Enhancement of Aqueous Solubility and Dissolution Profile of Atorvastatin Calcium: In vitro Evaluation of Solid Dispersion

Purpose: The objective of the present study was to formulate solid dispersions (SD) of Atorvastatin calcium to improve the aqueous solubility and dissolution rate to facilitate faster onset of action. Atorvastatin calcium is a lipid lowering agent belonging to BCS-II having low solubility and high permeability.

A Case Report on Korean Medical Treatment of a Patient with Abnormal Liver Function Induced by Rovazet

Objective: This study evaluated a clinical case of a patient with Rovazet-induced abnormal liver function treated with intradermal acupuncture.Method: A 59-year-old woman with abnormal liver function induced by Rovazet ceased taking the drug and instead received intradermal acupuncture treatment. After 15 days, clinical symptoms and laboratory test results were evaluated.Results: Aspartate aminotransferase and alanine aminotransferase levels decreased, and clinical symptoms such as nausea and fatigue improved after treatment with intradermal acupuncture and cessation of the Rovazet.Conclusion: This study meaningfully examined a clinical case of a patient with abnormal liver function induced by a lipid-lowering agent, which is uncommon in Korea. Unfortunately, the lack of clear evidence and the use of only one case are limitations of the study.

Xanthoma of Tendoachilles: Management and Follow-Up

Xanthoma is a rare pseudotumor of connective tissue, consisting of histiocytes with lipid deposits. Usually, it manifests as encapsulated lobular yellowish mass, often associated with familial hypercholesterolemia (FH). We present a case of xanthoma of tendoachilles just proximal to its insertion site, secondary to FH. The patient was a 28-year-old female presenting with a 2-year history of difficulty ambulating and complaints of swelling over the posterior aspect of her left lower leg just proximal to her heel. She had a deranged lipid profile level and was started on a lipid lowering agent for 3 weeks followed by total excision of the lesion with flexor hallucis longus tendon graft augmentation. The patient was able to bear full weight at 6 weeks and could stand on her toes by 4 months. No recurrences were noted at 1 year follow-up.

Statin-induced rhabdomyolysis: a cautionary tale for high-dose rosuvastatin

Statins are a widely prescribed lipid-lowering agent for preventing adverse cardiovascular events. However, a major side effect is rhabdomyolysis, a breakdown of muscle tissue, which can cause acute kidney injury and death. We present a case of a 77-year-old Chinese woman who was started on 40 mg rosuvastatin post-percutaneous coronary intervention and ultimately developed rhabdomyolysis and acute kidney injury one month later. This case highlights the need to consider patient risk factors for developing statin-induced rhabdomyolysis when choosing the right dose of statin to prescribe.

Berberine: A Promising Natural Isoquinoline Alkaloid for the Development of Hypolipidemic Drugs

: Berberine, as a representative isoquinoline alkaloid, exhibits significant hypolipidemic activity in both animal models and clinical trials. Recently, a large number of studies on the lipid-lowering mechanism of berberine and studies for improving its hypolipidemic activity have been reported, but for the most part, they have been either incomplete or not comprehensive. In addition, there have been a few specific reviews on the lipid-reducing effect of berberine. In this paper, the physicochemical properties, the lipid-lowering mechanism, and studies of the modification of berberine all are discussed to promote the development of berberine as a lipid-lowering agent. Subsequently, this paper provides some insights into the deficiencies of berberine in the study of lipid-lowering drug, and based on the situation, some proposals are put forward.

