Evaluation of Consistency of Treatment Response Across Regions-the LEADER Trial in Relation to the ICH E17 Guideline.

The US Food and Drug Administration in 2008 required new type 2 diabetes (T2D) medications to be subject to cardiovascular outcomes safety requirements. Accordingly, the global LEADER trial investigated cardiovascular outcomes of T2D treatment with liraglutide, a glucagon-like peptide-1 receptor agonist. LEADER (NCT01179048) was a multiregional clinical trial (MRCT) conducted from 2010 to 2016, thus completed before publication of the International Council for Harmonization (ICH) E17 guideline on MRCTs in 2017. Novo Nordisk pre-specified analysis of regional cardiovascular outcomes of LEADER participants. This paper assesses the pre-specified regional outcomes based on the ICH E17 guidelines on consistency evaluation. Regional LEADER participant numbers were broadly aligned with ICH E17 guidance and equally balanced across Europe, Asia, North America, and rest of the world. Overall primary major adverse cardiovascular events (MACE) composite outcome for the trial: hazard ratio (HR) (95% CI) 0.87 (0.78; 0.97); regional results varied, ranging from HR (95% CI) 0.62 (0.37; 1.04) (Asia) to 1.01 (0.84; 1.22) (North America). However, pre-specified Cox proportional-hazard regression analyses did not show clear evidence of interaction between regions and primary outcome (p = 0.20). Furthermore, post hoc analysis of the US population in the North American region found that adjusting for extrinsic or intrinsic factors did not account for this difference [HR (95% CI) 1.03 (0.84; 1.25)]. LEADER data evaluation demonstrated general consistency in cardiovascular safety across regions, except for US participants. Discrepancies in the North American region may relate to drug exposure or chance, but, as these were post hoc findings, the overall primary result is valid, aligned with ICH E17 guidelines.

Biogas production and saccharification of Salix pretreated at different steam explosion conditions.

Different steam explosion conditions were applied to Salix chips and the effect of this pretreatment was evaluated by running both enzymatic hydrolysis and biogas tests. Total enzymatic release of glucose and xylose increased with pretreatment harshness, with maximum values being obtained after pretreatment for 10 min at 210°C. Harsher pretreatment conditions did not increase glucose release, led to degradation of xylose and to formation of furfurals. Samples pretreated at 220 and 230°C initially showed low production of biogas, probably because of inhibitors produced during the pretreatment, but the microbial community was able to adapt and showed high final biogas production. Interestingly, final biogas yields correlated well with sugar yields after enzymatic hydrolysis, suggesting that at least in some cases a 24h enzymatic assay may be developed as a quick method to predict the effects of pretreatment of lignocellulosic biomass on biogas yields.

Solid-phase synthesis of new saphenamycin analogues with antimicrobial activity.

An array of 12 new saphenamycin analogues modified at the benzoate moiety was synthesized on solid support. Synthesis commenced with a chemoselective anchoring of saphenic acid through the carboxyl group to a 2-chlorotrityl functionalized polystyrene resin. The secondary alcohol was acylated in parallel with a series of differently substituted benzoic acid derivatives. Treatment with TFA-CH(2)Cl(2) (5:995) released the expected saphenamycin analogues into solution. These new analogues were purified, characterized and screened for antimicrobial activity against Bacillus subtilis and Proteus mirabilis. Eight analogues exhibited MIC values against B. subtilis ranging from 0.07 to 3.93 microg/mL, comparable to the activities of previously reported saphenamycin analogues.