Search

Aim Methods Results Conclusion Choreito (CRT) is a pharmaceutical‐grade Kampo medicine and has been widely prescribed for patients with lower urinary tract symptoms (LUTS) and cystitis in Japan. The purpose of this study was to investigate the efficacy and safety of CRT in patients with persisting bladder pain.This study was an open‐label, single‐arm exploratory study (Registration No. jRCTs071190017), and CRT was administered orally for eight weeks in addition to the standard therapy. The primary end‐point was the change in Core Lower Urinary Symptoms Score (CLSS) Q9 (bladder pain) from baseline to eight weeks after treatment. The secondary end‐points were all items of CLSS, International Prostate Symptom Score (IPSS), numerical rating scale of bladder pain, uroflowmetry, residual urine volume test, bladder diary and Overall Treatment Efficacy (OTE).In all, 13 female LUTS patients with bladder pain were enrolled. In the primary end‐point, CLSS Q9 (bladder pain) score significantly decreased at the point of week 8. Among secondary end‐points, IPSS Q7 (nocturia) has significantly decreased at weeks 4 and 8 compared with week 0. The numerical rating scale of bladder pain has significantly decreased at week 4. The 24‐hr urine volume significantly increased at week 8. However, no statistically significant changes in other subscores were observed. In satisfaction with CRT treatment according to OTE, 53.8% of patients reported “slightly improved.” There were no adverse drug reactions from CRT.We concluded that CRT has demonstrated therapeutic efficacy for bladder pain. CRT could be potentially a useful add‐on treatment for patients persisting with bladder pain. [ABSTRACT FROM AUTHOR]

Purpose: We aimed to evaluate the therapeutic efficacy and safety of TAS-303, a highly selective noradrenaline reuptake inhibitor, in Japanese women with stress urinary incontinence (SUI). Materials and Methods: A double-blind, placebo-controlled, phase 2 study randomized women with SUI symptoms to once-daily oral administration of TAS-303 18 mg or placebo for 12 weeks. The primary endpoint was percent change from baseline to Week 12 in mean SUI episode frequency per 24 hours (SUIEF) in the per-protocol set. The secondary endpoints were the proportion of patients with ≥ 50% reduction in mean SUIEF, incontinence episode frequency, incontinence amount, health-related quality of life, and safety in the full analysis set. Results: In total, 231 patients were randomized to TAS-303 (n = 116) or placebo (n = 115). At Week 12, TAS-303 had superior efficacy to placebo, with a least squares mean percent change in mean SUIEF of −57.7% vs −46.9%, respectively, in the per-protocol set (least squares mean difference −10.8%; P =.036). TAS-303 showed some evidence of improved incontinence episode frequency, incontinence amount, and health-related quality of life (although not statistically significant) at Week 12 vs placebo in the full analysis set. The between-group difference in SUIEF improvement was more clearly confirmed in patients with ≥ 2 SUI episodes daily at baseline. All adverse events (AEs) with TAS-303 were mild or moderate; there were no serious AEs, AEs leading to discontinuation, or nervous system– or gastrointestinal-related (eg, nausea or vomiting) adverse drug reactions. Conclusions: Once-daily TAS-303 18 mg showed superior efficacy to placebo for the treatment of SUI in Japanese women, with an adequate safety profile. Trial Registration: ClinicalTrials.gov: NCT04512053; Japan Registry of Clinical Trials: jRCT2080225307 (JapicCTI-205403 before site integration) [ABSTRACT FROM AUTHOR]

