Kei Kawada, Chiemi Sato, Tomoaki Ishida, Yui Nagao, Takaaki Yamamoto, Kohei Jobu, Yukihiro Hamada, Yuki Izawa-Ishizawa, Keisuke Ishizawa and Shinji Abe : Vitamin D Supplementation and Allergic Rhinitis: A Systematic Review and Meta-Analysis, Medicina, 61, 2, 2025.
(要約)
Background and Objectives: Vitamin D supplementation is effective for allergic rhinitis; however, its usefulness is unclear. We conducted a systematic review and meta-analysis to examine the conditions in which vitamin D supplementation was effective in allergic rhinitis management. Materials and Methods: Randomized controlled trials of vitamin D supplementation used for patients with allergic rhinitis were searched for across different databases. We extracted scores on patients' symptoms and the medication types used as the baseline treatments and performed a meta-analysis to evaluate the effect of vitamin D supplementation on allergic rhinitis symptoms. Meta-regression and subgroup analyses were performed for the average age, proportion of female participants, concomitant medications, vitamin D administration durations, and baseline serum 25-hydroxyvitamin D levels. Results: In total, 2389 articles were screened, and 5 randomized controlled trials (RCTs) were included in the meta-analysis. Compared with placebos, vitamin D supplementation alleviated allergic rhinitis symptoms, although the difference was not significant; there was significant heterogeneity among studies (standardized mean difference [SMD] = -2.69, 95% confidence interval [CI]: -6.20 to 0.82, I2 = 98%, p < 0.01). The proportion of female participants in the RCTs (slope: 0.21, p = 0.026) and concomitant corticosteroid use (slope: -9.16, p = 0.005) influenced the vitamin D response. Compared with the placebos, vitamin D supplementation without corticosteroids alleviated the allergic rhinitis symptoms (SMD = -0.56, 95% CI: -0.90 to -0.23). Combination treatment with corticosteroids also non-significantly alleviated symptoms. Additionally, the heterogeneity between studies was significant (SMD = -5.97, 95% CI: -13.55 to 1.16, I2 = 99%, p < 0.01). Conclusions: The study results suggest that vitamin D supplementation alleviates allergic rhinitis symptoms, although the effects differ according to the patient's sex and concomitant medications.
(キーワード)
25-hydroxyvitamin D / allergic rhinitis / dietary supplements / vitamin D
Takaaki Yamamoto, Kei Kawada, Chiemi Sato, Tatsuya Tai, Kazunori Yamaguchi, Kenta Sumiyoshi, Atsushi Tada, Naohiro Kurokawa, Takahiro Motoki, Hiroaki Tanaka, Shinji Kosaka and Shinji Abe : Optimal Blood Sampling Time for Area under the Concentration-Time Curve Estimation of Vancomycin by Assessing the Accuracy of Four Bayesian Software., Biological & Pharmaceutical Bulletin, 47, 12, 2021-2027, 2024.
(要約)
Effective blood sampling times, beyond trough and peak levels, have not been determined for estimating vancomycin's area under the concentration-time curve (AUC) using the Bayesian software. The aim of this study was to evaluate the accuracy of AUC estimation at different blood sampling times during the same dosing interval at steady state utilizing data from a prior phase I trial of vancomycin. Six healthy adult participants were sampled following intravenous administration of 1g vancomycin for 1.5h every 12h. The AUC was estimated using four software packages and four population pharmacokinetic models. Accuracy was assessed using bias (difference between the estimated and reference AUC) and imprecision (absolute percentage difference between the estimated and reference AUC). The accuracy varied with the sampling time. The optimal two-point sampling times were determined to be 2.5 and 5.5h post-injection using software packages for EasyTDM, Practical AUC-guided therapeutic drug monitoring (TDM), and Anti-MRSA Agents TDM Analysis Software (incorporating Rodvold, Yamamoto, and Yasuhara models). In these estimations, the mean bias (range, -1.7 to 9.5µg·h/mL) was unbiased and the mean imprecision (range, -3.0% to 5.0%) was precise. The optimal one-point sampling time was 5.5h post-injection for Anti-MRSA Agents TDM Analysis Software, which incorporated the Yamamoto and Yasuhara models. In conclusion, optimal blood sampling times may vary depending on the software and model used. Our findings suggest that identifying specific sampling times could improve the efficacy of TDM in clinical practice.
(キーワード)
Humans / Vancomycin / Bayes Theorem / Anti-Bacterial Agents / Adult / Area Under Curve / Software / Male / Drug Monitoring / Female / Young Adult / Blood Specimen Collection / Models, Biological
T Tai, Takaaki Yamamoto, K Yamaguchi, M Watanabe, H Tanaka, Y Muraki and S Kosaka : Evaluation of the meropenem dosage and administration schedule in patients with bacteremia initial therapy., Journal of Infection and Chemotherapy, 29, 8, 749-753, 2023.
(要約)
The standard meropenem (MEPM) regimen allowed by insurance in Japan is 0.5 g two or three times a day. Differences in dosages and administration schedules in Japan were evaluated. Patients with bacteremia for whom MEPM was used as the initial treatment at our institution between 2016 and 2021 were included. We retrospectively investigated patients classified into two groups: those treated according to severe infections (high-dose groupand others (low-dose group). After propensity score matching, we compared the probability of achieving free drug blood levels above the minimum inhibitory concentration (MIC) in 24 h (%fT > MIC) and outcomes. The probability of 100% fT > MIC was significantly higher in the high-dose group (96.4% vs 74.5%, odds ratio [OR] = 0.3, 95% confidence interval [CI] = 0.2-0.4, P = < 0.001). Regarding outcomes, the 30-day mortality rate was significantly lower in the high-dose group (1.4% vs. 11.4%, OR = 8.0, 95% CI = 1.5-43.7, P = 0.019). To improve outcomes in patients with bacteremia treated with MEPM, support for appropriate antimicrobial use is necessary for compliance with the dosage and administration schedule according to severe infections in initial treatment.