Efficacy, safety, tolerability and population pharmacokinetics of tedizolid, a novel antibiotic, in Latino patients with acute bacterial skin and skin structure infections

Abstract Acute bacterial skin and skin structure infections are caused mainly by Gram-positive bacteria which are often treated with intravenous vancomycin, daptomycin, or linezolid, with potential step down to oral linezolid for outpatients. Tedizolid phosphate 200 mg once daily treatment for six days demonstrated non-inferior efficacy, with a favourable safety profile, compared with linezolid 600 mg twice daily treatment for 10 days in the Phase 3 ESTABLISH-1 and -2 trials. The objective of the current post-hoc analysis of the integrated dataset of ESTABLISH-1 and -2 was to evaluate the efficacy and safety of tedizolid (N = 182) vs linezolid (N = 171) in patients of Latino origin enrolled into these trials. The baseline demographic characteristics of Latino patients were similar between the two treatment groups. Tedizolid demonstrated comparable efficacy to linezolid at 48–72 h in the intent-to-treat population (tedizolid: 80.2% vs linezolid: 81.9%). Sustained clinical success rates were comparable between tedizolid- and linezolid-treated Latino patients at end-of-therapy (tedizolid: 86.8% vs linezolid: 88.9%). Tedizolid phosphate treatment was well tolerated by Latino patients in the safety population with lower abnormal platelet counts at end-of-therapy (tedizolid: 3.4% vs linezolid: 11.3%, p = 0.0120) and lower incidence of gastrointestinal adverse events (tedizolid: 16.5% vs linezolid: 23.5%). Population pharmacokinetic analysis suggested that estimated tedizolid exposure measures in Latino patients vs non-Latino patients were similar. These findings demonstrate that tedizolid phosphate 200 mg, once daily treatment for six days was efficacious and well tolerated by patients of Latino origin, without warranting dose adjustment.

Comparación entre paclitaxel y MVAC en el tratamiento del cáncer de urotelio. Metaanálisis / Comparison between paclitaxel and MVAC in therapy of urothelium cancer. A meta-analysis

En su estadio clínico avanzado, el carcinoma urotelial ofrece una expectativa de vida muy baja. Durante los últimos 10 años, la terapia sistémica más utilizada consistió en el esquema MVAC, con índices de respuesta entre 56 y 72 por ciento y respuesta completa de 27 por ciento. El paclitaxel es el agente único que ofrece la mayor actividad en esta neoplasia, 42 por ciento. Para la presente revisión se analizaron los estudios durante el periodo comprendido entre 1990 y 1996, con paclitaxel como fármaco único y en combinación con carboplatino y cisplatino y, los informes sobre la combinación de metotrexato, vinblastina, doxorrubicina y cicplatino (MVAC). Comparativamente, es similar la respuesta que se obtiene con paclitaxel, 53.5 por ciento, y MVAC, 51.7 por ciento. En ambos tratamientos la toxicidad resultó semejante, pero con paclitaxel se observaron grados mayores de leucopenia (74 por ciento) y anemia (18 por ciento). En el caso de pacientes con lesión renal el agente indicado es el texano.