Efficacy of diltiazem 2% rectal gel in the treatment of chronic anal fissure: a retrospective observational study.

OBJECTIVE: The aim of this study is to describe the effectiveness and safety of a magistral formulation of diltiazem 2% rectal gel as a treatment for chronic anal fissure. MATERIAL AND METHODS: A retrospective observational study of all patients that began treatment with diltiazem 2% gel during 2019. The primary endpoint of the study was anal fissure healing. We also looked for differences in effectiveness between those initiating treatment and those who had been previously treated, long-term effectiveness through a 2-year follow-up and frequency of adverse effects. RESULTS: Of the 166 patients included in the study, anal fissure healed in 72.9%. We detected adverse effects in 12 patients, the most common was local irritation. After 2 years of follow-up, 88% of patients did not relapse. CONCLUSION: In this study, use of topical diltiazem 2% has been shown to be effective and safe in the treatment of anal fissure and should be considered as the first line of therapy.

OBJETIVO: El objetivo de este estudio es describir la efectividad y la seguridad de una fórmula magistral de diltiazem 2% gel rectal, como tratamiento de la fisura anal crónica. MATERIAL Y MÉTODOS: Un studio observacional retrospectivo de todos los pacientes que comenzaron a ser tratados con diltiazem 2% gel durante el año 2019. La variable principal del estudio fue la cicatrización de la fisura anal. También se buscaron diferencias de efectividad entre aquellos que iniciaban el tratamiento y los que ya habían sido tratados previamente, efectividad a largo plazo mediante un seguimiento de 2 años y frecuencia de aparición de efectos adversos. RESULTADOS: De los 166 pacientes incluidos en el estudio, el 72,9% cicatrizaron la fisura anal. No detectamos diferencias estadísticamente significativas de efectividad entre los pacientes naive y aquellos que ya habían sido tratados. Detectamos efectos adversos en 12 pacientes, siendo el más frecuente la irritación local. Tras 2 años de seguimiento, el 88% de los pacientes no presentaron ninguna recaída. CONCLUSIÓN: En este estudio, el uso de diltiazem 2% tópico ha mostrado ser efectivo y seguro en el tratamiento de la fisura anal y debería considerarse como primera línea terapéutica.

[Latrepirdine: a systematic review of the preclinical studies]. / Latrepirdina: revision sistematica de los estudios preclinicos.

We conduct a systematic review of the preclinical studies published to date involving the use of latrepirdine (Dimebon ®). Latrepirdine is capable of modulating different targets, such as those related with mitochondria, acetylcholinesterase activity or intraneuronal calcium levels, perhaps thanks to its action upon the N-methyl-D-aspartate-type receptor, which belongs to the glutamate family. The findings published on the possible effect of latrepirdine in protein aggregation processes in disorders such as Alzheimer's disease and Parkinson's disease are quite controversial. Likewise, the possible neuroprotective effect of latrepirdine has been evaluated in animal models of neurodegenerative diseases, again with heterogeneous results. Consequently, it can be concluded that no preclinical scientific evidence has been found to justify carrying out clinical trials.

TITLE: Latrepirdina: revision sistematica de los estudios preclinicos.Se realiza una revision sistematica sobre los estudios preclinicos publicados en los que se utiliza latrepirdina (Dimebon ®). La latrepirdina es capaz de modular diferentes dianas, como las relacionadas con la mitocondria, la actividad de la acetilcolinesterasa o los niveles de calcio intraneuronales, quizas gracias a su accion sobre el receptor tipo N-metil-D-aspartato, de la familia del glutamato. Los resultados publicados sobre el posible efecto de la latrepirdina en procesos de agregacion proteica en trastornos como la enfermedad de Alzheimer y la enfermedad de Parkinson muestran una gran controversia. Asimismo, el posible efecto neuroprotector de la latrepirdina se ha evaluado en modelos animales de enfermedades neurodegenerativas, y muestra de nuevo resultados heterogeneos. Por todo ello, se concluye que no se ha localizado la evidencia cientifica preclinica que avale la realizacion de los ensayos clinicos.

Evidence for the efficacy of latrepirdine (Dimebon) treatment for improvement of cognitive function: a meta-analysis.

Over the last few years, latrepirdine, a démodé antihistamine drug, has been proposed to be useful for treating neurodegenerative disorders such as Alzheimer's and Huntington's diseases, and more recently schizophrenia. The mechanisms and pharmacological targets that are responsible for the beneficial effects on neurodegenerative diseases remain unknown. But it has been proposed that latrepirdine may modulate several targets including voltage-gate Ca+2 channels, mitochondrial permeability pore transition, or several neurotransmitter receptors. Herein, we present a meta-analysis of randomized controlled trials to ascertain the efficacy and safety of latrepirdine on cognitive function. By doing a search in electronic databases, we found five clinical trials in which the effect of latrepirdine on cognition function has been studied, and this was evaluated using MMSE, ADAS-cog, ADCS-ADL, and NPI scores. Latrepirdine generally presented a good safety profile; it was well tolerated when given alone or in combination with a variety of other drugs. We observed heterogeneous results between trials; latrepirdine failed to exert a significant beneficial effect although it tended to improve cognitive scores. The only significant benefit that we found was for the NPI score in Alzheimer's disease patients.

Requiem for tetrazepam.

TITLE: Requiem por el tetracepam.

Latrepirdina: revisión sistemática de los estudios preclínicos / Latrepirdine: a systematic review of the preclinical studies

Se realiza una revisión sistemática sobre los estudios preclínicos publicados en los que se utiliza latrepirdina (Dimebon (R)). La latrepirdina es capaz de modular diferentes dianas, como las relacionadas con la mitocondria, la actividad de la acetilcolinesterasa o los niveles de calcio intraneuronales, quizás gracias a su acción sobre el receptor tipo N-metil-D-aspartato, de la familia del glutamato. Los resultados publicados sobre el posible efecto de la latrepirdina en procesos de agregación proteica en trastornos como la enfermedad de Alzheimer y la enfermedad de Parkinson muestran una gran controversia. Asimismo, el posible efecto neuroprotector de la latrepirdina se ha evaluado en modelos animales de enfermedades neurodegenerativas, y muestra de nuevo resultados heterogéneos. Por todo ello, se concluye que no se ha localizado la evidencia científica preclínica que avale la realización de los ensayos clínicos (AU)

We conduct a systematic review of the preclinical studies published to date involving the use of latrepirdine (Dimebon (R)). Latrepirdine is capable of modulating different targets, such as those related with mitochondria, acetylcholinesterase activity or intraneuronal calcium levels, perhaps thanks to its action upon the N-methyl-D-aspartate-type receptor, which belongs to the glutamate family. The findings published on the possible effect of latrepirdine in protein aggregation processes in disorders such as Alzheimer’s disease and Parkinson’s disease are quite controversial. Likewise, the possible neuroprotective effect of latrepirdine has been evaluated in animal models of neurodegenerative diseases, again with heterogeneous results. Consequently, it can be concluded that no preclinical scientific evidence has been found to justify carrying out clinical trials (AU)

Réquiem por el tetracepam / Requiem for tetrazepam

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