Morning administration of 0.4U/kg/day insulin glargine 300U/mL provides less fluctuating 24-hour pharmacodynamics and more even pharmacokinetic profiles compared with insulin degludec 100U/mL in type 1 diabetes.

AIM: To compare steady state pharmacodynamic and pharmacokinetic profiles of insulin glargine 300U/mL (Gla-300) with insulin degludec 100U/mL (Deg-100) in people with type 1 diabetes. METHODS: This single-centre, randomized, double-blind crossover euglycaemic clamp study included two parallel cohorts with fixed once-daily morning dose regimens. For both insulins participants received 0.4 (n=24) or 0.6U/kg/day (n=24), before breakfast, for 8 days prior to the clamp. The main endpoint was within-day variability (fluctuation) of the smoothed glucose infusion rate (GIR) over 24 hours (GIR-smFL0-24). RESULTS: Gla-300 provided 20% less fluctuation of steady state glucose infusion rate profiles than Deg-100 over 24 hours at 0.4U/kg/day (GIR-smFL0-24 treatment ratio 0.80 [90% confidence interval: 0.66 to 0.96], P=0.047), while at the dose of 0.6U/kg/day the difference between insulins was not statistically significant (treatment ratio 0.96 [0.83 to 1.11], P=0.603). Serum insulin concentrations appeared more evenly distributed with both dose levels of Gla-300 versus the same doses of Deg-100, as assessed by relative 6-hour fractions of the area under the curve within 24 hours. Both insulins provided exposure and activity until 30 hours (end of clamp). CONCLUSION: Gla-300 provides less fluctuating steady state pharmacodynamic profiles (i.e. lower within-day variability) and more evenly distributed pharmacokinetic profiles, compared with Deg-100 in a once-daily morning dosing regimen of 0.4U/kg/day.

[Differentiation of peripheral and central hyperalgesic effects of systemic procaine]. / Differenzierung peripherer und zentraler antihyperalgetischer Effekte einer systemischen Procaindauerinfusion.

OBJECTIVE: The aim of this study was to differentiate between the peripheral and central analgesic and antihyperalgesic properties of systemic procaine hydrochloride in standardized human pain models. METHOD: Subcutaneous injections of either 150 mg procaine hydrochloride or saline solution were administered at intervals of 2 weeks on a randomized and double blind basis. During the 90-min infusion and subsequent 60-min monitoring periods, touch sensitivity was determined and in addition two experimental hyperalgesic models were analyzed. RESULTS: While touch sensitivity was not affected by procaine hydrochloride, development of primary mechanical hyperalgesia was significantly reduced. CONCLUSION: The concentration of procaine hydrochloride used in our experiment elicited peripheral antihyperalgesic effects without central venous side effects. These results can account for the clinical effect of low-dose procaine hydrochloride in pain conditions exhibiting pronounced hyperalgesia.

Measurements of urinary prostaglandins in young ovulatory women during the menstrual cycle and in postmenopausal women.

The purpose of the present work was to study the prostaglandin excretion in young nonpregnant ovulatory women during the menstrual cycle on the one hand and in postmenopausal women on the other hand and to investigate the influence of female sex hormones (estradiol, progesterone) on urinary prostanoid excretion. Urinary excretion rates of prostaglandin E2 (PGE2), 6-keto-PGF1 alpha, thromboxane B2 (TxB2) and their metabolites PGE-M (11 alpha-hydroxy-9, 15-dioxo-2,3,4,5,20-pentanor-19-carboxyprostanoic acid), 2,3-dinor-6-keto-PGF1 alpha, 2,3-dinor-TxB2 and 11-dehydro-TxB2 were determined by gas chromatography-triple stage quadrupole mass spectrometry (GC/MS/MS) in 41 young non-pregnant women during the follicular phase and during the luteal phase and in 23 postmenopausal women. Excretion rates of all urinary prostanoids were not significantly different in the follicular phase when compared with the luteal phase. In contrast to the young ovulatory women, PGE2 and TxB2 were significantly higher in postmenopausal women. Concerning the other prostaglandins significant differences between these groups of women did not exist. Although serum levels of estradiol and progesterone were different in young and postmenopausal women, sex hormones have not been shown to correlate with prostaglandins. Our data do not suggest sex hormones to be responsible for the difference in the prostaglandin excretion in women of reproductive age and in women in the menopause. Further systematic investigations into age dependency of prostaglandin excretion in women are necessary.

Bioavailability study with 2 different levonorgestrel-containing drugs in women.

In a randomized, single dose, open crossover study in 24 healthy women, aged between 20 and 28 years, the relative bioavailability of the test product Mini 30 (0.03 mg levonorgestrel) in comparison to a reference, Microval, was investigated after single dose administration. Because there was a difference in the in vitro dissolution test, it was of interest whether this difference had an influence on the extent and rate of absorption. Whereas 99.4% of the test were dissolved after 20 minutes, only 48.3% of the reference were dissolved after 45 minutes, 74.8% after 120 minutes and 95.5% after 240 minutes. Blood samples were taken from time 0-72 hours after administration. All serum samples were analyzed twice in a radioimmunoassay which was validated before the start of the study. The limit of quantitation was at 50 pg/ml. The AUC0 -infinity ratio test/reference and the 90% confidence interval were 104.8%, and 99.10%, respectively. The Cmax ratio test/reference and the 90% confidence interval were 175.5%, and 159.8%-192.8%, respectively. With regard to the extent of absorption (AUC0-infinity) the 2 preparations were within the acceptance range for bioequivalence whereas they were outside the acceptance range for the rate of absorption (Cmax). The elimination half-lives of LNG did not differ between the test and reference preparations (25.08 +/- 11.94 h, and 25.70 +/- 10.08 h, respectively). So, the in vitro results concerning the rate of dissolution were confirmed by the in vivo findings in Cmax whereas regarding the extent of absorption (AUC) there were no differences between the 2 preparations.

Dipyrone and diclofenac do not influence creatinine-clearance, inulin-clearance or PAH-clearance in healthy male volunteers.

The effects of the non-steroidal anti-inflammatory drug diclofenac and the pyrazolone derivative dipyrone on renal function were compared with those of placebo in 12 healthy male volunteers in a randomized, controlled, triple-crossover study with a wash-out period of 4 days between each of the 3 trial periods (dipyrone, diclofenac and placebo) which lasted three days each. The volunteers received dipyrone (1 g, 3 times/day for 2 days, followed by twice 1 g on the main trial day, which was day 3 of each study period) or diclofenac (50 mg, 3 times/day for 2 days, followed by twice 50 mg on the main trial day) or placebo orally. Standardized meals (50 mEq sodium per day) were given from one week before the start until the end of the study and on the main trial days a protein-rich lunch (2 g protein/kg body weight) was taken. Renal function was assessed in each study period by measurement of creatinine-clearance, inulin-clearance and p-aminohippurate (PAH)-clearance to characterize glomerular filtration rate and renal plasma flow. High protein intake induced glomerular hyperfiltration (increased creatinine-clearance, inulin-clearance and PAH-clearance) in all 3 study periods (dipyrone, diclofenac, placebo). Dipyrone and diclofenac had no effect on renal clearance of creatinine, inulin or PAH in comparison to placebo. These results show that dipyrone and diclofenac at therapeutic dosages over 3 days do not decrease glomerular filtration and renal plasma flow in healthy individuals. Furthermore, it is unlikely that prostaglandins play a major role in protein-induced glomerular hyperfiltration.