Tous les articles par Jean-François GIRMENS

Ophtalmologie

Aspirine et Warfarine : facteurs de risque d’occlusion veineuse rétinienne ?

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Alors que beaucoup préconisent encore de donner en traitement des occlusions de la veine centrale de la rétine des antiagrégants plaquettaires (type aspirine) voire des anticoagulants, une étude présentée à l’ARVO semble démontrer qu’au contraire, certains d’entre eux pourraient en être un facteur de risque indépendant !

FORT LAUDERDALE, Fla. — Antithrombotic medications aspirin and warfarin are independent risk factors for the development of central retinal vein occlusion, according to one researcher speaking here.

« Past hypotheses have centered on the thrombus, » Hideki Koizumi, MD, said at the Association for Research in Vision and Ophthalmology meeting.

Dr. Koizumi presented data from 144 consecutive patients with central retinal vein occlusion CRVO who were compared with 144 gender- and age-matched controls to determine risk factors.

Mean age of CRVO patients was 70 years, and mean age of control patients was 69 years. Male-to-female ratio was 87:57 in both groups.

In addition to known CRVO risk factors such as hypertension, diabetes mellitus, atrial fibrillation and glaucoma, aspirin and warfarin were significantly linked to CRVO by univariate analysis, according to the study results.

Multivariate logistic regression model also found aspirin and warfarin to be independent risk factors for CRVO, he said.

« While these findings imply the vasculopathic and prothrombotic risks in some patients may not be fully addressed by antithrombotic therapy, they also suggest the pathogenesis of CRVO may be more complicated than just the development of a primary thrombus within the vein, » Dr. Koizumi said.

Bien sûr, il faudra lire en détail la publication pour conclure…
Cependant, vu le nombre de patients déjà sous ce type de traitements lorsque survient l’occlusion veineuse rétinienne, il est déjà fort probable qu’ils ne servent à rien…

Via OSN SuperSite.
Abstract complet : Continuer la lecture de Aspirine et Warfarine : facteurs de risque d’occlusion veineuse rétinienne ? →

Internet

Veille bibliographique avec PubMed (« My NCBI »)

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Les mails d’Amedeo (je vous en parlais en février) sont parfois indigestes, puisque reprenant toute la table des matières des revues. Résultat, il est facile de finalement rater une information intéressante au milieu de longs mails.
Il est possible de mieux cibler sa veille bibliographique, grâce au service My NCBI de PubMed.
My NCBI

Après inscription, il suffit d’enregistrer ses recherches « favorites » : à chaque publication d’un article correspondant, un email vous sera envoyé, avec un lien vers l’abstract.
Pratique pour se tenir au courant de ses sujets de prédilection… ou le référencement d’une de ses publications !

Un mode d’emploi en français de cette fonctionnalité est sur un site du Dr. Gilles Perrin sur la recherche médicale sur internet.

Ophtalmologie

Le prochain traitement de la DMLA sera-t-il un collyre ?

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Après les traitements par laser, thérapie photodynamique puis injections intra-vitréennes, l’avenir dans la prise en charge de la DMLA pourrait être un collyre. En effet, parallèlement au développement d’OT551 (Othera), au moins deux autres laboratoires travaillent sur cette voie d’administration.

  • Comentis (ex-Athenagen) lance un essai de phase II avec un inhibiteur des récepteurs nicotiniques à l’acétylcholine (ATG3) :

    CoMentis Initiates Phase II Clinical Trial for AMD Eye Drop Therapy
    South San Francisco, CA – April 10, 2007–CoMentis, Inc. (formerly Athenagen), a privately held biopharmaceutical company, announced today the initiation of a Phase II clinical study of ATG3, the company’s topical eye drop therapy for neovascular age-related macular degeneration (NV-AMD). A proprietary ophthalmic formulation of mecamylamine, ATG3 is an antagonist of the nicotinic acetylcholine (nACh) receptor pathway that mediates angiogenesis. The drug was developed to effectively penetrate into the retina and choroid following topical eye drop administration.

    This Phase II study is a double-masked, randomized, placebo-controlled clinical trial designed to evaluate the safety and efficacy of ATG3 in patients with NV-AMD (also known as “wet’ AMD). Approximately 330 patients will be randomized to one of three treatment groups, administered by eye drop twice daily: two different doses of ATG3 or placebo. One eye per patient will receive the study treatment. All patients will be treated for up to 48 weeks, during which time they will be monitored for safety, tolerability and efficacy assessments. Patients will be assessed for change in visual acuity and macular thickness using ocular coherence tomography.
    “In January we completed our Phase I study of ATG3 in healthy volunteers and found excellent ocular safety following eye drop administration,” said Henry Hsu, M.D., Chief Medical Officer of CoMentis. “We are very pleased to begin this international Phase II study as planned, and expect to have interim (six month) efficacy data by mid-2008. ATG3 could be the first topical angiogenic treatment for AMD and if approved, would compliment current therapies which require injection directly into the eye.” Inhibition of the nicotinic acetylcholine (nACh) receptor pathway, which was discovered at Stanford by two of CoMentis’s founding scientists, also down regulates vascular endothelial-derived growth factor (VEGF) dependent angiogenesis. Studies in animal models have demonstrated excellent penetration of the proprietary ATG3 formulation to the retina and choroid following eye drop application as well as reduction of new blood vessel growth in the eye.

  • Targegen développe un inhibiteur de kinases (TG100801) :

    TargeGen Announces Successful Completion of Phase I Clinical Trial Of Topical AMD Drug TG100801
    San Diego, CA – Feb. 27, 2007 – TargeGen, Inc. has announced that the Company has completed a single-center Phase I clinical trial of TG100801 in 42 healthy volunteer subjects. TG100801 is a small molecule, topically applied (eye drop), multi-target kinase inhibitor that is being developed for the treatment of macular degeneration and other debilitating diseases of the eye. Preliminary results from this Phase I study suggest that TG100801 is well tolerated in humans at the low and high doses tested when applied topically twice daily for 14 days. Final study results are expected by the end of April 2007. TargeGen currently plans to initiate Phase II clinical trials in wet age-related macular degeneration (AMD) patients in mid-2007.

    TG100801, applied daily in eye drop form, is designed to suppress disease related edema, angiogenesis and inflammation simultaneously. Edema, angiogenesis and inflammation are pathological hallmarks of AMD, diabetic macular edema (DME) and proliferative diabetic retinopathy (PDR). Currently approved therapies for macular degeneration require repeated injection into the eye.

    “The successful completion of this ‘first in human’ safety study with TG100801 represents a meaningful milestone for TargeGen and sets the stage for the near term initiation of human efficacy trials. We remain very optimistic about the potential for demonstrating efficacy in humans in the near future,” stated Peter G. Ulrich, President, CEO and Co-Founder of TargeGen.

Sources : http://www.athenagen.com/index.php?/athenagen/press_releases/43/
http://www.targegen.com/news022707.htm