Efficacy and safety of intravitreal HLX04-O, an anti-VEGF monoclonal antibody, for the treatment of wet age-related macular degeneration.

AIM: To evaluate the efficacy and safety of HLX04-O, an investigational ophthalmic formulation of HLX04 (bevacizumab biosimilar) for intravitreal injection, as a treatment for wet age-related macular degeneration (wAMD) in a phase 1/2 clinical trial (NCT04993352). METHODS: Eligible patients with wAMD were enrolled to receive HLX04-O intravitreal injections at a dose of 1.25 mg/0.05 mL every four weeks. Efficacy and adverse events were evaluated every month during study visits. RESULTS: A 76-year-old male with wAMD in his left eye participated in the trial and completed six cycles of HLX04-O intravitreal injections. Changes were observed in macular center point thickness (baseline vs last study visit, 437 vs 255 µm) and best-corrected visual acuity letter score (baseline vs last study visit, 36 vs 77) of the affected eye, which indicated an improvement in wAMD over treatment. No adverse events were reported by the data cutoff date. CONCLUSION: HLX04-O at 1.25 mg/0.05 mL every four weeks is well tolerated in this patient, demonstrating promising safety and efficacy in wAMD treatment. Large-scale studies are required to confirm the outcomes.

Efficacy of cattle encephalon glycoside and ignotin in patients with acute cerebral infarction: a randomized, double-blind, parallel-group, placebo-controlled study.

Cattle encephalon glycoside and ignotin (CEGI) injection is a compound preparation formed by a combination of muscle extract from healthy rabbits and brain gangliosides from cattle, and it is generally used as a neuroprotectant in the treatment of central and peripheral nerve injuries. However, there is still a need for high-level clinical evidence from large samples to support the use of CEGI. We therefore carried out a prospective, multicenter, randomized, double-blind, parallel-group, placebo-controlled study in which we recruited 319 patients with acute cerebral infarction from 16 centers in China from October 2013 to May 2016. The patients were randomized at a 3:1 ratio into CEGI (n = 239; 155 male, 84 female; 61.2 ± 9.2 years old) and placebo (n = 80; 46 male, 34 female; 63.2 ± 8.28 years old) groups. All patients were given standard care once daily for 14 days, including a 200 mg aspirin enteric-coated tablet and 20 mg atorvastatin calcium, both taken orally, and intravenous infusion of 250-500 mL 0.9% sodium chloride containing 40 mg sodium tanshinone IIA sulfonate. Based on conventional treatment, patients in the CEGI and placebo groups were given 12 mL CEGI or 12 mL sterile water, respectively, in an intravenous drip of 250 mL 0.9% sodium chloride (2 mL/min) once daily for 14 days. According to baseline National Institutes of Health Stroke Scale scores, patients in the two groups were divided into mild and moderate subgroups. Based on the modified Rankin Scale results, the rate of patients with good outcomes in the CEGI group was higher than that in the placebo group, and the rate of disability in the CEGI group was lower than that in the placebo group on day 90 after treatment. In the CEGI group, neurological deficits were decreased on days 14 and 90 after treatment, as measured by the National Institutes of Health Stroke Scale and the Barthel Index. Subgroup analysis revealed that CEGI led to more significant improvements in moderate stroke patients. No drug-related adverse events occurred in the CEGI or placebo groups. In conclusion, CEGI may be a safe and effective treatment for acute cerebral infarction patients, especially for moderate stroke patients. This study was approved by the Ethical Committee of Peking University Third Hospital, China (approval No. 2013-068-2) on May 20, 2013, and registered in the Chinese Clinical Trial Registry (registration No. ChiCTR1800017937).

Analysis of risk factors for vascular cognitive impairment in patients with cerebral infarction.

This study aimed to identify risk factors for vascular cognitive impairment (VCI) in cerebral infarction patients. Associations between VCI and age, gender, blood pressure, lipid levels, glycosylated hemoglobin, atrial fibrillation, tobacco smoking, alcohol consumption, homocysteine (Hcy), and High-Sensitivity C-Reactive Protein (HS-CRP) were evaluated in patients with cerebral infarction (n = 300) using single factor analysis and multivariate logistic regression analysis. By single factor analysis, the age, glycosylated hemoglobin, atrial fibrillation, blood pressure, Hcy, HS-CRP, tobacco smoking, and alcohol consumption were significantly associated with VCI in these patients. By multivariate logistic regression analysis, the age, glycosylated hemoglobin, blood pressure, Hcy, and HS-CRP were revealed as independent risk factors. The age, glycosylated hemoglobin, blood pressure, Hcy, and HS-CRP can serve as predictive factors for VCI in patients with cerebral infarction.

Microcalorimetric investigation on effects of La(III) on metabolic activity of mitochondria isolated from hybrid rice.

Rare earth elements (REEs) have beneficial influence on plant growth and are widely used in agriculture practice, but little is known about the behavior of the REEs in mitochondria of plant cell. Thermogenic metabolic curves were determined by the ampoule method at 303 K using a TAM air isothermal microcalorimeter in mitochondria isolated from hybrid rice Liangyoupeijiu (Oryza sativa L.), and the effect of La(III) on its mitochondrial metabolism was investigated. From the obtained heat flux curves, the crucial parameters including as activity recovery rate constant (k) and maximum heat power (P(max)) were determined. Application of La(3+) in concentrations ranging from 0 to 120 microg/ml significantly increased k and P(max) values with the high point reaching 346 and 222% of the control, respectively. Concentrations from 140-150 microg/ml had the opposite effect. These results were consistent with previous reports on the effects of REEs on plant growth. It was concluded that the La-induced change of mitochondrial metabolic activity is a possible mechanism by which La(III) ions influences hybrid rice growth.

Bioenergetic investigation of the effects of La(III) and Ca(II) on the metabolic activity of Tetrahymena thermophila BF5.

The heat flux of Tetrahymena thermophila BF5 during growth and the effects of La(3+) and Ca(2+) on them were investigated with microcalorimetry; simultaneously, morphological changes of T. thermophila were obtained by light microscope. La(3+) in low concentration (0-5.0 x 10(-4) mol/l) remarkably stimulated T. thermophila metabolism, but high dose of La(3+) (5.8-8.6 x 10(-4) mol/l) restrained it in a linear manner with IC(50) being 7.2 x 10(-4) mol/l. In contrast, low concentration of Ca(2+) did not manifest obvious stimulation on T. thermophila metabolism; moreover, the IC(50) of Ca(2+) was much higher than that of La(3+). Low concentration of La(3+) did not lead to changes in appearance of T. thermophila, but low dose of Ca(2+) clearly promoted the cell proliferation. In addition, the morphological changes of T. thermophila evoked by high concentrations of La(3+) and Ca(2+) were consistent with relevant microcalorimetric results. It is concluded that La and Ca influence T. thermophila via different pathways, and La represents toxic action rather than Ca analogy.