistosome life cycle; moreover drug-resistance represents a serious threat. The search for an alternative or complementary treatment is urgent and drug repurposing could accelerate a solution. The anti-anginal drug Perhexiline Maleate (PHX) has been previously shown to be effective on larval, juvenile, and adult stages of S. mansoni and to impact egg production in vitro. Since PHX is a racemic mixture of R-(+)- and S-(−)-enantiomers, we designed and realized a stereoselective synthesis of both PHX enantiomers and developed an analytical procedure for the direct quantification of the enantiomeric excess also suitable for semipreparative separation of PHX enantiomers. We next investigated the impact of each enantiomer on viability of newly transformed schistosomula (NTS) and worm pairs of S. mansoni as well as on egg production and vitellarium morphology by in vitro studies. Our results indicate that the R-(+)-PHX is mainly driving the anti-schistosomal activity but that also the S-(−)-PHX possesses a significant activity towards S. mansoni in vitro.