Antiretroviral therapy and liver disorders in the OPERA® cohort

Introduction: A comprehensive assessment of liver disorders was conducted among people living with HIV (PLWH) on a new antiretroviral regimen based on common core agents. Methods: Treatment-naïve and experienced PLWH first initiating dolutegravir (DTG), elvitegravir (EVG), raltegravir (RAL), or darunavir (DRV) in the OPERA® cohort were included if they had ⩾1 liver chemistry test performed both within 12 months before regimen start and over follow-up. Liver disorders were defined as a diagnosis of drug-induced liver injury (DILI) or moderate/severe liver chemistry elevations (LCE). History of liver disorders experienced within 12 months of initiation was summarized. Liver disorders occurring during follow-up were described as prevalent (all disorders) or incident (disorders occurring among PLWH without a history of liver disorders or advanced liver fibrosis). Results: Out of 16,024 PLWH, 38% initiated DTG, 43% EVG, 5% RAL, and 14% DRV. EVG users were younger and had a lower likelihood of comorbidities or lipid-lowering agent use than DTG users. EVG users were significantly less likely to have a history of moderate/severe LCE or to have prevalent moderate LCE. RAL users were older and had a higher likelihood of comorbidities or lipid-lowering agent use than DTG users. RAL users were significantly more likely to have a history of advanced liver fibrosis and prevalent moderate/severe LCE during follow-up. DRV users were older and had a lower likelihood of lipid-lowering agent use than DTG users. There was no difference in history of LCE, nor in prevalent or incident LCE between DRV and DTG users. No DILI diagnoses were recorded. Discontinuation following a liver disorder was rare (<1%) across all groups. Conclusion: While PLWH with comorbidities may have been channeled away from EVG and toward DTG and RAL, the incidence of moderate/severe LCE did not differ between DTG and EVG, RAL, and DRV. Plain language summary Liver disorders and HIV treatment A comprehensive assessment of liver disorders was conducted using data from the OPERA® cohort, which provides anonymous patient-level clinical data from electronic health records. People living with HIV (PLWH) who were starting a new HIV treatment regimen that included one of four common HIV drugs were included in this study. Liver disorders included drug-induced liver injury (DILI) and moderate or severe liver chemistry elevations. History of a disorder was defined as liver disorders that occurred before starting the new treatment. Prevalent disorders were those that occurred after starting the new treatment in the whole population. Incident disorders were those that occurred after starting the new treatment, but only among PLWH without any history of liver disorders. Out of 16,024 PLWH, 38% initiated dolutegravir (DTG), 43% elvitegravir (EVG), 5% raltegravir (RAL), and 14% darunavir (DRV). EVG users were younger and less likely to have other diseases or use cholesterol lowering drugs compared to DTG users. They were also less likely to have a history of moderate/severe liver chemistry elevations or to have prevalent moderate liver chemistry elevations. RAL users were older and more likely to have other diseases or use cholesterol lowering drugs compared to DTG users. They were also more likely to have prevalent moderate/severe liver chemistry elevations than DTG users. DRV users were older and less likely to use cholesterol lowering agents compared to DTG users. There was no difference in history of liver chemistry elevations, or in prevalent, or incident liver chemistry elevations between DRV and DTG users. There were no DILI diagnoses and discontinuation of treatment following liver disorders was rare across all groups. Overall, the incidence of liver disorders after starting a new HIV treatment regimen did not differ between four common antiretroviral drugs.

Activation of HCAR2 by niacin: benefits beyond lipid lowering

Niacin (nicotinic acid) is a potent lipid-lowering agent that has been used for prevention of coronary heart disease. Niacin activates the HCAR2 receptor found on adipocytes, macrophages and various immune cells throughout the body. Activation of the HCAR2 receptor by niacin results in beneficial anti-inflammatory effects that are independent of lipid lowering. This review summarizes the use of niacin in treatment of dyslipidemia, the pharmacogenetics of niacin response and the potential role of HCAR2 signaling in the treatment of a variety of inflammatory and metabolic diseases.

CLASSIFICATION OF ENLISTED AYURVEDIC LIPID LOWERING HERBS ACCORDING TO PRINCIPLE OF AYURVEDA

INTRODUCTION: Dyslipidemia is a condition marked by unhealthy abnormal concentrations of lipids in blood. There is no direct description of dyslipidemia in Ayurvedic texts. However Medo Rogas (Fat disorders) are described in Ayurvedic texts since ancient times. Dyslipidemia (Medo roga) is a disease of diminished Jatharagni, Bhutagni and Dhatwagni induced apachita or saam asthayi meda dhatu vriddhi. So for the management of Dyslipidemia (Medo roga) such drugs are needed which having Deepan, Pachan, Kaphaghna and Medoghna properties. In this regards it is time essential to classify them by considering its specific therapeutic effect and not only by using as a indistinct lipid lowering agent. AIM: To review the properties and action of Ayurvedic lipid lowering herbs against specific involved samprapti ghatak (Pathological factor) in the management of Dyslipidemia (Medo roga). RESULT: Study provides good evidence of classification of Ayurvedic lipid lowering herbs in the management of Dyslipidemia (Medo roga).