Comparison of cutaneous adverse events between second-generation tyrosine kinase inhibitors and imatinib for chronic myeloid leukemia: a systematic review and meta-analysis.

BACKGROUND: Patients with chronic myeloid leukemia (CML) treated with tyrosine kinase inhibitors (TKIs) often experience cutaneous adverse events, such as rashes and pruritus. In this study, we aimed to compare the risks of cutaneous adverse events between imatinib- and second-generation TKI-treated patients with CML. MATERIAL AND METHODS: Paired reviewers independently obtained studies from PubMed, Embase, and Cochrane Library published until 15 March 2022. The following terms were searched: (Leukemia, Myelogenous, Chronic and BCR-ABL Positive), chronic myeloid leukemia, tyrosine kinase inhibitor, TKI, imatinib, dasatinib, nilotinib, bosutinib, and radotinib. Two independent reviewers screened the results and selected articles on cutaneous adverse events. RevMan 5.4 and the Cochrane Collaboration tool were used to perform the meta-analysis and risk of bias assessment. RESULTS AND CONCLUSION: Eleven trials involving 4502 patients were analyzed in this study. Patients treated with second-generation TKIs were significantly more likely to experience cutaneous adverse events than those treated with imatinib with a relative risk (RR) of 1.62 (95% confidence interval [CI], [1.25-2.09]). Except dasatinib (RR [95% CI], 1.39 [0.75-2.56]), the risk of adverse events was more with second-generation TKIs than with imatinib as follows: nilotinib (2.11 [1.53-2.90]), bosutinib (1.41 [1.07-1.86]), and radotinib (1.87 [1.33-2.63]). Rash was the most common cutaneous adverse event that was observed in 21.6% of cases across all grades, followed by pruritus (5.7%) and alopecia (4.3%). In conclusion, our findings suggest that cutaneous adverse events occur more frequently with second-generation TKIs than with imatinib. Therefore, effective management of the cutaneous outcome is necessary to achieve high patient adherence to medication and successful treatment with TKIs.

Effect of Ginseng Powder Supplementation on the Physicochemical Properties, Antioxidant Capacity, and Sensory Characteristics of Cream Soup.

Ginseng has been used as a medicinal herb in Asian countries for hundreds of years. It contains many kinds of ginsenosides as major active ingredients and is known to have neuroprotective, anti-inflammatory, antitumor, and antidiabetic properties. In this study, we have developed cream soup with different concentrations (0%, 3%, 5%, 7%, and 10%) of ginseng powder (GP) and determined the quality characteristics (color, viscosity, salinity, etc.) and antioxidant activity, along with sensory parameters. After the addition of GP, significant differences in salinity, L* and a*color value, DPPH, and ABTS were found among different concentrations of GP. Cream soup supplemented with GP 10% exhibited the highest values for DPPH and ABTS (83.5% and 87%, respectively), while the contents of total phenolic and saponin were 0.651 ± 0.02 (mg Gallic acid Equiv./g, DW) and 0.797 ± 0.05 (mg Diosgenin Equiv./g, DW), respectively. Moreover, there were no significant changes for °Brix value, pH, acidity, and total flavonoids content compared to control. The sensory characteristics indicated bitterness with the increase in the concentration of GP. However, a non-significant difference was observed between the control and supplemented samples for color, viscosity, and overall preference. Therefore, the supplementation of GP to cream soup could exhibit health benefits and increase the demand for ginseng to promote public health as functional food material.

Influence of Mineral Supplementation on the Results from Analysis of Flavonol Glycoside Content in Ginkgo biloba Dietary Supplements.

Flavonoids are a major component of Ginkgo biloba extract (GBE). Several studies have investigated chelate formation and the redox reaction between flavonoids and metal ions; however, the effect of mineral supplements on the results from the analysis of the flavonol glycoside content in products containing GBE dietary supplement remains unknown. In this study, the effects of commonly used mineral supplements on the recovery of quercetin from GBE-containing dietary supplements were investigated using conventional methods of flavonol glycoside determination. Mineral supplements containing Zn (II), Mn (II), and Fe (II) did not affect quercetin recovery, whereas Cu (II) and Fe (III) significantly reduced recovery (P<0.05). Quercetin oxidation was prevented by adding an antioxidant to the diluent (extraction solvent). Among the tested synthetic antioxidants, tert-butyl hydroquinone (TBHQ) promoted the greatest increase in quercetin recovery. The flavonol glycoside content of commercially available GBE-containing dietary supplements was analyzed using a conventional diluent or a diluent containing 20 mg/mL TBHQ. The amount of quercetin recovered from products containing Cu (II) was found to decrease with increasing hydrolysis duration and the duration in the final test solution state using the conventional diluent, while the TBHQ-containing diluent yielded consistent quercetin contents (P<0.05). These findings suggest that quercetin, a major aglycone of GBE flavonol glycosides, can be oxidized by Cu (II) and Fe (III) during the analytical process and, therefore, the total flavonol glycoside content may be underestimated. The addition of TBHQ to the diluent can improve the accuracy and reproducibility of flavonol glycoside content analysis in GBE-containing dietary products supplemented with minerals.