Pharmacokinetic interaction study between eslicarbazepine acetate and lamotrigine in healthy subjects.

OBJECTIVE: Anti-epileptic drugs are often used in combination. Both eslicarbazepine (main metabolite of eslicarbazepine acetate, ESL) and lamotrigine undergo conjugation with glucuronic acid, and both eslicarbazepine and its glucuronide and lamotrigine glucuronide undergo extensive renal elimination; therefore, there is a potential for interaction. This study investigated the interaction between ESL and lamotrigine in healthy subjects. METHODS: Open-label study in two parallel groups of 16 healthy volunteers each. After an 8-day treatment with ESL or lamotrigine, ESL (1200 mg once-daily) and lamotrigine (150 mg once-daily) were co-administered for 19 days. Geometric mean ratios (GMR) and 90% confidence intervals (90% CI) for maximum plasma concentration (C(max)) and area under the plasma concentration-time curve in the dosing interval (AUC(0-24)) were calculated for eslicarbazepine (ESL active metabolite) and lamotrigine. RESULTS: The C(max) and AUC(0-24) GMR (90% CI) were, respectively, 95% (87-102%) and 96% (91-102%) for eslicarbazepine, and 88% (82-94%) and 86% (81-92%) for lamotrigine. The 90% CI of the C(max) and AUC(0-24) GMR fell within the prespecified acceptance interval (80-125%) both for eslicarbazepine and lamotrigine. CONCLUSION: There was no significant pharmacokinetic interaction between ESL and lamotrigine in healthy subjects. Therefore, no dosage adjustment appears to be usually required in either lamotrigine or ESL when the drugs are co-administered.

Multicentre phase II study and pharmacokinetic analysis of irinotecan in chemotherapy-naïve patients with glioblastoma.

BACKGROUND: To assess the antitumour activity and safety profile of irinotecan and its pharmacokinetic interactions with anticonvulsants in patients with glioblastoma multiforme. PATIENTS AND METHODS: This multicentre phase II and pharmacokinetic study investigated the effects of irinotecan 350 mg/m(2) given as a 90-min infusion every 3 weeks either prior to (group A) or after relapse following radiotherapy (group B) in chemotherapy-naïve patients with glioblastoma. Preferred concomitant medication for seizure prevention was valproic acid. Pharmacokinetic analysis of irinotecan and its main metabolites (SN-38, SN-38-G, APC and NPC) was performed during cycle 1. An independent panel of experts reviewed the activity data. RESULTS: Fifty-two patients (25 patients in group A and 27 patients in group B) received a total of 191 cycles of irinotecan. Forty-six patients (22 patients in group A and 24 patients in group B) were evaluable and externally reviewed for activity. According to external review, one partial response (group B), seven minor responses (three in group A and four in group B), 12 disease stabilisations (seven in group A and five in group B) were observed. This resulted in an overall response rate of only 2.2% (95% confidence interval 0.2% to 6.5%). The median time to tumour progression was 9 weeks in group A and 14.4 weeks in group B. Six-month progression-free survival rates were 26% in group A and 43% in group B. Grade 3-4 toxicities (percentage of patients in groups A and B) consisted of neutropenia (12.5% and 25.9%), diarrhoea (8.3% and 7.4%), asthenia (12.5% and 7.4%) and vomiting (0% and 7.4%). The clearance of irinotecan was 12.4 and 14.4 l/h/m(2) in two patients who received no anticonvulsant. In patients receiving valproic acid, the clearance of irinotecan was 17.2 +/- 4.4 l/h/m(2). CONCLUSIONS: Irinotecan given at the dose of 350 mg/m(2) every 3 weeks has limited clinical activity as a single agent in patients with newly diagnosed and recurrent glioblastoma after radiotherapy. The toxicity profile and plasma disposition of irinotecan and SN-38 were not strongly influenced by anticonvulsant valproic acid therapy. Although the response rate of irinotecan as a single agent was limited, it remains an attractive drug for combination studies in patients with glioblastoma.

[Vocalab: a new software for voice evaluation and therapy]. / VOCALAB, logiciel d'aide à l'évaluation et à la rééducation de la voix.

When handling vocal pathologies, speech therapists need tools to visualise voice and speech, in order to correlate personal auditory analysis with accurate data. Vocalab2 is a spectral analysis tool designed for speech therapists, developed in partnership with INSA Toulouse, France. Vocalab is a simple and user-friendly tool with important features to be used during evaluation and therapy. The software is based on a set of phoniatric data and sophisticated real-time signal analysis (Fourier transform, fundamental detection). One of the key tools of Vocalab2 is the real-time spectrum for visualising, differentiating and comparing every cord approximation and speech movement. Animations are proposed for illustrating most phonemes, and videos related to folding cords in the case of pathologic and normal sound production are also proposed. An extensive test has been conducted during 18 month, with important feedback that has considerably improved the tool. The satisfaction ratio is around 8/10.

Innate and acquired control of trypanosome parasitaemia in Cape buffalo.

The review discusses the roles of serum xanthine oxidase, serum catalase and trypanosome-specific immune responses in the regulation of the level of trypanosome parasitaemic waves in Cape buffalo.

Site-directed solid-state NMR measurement of a ligand-induced conformational change in the serine bacterial chemoreceptor.

The challenging nature of studies of membrane proteins has made it difficult to determine the molecular mechanism of transmembrane signaling. For the bacterial chemoreceptor family, there are crystal structures of the internal and external domains, structural models of the transmembrane domain, and evidence for subtle ligand-induced conformational changes, but the signaling mechanism remains controversial. We have used a novel site-directed solid-state NMR distance measurement approach, using (13)C(19)F REDOR, to measure a ligand-induced change of 1.0 +/- 0.3 A in the distance between helices alpha 1 and alpha 4 of the ligand-binding domain in the intact, membrane-bound serine receptor. This distance change is shown not to be due to motion of the side chain and thus is due to motion of either the alpha 1 or the alpha 4 helix. Additional distance measurements can be used to determine the type of backbone motion and to follow it to the cytoplasm, to test and refine current proposals for the mechanism of transmembrane signaling. This is a promising general method for high-resolution measurements of local structure in intact, membrane-bound proteins.

Modulations of collicular visual responses by acoustic stimuli in rabbits.

This study analyzes the influences of an acoustic stimulus upon neuronal light responses of superficial layers of the superior colliculus in anesthetized and paralyzed rabbits. The results have revealed that even if visually-responsive cells fail to be excited by sound, the latter is still capable of modifying light-evoked discharge. The influence may be "short-term" (the discharge rate recovers within 500 ms) or it may be "long-term" (the firing rate remains modified for several seconds). This audio-visual interaction depends upon several factors: the time of occurrence of both stimuli, the physical aspects of the visual target, the relative positions of the speaker and the visual receptive field, and finally, the sensitivity of the unit to movement direction. Data indicates that cells of the most dorsal (hence visual) layers of the superior colliculus are influenced by sound. It is concluded that the colliculus may use the sound as an additional cue to orientate the animal. Also, collicular cells could "memorize" for several seconds various features present in the environment.