Retrospective Comparison of Appropriate Statin Use Between Patients With Diabetes in the Primary Care Setting Managed by Pharmacists or Internal Medicine Providers.

OBJECTIVE: The purpose of this study was to compare statin prescribing practices according to the American Diabetes Association's Standards of Medical Care in Diabetes-2017 between diabetes patients managed by pharmacists versus those managed by internal medicine providers. DESIGN AND METHODS: A retrospective observational study was completed using the electronic health record of a multispecialty private practice. A total of 176 patients were included in the study, with 88 each in the pharmacy and internal medicine groups. Patients were ≥40 years of age with diabetes and managed by an internal medicine provider or a pharmacist between January and December 2017. Descriptive statistics, χ2, and unpaired t tests were used to describe between-group differences. RESULTS: More pharmacy than internal medicine patients were prescribed appropriate statin therapy (47.7 vs. 34.1%, P = 0.092), particularly those needing high-intensity statins (44.3 vs. 27.4%, P = 0.03). Females, patients 40-75 years of age, and patients with no history of atherosclerotic cardiovascular disease in the pharmacy group were more likely to receive appropriate treatment (37.5 vs. 15.0%, P = 0.022; 46.8 vs. 29.7%, P = 0.039; and 45.3 vs. 23.5%, P = 0.015, respectively). Overall, more males than females were prescribed appropriate statin therapy (53.1 vs. 26.3%, P = 0.001). CONCLUSION: Although there were no overall significant differences in statin prescribing between the pharmacy and internal medicine groups, patients needing high-intensity statins, those who were female, and those who were younger were more likely to receive appropriate therapy when managed by a pharmacist. Appropriate statin prescribing remains low among diabetes patients, and optimization of this therapy should be prioritized.

Boosting NAD+ with a small molecule that activates NAMPT.

Pharmacological strategies that boost intracellular NAD+ are highly coveted for their therapeutic potential. One approach is activation of nicotinamide phosphoribosyltransferase (NAMPT) to increase production of nicotinamide mononucleotide (NMN), the predominant NAD+ precursor in mammalian cells. A high-throughput screen for NAMPT activators and hit-to-lead campaign yielded SBI-797812, a compound that is structurally similar to active-site directed NAMPT inhibitors and blocks binding of these inhibitors to NAMPT. SBI-797812 shifts the NAMPT reaction equilibrium towards NMN formation, increases NAMPT affinity for ATP, stabilizes phosphorylated NAMPT at His247, promotes consumption of the pyrophosphate by-product, and blunts feedback inhibition by NAD+. These effects of SBI-797812 turn NAMPT into a "super catalyst" that more efficiently generates NMN. Treatment of cultured cells with SBI-797812 increases intracellular NMN and NAD+. Dosing of mice with SBI-797812 elevates liver NAD+. Small molecule NAMPT activators such as SBI-797812 are a pioneering approach to raise intracellular NAD+ and realize its associated salutary effects.

Evaluation of modified team-based learning activities on student performance on therapeutic assessments.

BACKGROUND AND PURPOSE: To determine if changing the focus of team-based learning (TBL) grading from written to verbal responses impacted students' exam performance in those subjects and to assess student perception of utilization of course time. EDUCATIONAL ACTIVITY AND SETTING: Assessment data from two consecutive respiratory therapeutics semesters was analyzed. These were the classes immediately before and after the TBL structural change. All data were de-identified, and student performance was assessed based on exam scores in each major subject that was covered by a TBL activity. Letter grades and student course evaluations were also compared. FINDINGS: One hundred fifty-two students were assessed. There was no significant difference in overall course grades between semesters. There was improvement in exam scores for allergic rhinitis and chronic obstructive pulmonary disease (p = 0.001) and a decrease in exam scores for respiratory devices (p = 0.03). Total exam scores and other therapeutic topic scores demonstrated no differences. Student satisfaction in regard to having sufficient course time improved (p = 0.016). DISCUSSION: Overall, students performed equally well in the class when removing the graded written portion of the TBL activity. There was also a trend towards improved student satisfaction after this modification. SUMMARY: The change in TBL grading was successful in improving students' perceptions of the course without impacting their overall course grades, demonstrating that the TBL structure can be altered without losing the positive learning outcomes.

Repurposing antimalarial aminoquinolines and related compounds for treatment of retinal neovascularization.

Neovascularization is the pathological driver of blinding eye diseases such as retinopathy of prematurity, proliferative diabetic retinopathy, and wet age-related macular degeneration. The loss of vision resulting from these diseases significantly impacts the productivity and quality of life of patients, and represents a substantial burden on the health care system. Current standard of care includes biologics that target vascular endothelial growth factor (VEGF), a key mediator of neovascularization. While anti-VGEF therapies have been successful, up to 30% of patients are non-responsive. Therefore, there is a need for new therapeutic targets, and small molecule inhibitors of angiogenesis to complement existing treatments. Apelin and its receptor have recently been shown to play a key role in both developmental and pathological angiogenesis in the eye. Through a cell-based high-throughput screen, we identified 4-aminoquinoline antimalarial drugs as potent selective antagonists of APJ. The prototypical 4-aminoquinoline, amodiaquine was found to be a selective, non-competitive APJ antagonist that inhibited apelin signaling in a concentration-dependent manner. Additionally, amodiaquine suppressed both apelin-and VGEF-induced endothelial tube formation. Intravitreal amodaiquine significantly reduced choroidal neovascularization (CNV) lesion volume in the laser-induced CNV mouse model, and showed no signs of ocular toxicity at the highest doses tested. This work firmly establishes APJ as a novel, chemically tractable therapeutic target for the treatment of ocular neovascularization, and that amodiaquine is a potential candidate for repurposing and further toxicological, and pharmacokinetic evaluation in the clinic.

A service learning program in providing nutrition education to children.

OBJECTIVE: To implement a service learning program in nutrition and assess its impact on pharmacy students' communication skills and professionalism and elementary school children's knowledge of nutrition concepts. DESIGN: First-year pharmacy students completed 4 nutrition education sessions led by a registered dietitian and then presented the material to pre-selected classes of at-risk elementary school children in kindergarten through third grade. ASSESSMENT: Ninety-six pharmacy students completed the pre- and post-experience survey and more than 90% rated achievement of course objectives as strongly agree or agree. Four hundred sixty-eight elementary students completed a pre- and posttest on nutrition knowledge. Significant improvement was found in all grade levels on the knowledge test. CONCLUSION: This service learning experience was beneficial for the elementary school children and pharmacy students, enhancing the knowledge of both groups and establishing a positive relationship between the pharmacy school and the community.