This Asia‐Pacific (AP) AMS 800™ artificial urinary sphincter (AUS) consensus statement aims to provide a set of practical recommendations to assist surgeons with the AMS 800 device surgery. The AP consensus committee consisted of key opinion leaders with extensive experience with AMS 800 surgery across several AP countries. The panel reviewed and discussed relevant findings with emphasis on locoregional and specific clinical challenges relevant to the AP region. Recommendations were made in key areas namely (1) patient selection and informed consent process; (2) preoperative assessment; (3) dealing with co‐existing urological disorders; (4) surgical principles and intraoperative troubleshooting; (5) postoperative care; (6) special populations; and (7) cost analysis and comparative review. The AMS 800 device should be offered to males with moderate to severe stress urinary incontinence (SUI). Full informed consent should be undertaken, and emphasis is placed on surgical contraindications and high‐risk candidates. The presence of a surgical mentor or referral to experts is recommended in complex AUS candidates. Preoperative cystoscopy with or without multichannel urodynamic study is necessary and patients with pre‐existing urological disorders should be treated adequately and clinically stable before surgery. Adherence to strict patient selection and safe surgical principles are critical to ensure excellent clinical outcomes and minimize complications. Given that InhibiZone‐coated device is not available in many AP countries, the use of prophylactic antibiotics pre‐and post‐operatively are recommended. The AMS 800 device should be prepared according to the manufacturer's guidelines and remains a cost‐effective treatment for male SUI. The AMS 800 device remains the surgical benchmark for male SUI but is associated with certain mechanical limitations and a unique set of complications. [ABSTRACT FROM AUTHOR]

Abstract Background Z-360 is an orally active cholecystokinin-2 (CCK2)/gastrin receptor antagonist currently under development as a therapeutic drug for pancreatic cancer. It was previously reported that Z-360 treatment in combination with gemcitabine prolonged the survival period in a lethal pancreatic cancer xenograft model in mice. In a phase Ib/IIa clinical study, Z-360 treatment displayed a trend of reduced pain in patients with advanced pancreatic cancer in combination with gemcitabine including analgesics such as opioids. Here, we investigated the mechanism of analgesic action of Z-360 in a severe cancer-induced pain model in mice, which is considered to be opioid-resistant, by examining ephrin B1 gene expression, N-methyl-D-aspartate receptor NR2B subunit phosphorylation, and interleukin-1β (IL-1β) production. Results In a mouse model of cancer-induced pain, ephrin B1 gene expression in dorsal root ganglia (DRGs) and the phosphorylation of NR2B in the spinal cord were induced. Z-360 treatment inhibited both ephrin B1 gene expression and the phosphorylation of NR2B. In addition, IL-1β production increased in the cancer-inoculated hind paw of mice, but could be suppressed by treatment with Z-360. Moreover, we observed that the CCK1 receptor antagonist devazepide similarly suppressed up-regulation of ephrin B1 gene expression and IL-1β production, and that the intraperitoneal injection of sulfated CCK-8 induced the production of IL-1β in the cancer-inoculated region. Conclusions We have identified a novel pain cascade, in which IL-1β production in cancer-inoculated regions induces ephrin B1 gene expression in DRGs and then ephrin B1 enhances the tyrosine phosphorylation of NR2B via Eph B receptor in the spinal cord. Notably, Z-360 relieves cancer-induced pain by preventing this pain cascade through the suppression of IL-1β production, likely via the blockade of CCK1 receptor. The pre-clinical results presented here support the analgesic action of Z-360 in pancreatic cancer patients with severe, opioid-resistant pain. Pre-clinical and clinical results have demonstrated that Z-360 combined with gemcitabine represents a promising pancreatic cancer therapy approach with characteristic analgesic effects in addition to the prolongation of survival.

Diagnostic methods for CP have not been established.4 Thus, we proposed "The Project to Develop a Novel Diagnostic Tool for Chronic Prostatitis" to enable the easy diagnosis of CP by patients and medical professionals who are not urologists. Crowdfunding may also be effective for raising nonmedical professionals' awareness regarding CP. Abbreviation & Acronym CP chronic prostatitis Obtaining research grants is a critical global issue for researchers.1 In Japan, research grants are typically provided using public funds, such as the JSPS KAKENHI Grant, or given by public interest foundations. [Extracted from the article]