Friday, May 17, 2013

Long-Term Treatment With Imatinib Affected Bone Mineral Density - Cancer Network

Crystal structure of the c-abl kinase domain (...
Crystal structure of the c-abl kinase domain (green) in complex with Sti-571 (imatinib, red). Rendered with Accelrys DS Visualizer Pro 1.6 and edited in the GIMP. Conformation and style made to match Image:Bcr abl sti.jpg, originally created by Mxpule for use in Wikipedia. (Photo credit: Wikipedia)
Long-Term Treatment With Imatinib Affected Bone Mineral Density - Cancer Network by Leah Lawrence: 


"A majority of patients on imatinib(Drug information on imatinib) for treatment of gastrointestinal stromal tumor (GIST) or chronic myelogenous leukemia (CML) had low or absent levels of osteocalcin, a bone marker secreted by osteoblasts, and about 50% of patients had a decrease in bone mineral density, signaling that long-term treatment may affect bone health in these patients.

The results were published in Leukemia Research.
Berman and colleagues enrolled 28 patients with either CML or GIST, and prospectively analyzed levels of osteocalcin and serum N-telopeptide of type 1 collagen(Drug information on collagen) (NTX), a marker of bone resorption. Patients were on imatinib for a median of 31 months at baseline. Nineteen patients completed measures of bone mineral density at baseline, 1 year, and 2 years.
Ninety-five percent of the patients were found to have low levels of osteocalcin, and 37% of patients had no measurable amounts at least once during the study period.
Eleven patients (58%) had normal NTX levels. Only four patients (21%) had elevated levels of NTX, and four patients had low levels of NTX.
At 2 years, DEXA scans indicated that 47% of patients had a decrease in bone mineral density and 32% had no change. Seven of the nine patients with decreases saw significant changes at the total hip.
“Imatinib appears to halt or at least decrease bone growth,” Berman said. “Bone is always growing or remodeling. It slows when you are older, in postmenopausal women particularly, but it is always a living organ.”

Of course, current practice is to give imatinib indefinitely. The authors, then, suggest careful monitoring of bone density and should the patient have indication of loss, consider therapy with calcium and vitamin D. They stated hormone therapy may need to be started. The role of bisphosphonates will also have to be later established.

Full article - click here
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"The earliest known compilation of medicinal substances was ARIANA the Sushruta Samhita, an Indian Ayurvedic treatise attributed to Sushruta in the 6th century BC. However, the earliest text as preserved dates to the 3rd or 4th century AD.
Many Sumerian (late 6th millennium BC - early 2nd millennium BC) cuneiform clay tablets record prescriptions for medicine.[3]

Ancient Egyptian pharmacological knowledge was recorded in various papyri such as the Ebers Papyrus of 1550 BC, and the Edwin Smith Papyrus of the 16th century BC.

The earliest known Chinese manual on materia medica is the Shennong Bencao Jing (The Divine Farmer's Herb-Root Classic), dating back to the 1st century AD. It was compiled during the Han dynasty and was attributed to the mythical Shennong. Earlier literature included lists of prescriptions for specific ailments, exemplified by a manuscript "Recipes for 52 Ailments", found in the Mawangdui tomb, sealed in 168 BC. Further details on Chinese pharmacy can be found in the Pharmacy in China article."

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