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- 저자 : Tatsuya Kurihara (검색결과 2 건)
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Clinical Response to Valproate in Patients with Migraine
Mizuki Ichikawa,Hirotaka Katoh,Tatsuya Kurihara,Masakazu Ishii 대한신경과학회 2016 Journal of Clinical Neurology Vol.12 No.4
Background and Purpose Valproate is used as a prophylactic drug for migraine, but it is not be effective in all patients. We used medical records to investigate which clinical factors affected the response to valproate in patients with migraine as an original headache, and estab-lished a scoring system for predicting the clinical response to prophylactic therapy. Methods We investigated clinical factors from the medical records of 95 consistent respond¬ers (CRs) and 24 inconsistent responders (IRs) to valproate. Results Multivariate stepwise logistic regression analysis revealed that a history of hyperlip¬idemia and hay fever and the complication of depression or other psychiatric disorder were significant factors that independently contributed to a negative response, with odds ratios of 6.024 [no vs. yes; 95% confidence interval (CI)=1.616–22.222], 2.825 (no vs. yes; 95% CI= 1.046–7.634), and 2.825 (no vs. yes; 95% CI=1.052–7.576), respectively. A predictive index (PI) of the clinical response to valproate in patients with migraine was calculated using the regres¬sion coefficients of these three factors as an integer, and the index was significantly higher for IRs than for CRs (1.46±1.10 vs. 0.69±0.74, mean±SD, p<0.001). Conclusions The obtained PI may represent an appropriate scoring system for predicting the responses in these patients.
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조규영,Nakamura Akinobu,Oba-Yamamoto Chiho,Tsuchida Kazuhisa,Yanagiya Shingo,Manda Naoki,Kurihara Yoshio,Aoki Shin,Atsumi Tatsuya,Miyoshi Hideaki 대한당뇨병학회 2020 Diabetes and Metabolism Journal Vol.44 No.4
Background: To explore the efficacy and safety of switching from once-daily basal insulin therapy to once-daily pre-meal injection insulin degludec/insulin aspart (IDegAsp) with respect to the glycemic control of participants with type 2 diabetes mellitus (T2DM). Methods: In this multicenter, open-label, prospective, randomized, parallel-group comparison trial, participants on basal insulin therapy were switched to IDegAsp (IDegAsp group; n=30) or continued basal insulin (Basal group; n=29). The primary endpoint was the superiority of IDegAsp in causing changes in the daily blood glucose profile, especially post-prandial blood glucose concentration after 12 weeks. Results: Blood glucose concentrations after dinner and before bedtime were lower in the IDegAsp group, and the improvement in blood glucose before bedtime was significantly greater in the IDegAsp group than in the Basal group at 12 weeks (−1.7±3.0 mmol/L vs. 0.3±2.1 mmol/L, P<0.05). Intriguingly, glycemic control after breakfast was not improved by IDegAsp injection before breakfast, in contrast to the favorable effect of injection before dinner on blood glucose after dinner. Glycosylated hemoglobin significantly decreased only in the IDegAsp group (58 to 55 mmol/mol, P<0.05). Changes in daily insulin dose, body mass, and recorded adverse effects, including hypoglycemia, were comparable between groups. Conclusion: IDegAsp was more effective than basal insulin at reducing blood glucose after dinner and before bedtime, but did not increase the incidence of hypoglycemia. Switching from basal insulin to IDegAsp does not increase the burden on the patient and positively impacts glycemic control in patients with T2DM.
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