Country-wise Listing - Thailand

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S.NO Title & Authors Name page
1
CHEMOTHERAPY UTILIZATION OF BREST CANCER IN CANCER CENTER, THAILAND
Chaninun Ketkaew, Kitisuk Thepsuwan, Niyada Kiatying-Angsule
 Abstract                  View                 Download                 XML
This study aimed to describe chemotherapy utilization situation of breast cancer patients after NHSO cancer protocol version 2010 had been launched. The 3,485 chemotherapy prescriptions of out-patient departments between January to June 2010 were analyzed. The most common prescribed chemotherapy regimens were Fluorouracil+Doxorubicin+Cyclophosphamide or FAC regimen (36.15%, 1,260 prescriptions), Cyclophosphamide+Methotrexate+Fluorouracil or CMF regimen (16.15%, 563 prescriptions), Doxorubicin+Cyclophosphamide or AC regimen (14.84%, 517 prescription), Paclitaxel (12.63%, 440 prescriptions), Capecitabine (7.49% 261 prescriptions) and Docetaxel (4.88%, 170 prescriptions). Each cancer center was significantly different in the utilization pattern due to the incidence of cancer type, hospital formularies and hospital policy (p = 0.00). 92.14% of all chemotherapy prescriptions adhered to NHSO cancer protocol. The highest ratio of adherence to cancer protocol was UC scheme (96.45%) and the lowest one was CSMBS scheme (75.50%). Each health benefit scheme was significantly different in ratio of adherence to protocol (p = 0.00). The total cost of chemotherapy regimen was 20,677,599 Baht. 16,704,514 Baht (80.79%) was the cost of adherence to protocol prescriptions.
28-32
2
INFLUENCE OF MULTIDRUG RESISTANCE PROTEIN-2 GENETIC POLYMORPHISM ON THE PHARMACOKINETICS OF MYCOPHENOLATE MOFETIL IN THAI KIDNEY TRANSPLANT PATIENTS
*Wanarat Anusornsangiam, Duangchit Panomvana, Kearkiat Praditpornsilpa,Amnart Chaiprasert, Surat Thungpanit
 Abstract                  View                 Download                 XML
The objective of this study was to investigate the influence of multidrug resistance protein (MRP), MRP-2 -24C>T polymorphism on the pharmacokinetics of mycophenolate mofetil in 118 Thai kidney transplant patients. The patients with MRP-2 -24C>T variant had a predicted area under the concentration-time curve (AUC 0-12 hr) of mycophenolic acid (MPA) significantly lower than the patients with wild-type gene (5.04 versus 5.92 mg x h/L/kg/mg dose, respectively, p-value = 0.008). In addition, the oral clearance of MPA in the patients with MRP-2   -24C>T variant was significantly higher than that of MPA in the patients with wild-type gene (0.15 versus 0.12 L/h/kg, respectively, p-value = 0.025). Therefore, this single nucleotide polymorphism (SNP) reduced MPA exposure and might lead to inferior immunosuppressive effect and eventually loss of clinical outcomes of immunosuppressive drug in Thai kidney transplant patients.
807-812
3
Association between HLA-B*5801 Allele and Other Risk Factors to Allopurinol - Induced Severe Cutaneous Adverse Reaction and Exfoliative Dermatitis in Thai Population
*Sunicha Limkobpaiboon, Duangchit Panomvana, Ajchara Koolvisut, Sasijit Vejbaesya
 Abstract                  View                 Download                 XML
To investigate the association of HLA-B*5801 and HLA-Cw*0302 alleles in Thai patients who had allopurinol induced SCAR including exfoliative dermatitis. Other risk factors besides genetic were also investigated. A case - control study was used. The study was performed during December 2009 – March 2010 at Siriraj Hospital, Bangkok. The totals of 82 patients were recruited into the study; 34 patients were recruited from patient with adverse drug reactions from allopurinol. Genotyping of HLA-B*5801 and HLA-Cw*0302 alleles were determined. Within 34 patients with ADR from allopurinol, there were 25 SCAR (SJS/TEN/HSS) cases HLA-B*5801 and HLA-Cw*0302 alleles were found in all 25 patients with SCAR. Odds ratio was 282.2. This study demonstrated that HLA-B*5801 allele was also associated to allopurinol induced exfoliative dermatitis. Other significant risk factors for hypersensitivity to allopurinol besides genetics were female gender and the presence of diabetes mellitus along with chronic renal insufficiency.
