References: Laxative
temp/constipation-1.matches:
Semin Hematol. 2003 Oct;40(4 Suppl 4):17-22.
Thalidomide in newly diagnosed multiple myeloma and overview of experience in smoldering/indolent disease.
Rajkumar SV.
Division of Hematology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.
Based on the activity of single-agent thalidomide demonstrated in relapsed or refractory multiple myeloma, investigators have evaluated the role of this agent in the treatment of earlier stage disease. Two key phase II trials of thalidomide plus dexamethasone in patients with previously untreated symptomatic multiple myeloma have yielded overall response rates of 64% to 73%. Comparable response rates, reduced toxicity, and increased patient convenience with oral administration suggest it may offer an alternative to standard infusional chemotherapies, such as vincristine/doxorubicin/dexamethasone (VAD), before stem cell mobilization and high-dose chemotherapy in patients with active disease; further study is warranted. Two key phase II trials of single-agent thalidomide in patients with smoldering/indolent (asymptomatic) disease have yielded overall response rates of approximately 35%, and further study of thalidomide in this setting is also indicated. The primary toxicities of thalidomide-based therapy are neuropathy, sedation/fatigue, constipation, and rash. Studies of thalidomide in combination with dexamethasone suggest toxicities of both agents may be increased due to the synergy of these agents. Phase III trials of thalidomide in newly diagnosed symptomatic multiple myeloma or smoldering/indolent disease are ongoing.
online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15015892&dopt=Abstract [PubMed - in process]
temp/constipation-1.matches:
Semin Hematol. 2003 Oct;40(4 Suppl 4):23-32.
The role of immunomodulatory drugs in multiple myeloma.
Anderson KC.
Jerome Lipper Multiple Myeloma Center, Dana-Farber Cancer Institute, Harvard Medical School, 44 Binney St, Boston, MA 02155, USA.
Thalidomide has shown promise in the treatment of newly diagnosed multiple myeloma and relapsed/refractory disease, but side effects such as somnolence, constipation, and neuropathy limit its use. CC-5013, an immunomodulatory drug (IMiD), is more potent than thalidomide. CC-5013 has various immunomodulatory effects, including growth arrest or apoptosis of drug-resistant myeloma cell lines and inhibition of binding of myeloma cells to bone marrow stromal cells. Clinically, 17 of 24 patients (71%) with relapsed/refractory disease experienced a reduction of paraprotein of > or = 25% following treatment with CC-5013, including 11 who had a history of treatment with thalidomide. Another two experienced stable disease. Median time to best response was 2 months (range, 1 to 11) and median duration was 6 months (range, 2 to 18). Grade 3 thrombocytopenia was seen in 20% of patients; grade 3 neutropenia was seen in 60%; and grade 4 neutropenia was seen in 16%. CC-5013 use was not associated with somnolence, constipation, or neuropathy. This article reviews thalidomide in multiple myeloma, the effects of thalidomide analogues IMiDs, and the preclinical and clinical data on CC-5013 in relapsed/refractory multiple myeloma.
online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15015893&dopt=Abstract [PubMed - in process]
temp/constipation-1.matches:yahoo.com
BACKGROUND & AIMS: There have been few reports of successful treatment of chronically symptomatic patients with irritable bowel syndrome. We performed a preliminary single center study to evaluate a new collaborative treatment model that used both gastroenterologist and psychologist working together, compared to medical treatment or psychological treatment alone. A second goal was to determine the sample size that would be necessary to definitively demonstrate efficacy of such a collaborative treatment program. METHODS: Forty-one patients with irritable bowel syndrome, seen in a tertiary setting, were randomly assigned to the 3 treatment groups. The research design was weighted toward collaborative treatment, which consisted of 3 biweekly visits. A series of questionnaires, including a 2-week daily diary as well as measures of quality of life, anxiety, depression, and relationships, were administered before treatment, after treatment, and again 3 months later. At termination of the study, patients completed a global assessment scale. RESULTS: Sixteen patients completed the collaborative program, 8 completed medical treatment directed at gastrointestinal function, and 6 completed psychological therapy. Eleven patients dropped out of the study; 2 had organic disease. Intent to treat and per protocol analyses showed that global self-assessment improved significantly at long-term follow-up in the collaborative treatment group (P<0.0002). Abdominal pain, diarrhea, and constipation also improved significantly in the collaborative treatment group (P<0.001). Collaborative treatment was statistically superior to medical treatment alone (P<0.05). The psychological treatment group had 50% improvement in global score. There was no significant improveme
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