Journal of Research in Pharmacy Practice

Summary of COVID-19 vaccine-related reports in the vaccine adverse event reporting system

Shirinsadat Badri; Sahar Vahdat; Morteza Pourfarzam; Samaneh Assarzadeh; Shiva Seirafian; Sara Ataei; Alice C Ceacareanu; Zachary A. P. Wintrob

Volume 10, Issue 3 , July 2021, , Pages 107-113

Abstract

Identification of the severe acute respiratory syndrome coronavirus 2 in humans toward the end of 2019 triggered a rapid, intensive effort to develop a vaccine. Among the first three ... Read More

Statin type and cancer outcomes in patients with diabetes type 2 and solid tumors

Alice C Ceacareanu; Shanria D Jolly; George K Nimako; Zachary A. P. Wintrob

Volume 10, Issue 1 , January 2021, , Pages 50-56

Abstract

Type 2 diabetes mellitus (T2DM) affects 10% of Americans and is associated with an increased incidence of cancer. Statins are first-line cholesterol-lowering medications in the ... Read More

Application of a pharmacokinetic model of metformin clearance in a population with acute myeloid leukemia

Alice C Ceacareanu; Geoffrey W Brown; Hoda A Moussa; Zachary A P. Wintrob

Volume 7, Issue 1 , January 2018, , Pages 41-45

Abstract

We aimed to estimate the metformin-associated lactic acidosis (MALA) risk by assessing retrospectively the renal clearance variability and applying a pharmacokinetic (PK) model ... Read More

Missing the benefit of metformin in acute myeloid leukemia: A problem of contrast?

Alice C Ceacareanu; George K Nimako; Zachary A. P. Wintrob

Volume 6, Issue 3 , July 2017, , Pages 145-150

Abstract

To evaluate whether metformin's cancer-related benefits reported in patients with solid tumors (ST) are also present in acute myeloid leukemia (AML) patients. Methods: Baseline ... Read More To evaluate whether metformin's cancer-related benefits reported in patients with solid tumors (ST) are also present in acute myeloid leukemia (AML) patients. Methods: Baseline demographic and clinical history for all diabetes mellitus patients newly diagnosed with AML or cancer of the breast, ovary, prostate, gastrointestinal tract, lung, or kidney at Roswell Park Cancer Institute in Buffalo, NY (January 2003–December 2010, n = 924) was collected. Overall survival (OS) and disease-free survival (DFS) were assessed by Kaplan–Meier (KM) analysis and Cox proportional hazards regression (hazard ratio [HR]). Findings: Baseline metformin use provided significant OS and DFS benefit in ST but not in AML (KM: PST-OS= 0.003; PST-DFS= 0.002; PAML-OS= 0.961; PAML-DFS= 0.943). AML median survival was slightly better with metformin use, but users derived no relapse benefit. In ST, metformin nonusers had shorter median survival, 57.7 versus 86 months, and poorer outcomes (HRST-OS= 1.33; PST-OS= 0.002; HRST-DFS= 1.32; PST-DFS= 0.002). These findings remained significant in age-adjusted models (HRST-OS= 1.21; PST-OS= 0.039; HRST-DFS= 1.23; PST-DFS= 0.02) but not fully adjusted models (HRST-OS= 0.96; PST-OS= 0.688; HRST-DFS= 1.0; PST-DFS= 0.94). Higher mortality was noted in AML patients taking insulin versus oral diabetes pharmacotherapy at baseline (HRAML-OS= 2.03; PAML-OS= 0.04). Conclusion: Lack of metformin benefit in AML could be due to advanced age at cancer diagnosis. Metformin substitution with insulin before computed tomography scans with contrast – a frequent AML assessment practice – may also explain the lack of subsequent benefit despite taking metformin at baseline. A temporary metformin substitution is recommended by the package insert due to a possible drug interaction with the contrast dye. Our data suggest that metformin substitution was permanent in many patients. Nonetheless, the observed benefit in other malignancies warrants further investigation of metformin use in AML.

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Author = Alice C Ceacareanu

Summary of COVID-19 vaccine-related reports in the vaccine adverse event reporting system

Abstract

Statin type and cancer outcomes in patients with diabetes type 2 and solid tumors

Abstract

Application of a pharmacokinetic model of metformin clearance in a population with acute myeloid leukemia

Abstract

Missing the benefit of metformin in acute myeloid leukemia: A problem of contrast?

Abstract