692-697
4
PHARMACOKINETICS OF ATAZANAVIR IN RITONAVIR-BOOSTED COMBINATION IN ASIAN HEALTHY VOLUNTEERS: COMPARISONS BETWEEN THE STANDARD AND REDUCED DOSES OF BOTH AGENTS
*Chankit Puttilerpong, Duangchit Panomvana and Kiat Ruxrungtham
 Abstract                  View                 Download                 XML
Atazanavir/ritonavir (ATV/r) 200/100 mg once-daily (OD) has been shown comparable in drug exposure to the standard dose in Asian study. We explored the pharmacokinetic profiles of the boosting effect of ritonavir at 50 mg to either atazanavir 300 or 200 mg in 32 adult Thai healthy volunteers. The geometric means (GM) of ATV AUC0-24 were 40.66, 25.50 and 24.97 mg-h/L and Cmin were 0.53, 0.27 and 0.24 mg/L for 300/100, 300/50 and 200/50 mg OD doses, respectively. Subjects while taking ATV/r 300/50 and 200/50 mg OD had ATV AUC0-24 and Cmin significantly lower than when 300/100 mg was taken (P &lt; 0.05). The GM of bilirubin concentrations were&nbsp; significantly reduced 2.46 vs 1.48 mg/dL for 300/50 mg and 2.60 vs 1.36 mg/dL for 200/50 mg (P = 0.001). The reduced dose of ATV/r decreased in ATV AUC0-24, Cmin and the rate of hyperbilirubinaemia. However, one-third of subjects taken either ATV/r 300/50 or 200/50 had subtherapeutic ATV levels, boosted with 50 mg RTV is therefore not recommended.&nbsp; <br />
643-654
5
INFLUENCE OF SEROTONIN TRANSPORTER-LINKED POLYMORPHIC REGION (5-HTTLPR) VARAINTS ON CLINICAL OUTCOMES IN THAI PATIENTS WITH DEPRESSIVE DISORDER
*Kamolwan Tantipiwattanaskul, Duangchit Panomvana, and Verayuth Praphanphoj
 Abstract                  View                 Download                 XML
The influence of the serotonin transporter polymorphisms on fluoxetine clinical outcomes was determined in 69 Thai patients with major depressive disorder. The results indicated that patients with l/l genotype had a significantly better response to fluoxetine treatment when compared with s allele carriers either evaluated based on the Thai HRS-D scores or psychiatrist efficacy evaluation (p = 0.001). At the same time, carriers with s allele had significantly higher rate of various side effects than the l/l genotype group (p = 0.002). These preliminary data might be used to reduce or prevent adverse effects and improve prescribing efficacy for depressive patients with different genotypes.&nbsp; <br />
426-430
6
SELF-MONITORED BLOOD GLUCOSE LEVEL TIMING TO REPRESENT HEMOGLOBIN A1C LEVEL IN TYPE 2 DIABETIC PATIENTS
*Sutathip Pichayapaiboon, Duangchit Panomvana
 Abstract                  View                 Download                 XML
Glycosylated hemoglobin A1C (HbA1C) is used to assess treatment efficacy in type 2 diabetic patients (T2DM). It is a function of both fasting and postprandial hyperglycemia. This study evaluated the relationship between different time point of self-monitored blood glucose (SMBG) testing and HbA1C.&nbsp; Within 2 weeks, 64 T2DM patients at Police General Hospital, Bangkok, Thailand,&nbsp; performed 12-point SMBG (4 points per each meal per day on every other day: immediately pre meal, 1,2,and 4-hour post meal) twice . SMBG level was reported as mean level from two measurements. HbA1C was measured 2 months later.&nbsp; SMBG levels of all 3 meals and of pre breakfast indicated good relationship with HbA1C (r = 0.766, and r = 0.689, p &lt; 0.01). SMBG level at 4-hour post lunch was also exhibited a good relationship with HbA1C (r = 0.671, p &lt;0.01). Therefore, SMBG testing at 4-hour post lunch might be recommended as another good option to assess glycemic control in T2DM patients. <br /><br />
