Iron Deficiency Anemia in Patients With Inflammatory Bowel Disease.

Iron deficiency anemia in patients with inflammatory bowel disease.

Clin Exp Gastroenterol. 2013; 6: 61-70
Goldberg ND

Iron deficiency anemia is the most common form of anemia worldwide, caused by poor iron intake, chronic blood loss, or impaired absorption. Patients with inflammatory bowel disease (IBD) are increasingly likely to have iron deficiency anemia, with an estimated prevalence of 36%-76%. Detection of iron deficiency is problematic as outward signs and symptoms are not always present. Iron deficiency can have a significant impact on a patient’s quality of life, necessitating prompt management and treatment. Effective treatment includes identifying and treating the underlying cause and initiating iron replacement therapy with either oral or intravenous iron. Numerous formulations for oral iron are available, with ferrous fumarate, sulfate, and gluconate being the most commonly prescribed. Available intravenous formulations include iron dextran, iron sucrose, ferric gluconate, and ferumoxytol. Low-molecular weight iron dextran and iron sucrose have been shown to be safe, efficacious, and effective in a host of gastrointestinal disorders. Ferumoxytol is the newest US Food and Drug Administration-approved intravenous iron therapy, indicated for iron deficiency anemia in adults with chronic kidney disease. Ferumoxytol is also being investigated in Phase 3 studies for the treatment of iron deficiency anemia in patients without chronic kidney disease, including subgroups with IBD. A review of the efficacy and safety of iron replacement in IBD, therapeutic considerations, and recommendations for the practicing gastroenterologist are presented. HubMed – drug


A retrospective analysis of dermatological problems in a hematology ward.

Clin Cosmet Investig Dermatol. 2013; 6: 145-9
Koh H

Skin problems are common in patients with hematological disorders. Dermatologists play an important role in providing consultative service to other medical specialties. While most requests for dermatologic consultations are for common skin conditions, challenging scenarios and diagnostic dilemmas are frequently encountered, especially in acutely ill, immunocompromised patients.To characterize the profile of dermatological problems encountered in a hematology unit in a tertiary hospital, and to delineate clinical features that may help to distinguish cutaneous adverse drug reactions from toxic erythema of chemotherapy.A retrospective study was conducted reviewing all inpatient referrals for dermatology consultations from the hematology unit during a 6-month period from January 2010 to June 2010, at the largest multidisciplinary tertiary hospital in Singapore.Of the 692 referrals for dermatology consultation, 58 (8.3%) came from the hematology department. A total of 60 dermatological diagnoses were made. Most patients were referred for primary dermatological disorders (43.33%, n = 26). The most common diagnoses within this category were cutaneous infections (15%, n = 9) and dermatitis (13.33%, n = 8). Cutaneous adverse drug reactions (16.67%, n = 10) and toxic erythema of chemotherapy (10%, n = 6) were also frequently encountered. We could not identify any distinctive clinical feature that may help to differentiate the two conditions.Our study reinforces the importance of inpatient medical dermatology in terms of both service and education to nondermatologists, who continue to face difficulties diagnosing common skin disorders. Cutaneous adverse drug reactions and toxic erythema of chemotherapy are clinically similar and difficult to differentiate. Larger prospective studies are needed to examine this problem. HubMed – drug


Profile of blonanserin for the treatment of schizophrenia.

Neuropsychiatr Dis Treat. 2013; 9: 587-94
Tenjin T, Miyamoto S, Ninomiya Y, Kitajima R, Ogino S, Miyake N, Yamaguchi N

Blonanserin was developed as an antipsychotic drug in Japan and approved for the treatment of schizophrenia. It belongs to a series of 4-phenyl-2-(1-piperazinyl)pyridines and acts as an antagonist at dopamine D2, D3, and serotonin 5-HT2A receptors. Blonanserin has low affinity for 5-HT2C, adrenergic ?1, histamine H1, and muscarinic M1 receptors, but displays relatively high affinity for 5-HT6 receptors. In several short-term double-blind clinical trials, blonanserin had equal efficacy as haloperidol and risperidone for positive symptoms in patients with chronic schizophrenia and was also superior to haloperidol for improving negative symptoms. Blonanserin is generally well tolerated and has a low propensity to cause metabolic side effects and prolactin elevation. We recently reported that blonanserin can improve some types of cognitive function associated with prefrontal cortical function in patients with first-episode and chronic schizophrenia. Taken together, these results suggest that blonanserin may be a promising candidate for a first-line antipsychotic for acute and maintenance therapy for schizophrenia. Further comparative studies are warranted to clarify the benefit/risk profile of blonanserin and its role in the treatment of schizophrenia. HubMed – drug


Alendronate sodium hydrate (oral jelly) for the treatment of osteoporosis: review of a novel, easy to swallow formulation.

Clin Interv Aging. 2013; 8: 681-8
Imai K

Osteoporosis is a skeletal disorder characterized by loss of bone mass, decreased bone strength, and an increased risk of bone fracture. The disease progresses with age, especially in postmenopausal women. Japan is one of the most rapidly aging societies worldwide. Japanese individuals over 65 years of age constituted 23.0% of the population in 2010 and 25.1% to 25.2% as of 2013. The estimated number of people with osteoporosis in Japan is currently 13 million. Bisphosphonates increase bone mineral density by inhibiting osteoclast-mediated bone resorption, thereby reducing the risk of fractures. Alendronate sodium hydrate (alendronate) is a bisphosphonate that potently inhibits bone resorption and is used to treat osteoporosis. Sufficient water is required to take an alendronate oral tablet; insufficient water could result in digestive system diseases, such as esophageal ulceration. Elderly patients with swallowing difficulty may choke on the tablet. Taking a tablet with oral jelly is a method to prevent digestive system disease and reduce the choking hazard. Once-weekly alendronate oral jelly was approved in 2012 by the Ministry of Health, Labour, and Welfare of Japan as the world’s first drug for osteoporosis in a jelly formulation. It consists of a jelly portion and an air portion. The jelly formulation is smoothly discharged by pushing the air portion. Therefore, elderly patients with physical disabilities are able to easily take all of the jelly formulation from the package. In this review, this new formulation of alendronate sodium hydrate (oral jelly) is introduced and discussed in terms of osteoporosis treatment. This new formulation provides an alternative so that patients may select a method of dosing tailored to their preferences. Management of osteoporosis involves assessing fracture risk and preventing fractures. Higher adherence to the treatment of patients with osteoporosis and prevention of osteoporotic fractures are issues to be resolved. HubMed – drug