@article {48, title = {Mepolizumab in Eosinophilic Asthma-Striking a Target that was almost Debunked}, journal = {Pharmacology, Toxicology and Biomedical Reports}, volume = {2}, year = {2016}, month = {May 2016}, pages = {24-26}, type = {Review Article}, chapter = {24}, abstract = {

Bronchial asthma continues to be a disease that has high morbidity and a significant proportion of patients remain symptomatic with frequent exacerbations, particularly the eosinophilic variant asthma. Mepolizumab is an anti-interleukin-5 humanized monoclonal antibody that prevents the eosinophilic inflammation in the lungs. The drug was found to reduce the sputum and blood eosinophilic count which was in consonance with its mechanism of action. However earlier clinical trials with the drug proved to be disappointing, due to the lacklustre performance with end points that focussed on the symptoms of the disease and pulmonary function testing. Subsequently trials focussed on selecting patients who had eosinophilic variant asthma with frequent exacerbations who were resistant to even treatment with systemic corticosteroids. The drug was shown to reduce the frequency of exacerbations in pivotal clinical trials besides reducing the dose of steroid requirement. Mepolizumab is to be given via subcutaneous injection once monthly at a dose of 75 to 250 mg. While the drug does meet an unmet need in the population, the long terms effects, most appropriate dose and frequency of usage and its efficacy in other related hypereosinophilic disorders warrants further exploration.

}, keywords = {Bronchial asthma, Eosinophilic asthma, Exacerbations, Hypereosinophilic asthma, Interleukin 5., Mepolizumab}, doi = {10.5530/PTB.2016.2.1}, author = {Damal Kandadai Sriram and Govindaraj Gowri and Melvin George} } @article {59, title = {Comparison of Visceral Adiposity Index with Other Indices of Adiposity in Patients with Acute Myocardial Infarction}, journal = {Pharmacology, Toxicology and Biomedical Reports}, volume = {1}, year = {2015}, month = {5th May, 2015}, pages = {55-61}, type = {Original Article}, chapter = {55}, abstract = {

Background: Obesity continues to increase exponentially across the globe. BMI has been the traditional method used to define and quantify the severity of obesity. In recent years, visceral fat has emerged as an important measure of cardiovascular risk. Although MRI and CT scan can estimate the degree of visceral fat, these methods are not feasible in the routine clinical setting. Visceral Adiposity Index (VAI) is a recently derived index to measure visceral fat based on the knowledge of Waist Circumference (WC), plasma HDL, triglycerides and BMI. The study aimed to compare VAI with other adiposity indices in Acute MI and to also assess its ability to detect metabolic syndrome. Methods: In this crosssectional study, 213 patients (Acute STEMI- 106, Controls-107) were included. The lipid profile and all other routine laboratory investigations were performed. Waist and hip circumference (HC) were measured. VAI and other adiposity indices were measured such as atherogenic index (AI), Conicity index (CI), Waist Hip Ratio (WHR) and Waist Height Ratio (WHtR) using appropriate formulae. Results: Patients with metabolic syndrome had higher VAI index (p=0.0001), higher AI index (p=0.0001), higher CI (p=0.0001), higher BMI (p=0.0001), higher WC (p=0.0001) and higher HC (p=0.0001). An ROC curve plotted for each adiposity index to detect metabolic syndrome showed VAI to have the maximal AUC. A VAI of 2.69 was chosen as the cut-off value which had a sensitivity of 70.1\% and specificity of 74.35 \% ( AUC=0.81, CI-0.74 to 0.87; P=0.0001). Conclusion: VAI is an excellent and simple tool to detect Mets as compared to other adiposity indices. It remains to be seen if VAI could accurately reflect the degree of cardiovascular risk from prospective cohort studies.

}, keywords = {Acute Myocardial Infarction, Anthropometric indices, Atherogenic Index, Metabolic syndrome (Mets), Visceral Adiposity index, Waist circumference.}, doi = {10.5530/PTB.1.2.4}, author = {Vengatesh Munusamy and Melvin George and Amrita Jena and Aruna Sridhar and Dhandapani Vellala Elumalai} }