296-300
7
EFFECT OF THE CYP3A5 GENETIC POLYMORPHISM ON BLOOD LEVEL TO DOSE RATIO OF CYCLOSPORINE IN THAI RENAL ALLOGRAFT RECIPIENTS
*Pailin Wannapraphan, Duangchit Panomvana and Viroon Mavichak
 Abstract                  View                 Download                 XML
This study concentrated on the effect of CYP3A5 polymorphism on cyclosporine (CsA) pharmacokinetics in Thai renal allograft recipients. A prospective descriptive study design was used. Thirty-four renal transplant outpatients who were on microemulsion CsA (Neoral&reg;) and have had stable renal allograft function for at least 3 months were recruited. CsA dose and general demographic data of the patients were recorded. The CsA concentrations at C0 and C2 were determined in whole blood using the chemiluminescent microparticle immunoassay (CMIA). CYP3A5 genotyping was determined by real-time PCR technique. The results obtained indicated that CYP3A5 polymorphism was correlated with CsA dosage requirement in Thai renal transplant patients. The weight-adjusted dose was significantly higher in the CYP3A5*1/*1 group as compare to CYP3A5*1/*3 and CYP3A5*3/*3 group (2.66&plusmn;0.49 vs 2.07&plusmn;0.53 mg/kg/day, p=0.028) while the dose-adjusted C0 and C2 showed tendency to be lower in the CYP3A5*1/*1 group as compare to the other group.
230-236
8
COMPARISONS OF EFFECTIVENESS, SAFETY, AND PHARMACOKINETIC PARAMETERS BETWEEN LOW AND HIGH DOSES OF PIOGLITAZONE IN TYPE 2 DIABETIC PATIENTS
*Wannakamol Sonsingh, Duangchit Panomvana and Wallaya Jongjaroenprasert
 Abstract                  View                 Download                 XML
Pioglitazone (PIO) is highly effective in decreasing blood glucose levels for type 2 diabetes mellitus (T2D), but it can induce serious adverse events such as edema and heart failure (HF). Some previous studies showed that the efficacy on glucose control and lipid levels was not related to the difference in doses of PIO in opposite to the incidence of edema which was doses-dependent of PIO. To compare glucose control, lipid control, adverse events, and pharmacokinetic (PK) parameters between low and high doses of PIO in T2D. Medical chart of 139 diabetic patients using PIO at Ramathibodi hospital were reviewed to compare outcomes and adverse effects between low and high doses of PIO. 38 patients who stabilized dose of PIO and agree to participate were recruited to collect 2 blood samples at 2 appropriated times and were analyzed their PIO concentrations, then, PK parameters were determined. The outcomes of glucose control and lipid control were not differences between low and high dose of PIO, but edema and HF events were significantly higher in high dose of PIO (P=0.010 and P=0.014, respectively). For PK parameters of PIO, elimination rate constant (ke) and clearance rate (CL) values of patients who were stabilized on high dose of PIO were significantly higher (P=0.022 and P=0.031, respectively) while elimination half-life (t1/2) was significantly shorter (P=0.007) than those who were stabilized on low dose of PIO. PK monitoring for optimal dose of PIO might possibly provide good controlling of blood glucose and lower adverse events in T2D. <br />
8-14