Harrow Health, Inc. · NR3C1 · 小分子
triamcinolone acetonide + moxifloxicin + vancomycin 是一种小分子，由Harrow Health, Inc.研发。该药已获批，用于治疗相关适应症，给药途径：Injectable (Others)、Intraocular Injection。
| 公司 | Harrow Health, Inc. |
| 药物类别 | 小分子 |
| 分子靶点 | NR3C1, , |
| 给药途径 | Injectable (Others), Intraocular Injection |
| 状态 | Approved |
triamcinolone acetonide + moxifloxicin + vancomycin 作用于 3 个分子靶点：
| NR3C1 | nuclear receptor subfamily 3 group C member 1 (GR, GCCR) |
| () | |
| DNA gyrase subunit A, Staphylococcus aureus MRSA () |
triamcinolone acetonide + moxifloxicin + vancomycin 针对 3 个适应症，涉及 2 个治疗领域。
| 治疗领域 | 疾病/病症 | 分期 |
|---|---|---|
| Eye disorders | Cataract | ✓ Approved |
| Infections and infestations | Eye infection | ✓ Approved |
| Eye disorders | Glaucoma | ✓ Approved |
Rebollo Caballero Blanca B, Ruiz Martínez Javier J, Gómez-Olit Pérez Manuel M, Romera Pallarés Juan C JC
Mamizadeh Hamed H, Herizchi Ghadim Hamideh H, Pourasghary Sajjad S
To evaluate whether adding topical 5% caffeine to fluocinolone acetonide 0.025% cream (FAC) improves short-term clinical outcomes compared with FAC alone in patients with chronic plaque psoriasis. This randomized, parallel-group, masked, active-controlled clinical trial included 40 patients with chronic plaque psoriasis treated at the dermatology outpatient clinic of Sina Hospital, Tabriz, Iran. Participants were randomly allocated in a 1:1 ratio to receive either topical 5% caffeine plus fluocinolone acetonide 0.025% (intervention group, n=20) or topical fluocinolone acetonide 0.025% alone (control group, n=20). Psoriasis severity was assessed using the Psoriasis Area and Severity Index (PASI) at baseline and weekly for four weeks. Treatment response and adverse events were also recorded. Baseline PASI scores were comparable between the intervention and control groups (3.41 ± 1.86 vs 3.79 ± 1.51, respectively; P=0.484). PASI scores were significantly lower in the intervention group at each post-treatment assessment. At week 4, mean PASI was 0.39 ± 0.17 in the intervention group and 2.29 ± 1.31 in the control group (P=0.001). The mean reduction from baseline to week 4 was 3.01 ± 1.48 with 5% caffeine plus FAC and 1.49 ± 1.01 with FAC alone (P<0.001). Complete clearance, defined as PASI=0, occurred in 14 of 20 patients (70%) in the intervention group compared with 1 of 20 (5%) in the control group (P=0.001). No adverse events were reported during the study. Adding topical 5% caffeine to FAC produced a greater short-term reduction in psoriasis severity than FAC alone. No adverse events were reported during the 4-week treatment period. Larger randomized trials with longer follow-up are warranted to confirm efficacy and characterize longer-term tolerability. Iranian Registry of Clinical Trials (IRCT), IRCT20091012002581N10, registered on October 28, 2023; https://irct.ir/trial/73367.
Lan Yang Y, Liu Xuemin X, Shi Zhifeng Z, Li Yuanlong Y et al.
Conventional static biomaterials and synthetic nanomedicines struggle to penetrate recalcitrant biofilms and orchestrate tissue regeneration in deep-seated infections due to limited autonomous navigation and a lack of spatiotemporal responsiveness. Here, we conceptualize and develop a programmable engineered living vehicle (ELV) that functions as an autonomous biofactory for the synergistic management of drug-resistant osteomyelitis. Built upon a self-propelled Escherichia coli Nissle 1917 chassis with innate ecological dominance, these living biofactories are hierarchically equipped with environmental biosensors and logic-gated computing modules. Crucially, leveraging AlphaFold 3-guided molecular docking, we engineered multiscale thermo-responsive genetic logic circuits that enable precise, temperature-dependent biomanufacturing of bacteriolytic lysostaphin (LYS) and vasoactive intestinal peptide (VIP) (≥37°C), coupled with a fail-safe thermal self-destruct mechanism (≥42°C). Furthermore, surface-engineered (DSS)6 peptides confer robust hydroxyapatite affinity, acting as a bone-homing navigation module. In a rat osteomyelitis model induced by methicillin-resistant Staphylococcus aureus (MRSA), intravenously deployed ELV biofactories autonomously navigate to the infected niche, actively penetrate biofilms, and outperform vancomycin in pathogen clearance. Concurrently, localized payload secretion reprograms the osteo-immune microenvironment, significantly accelerating bone repair. This work establishes a versatile paradigm for next-generation smart living therapeutics, bridging synthetic biology with micro-engineering to address complex clinical challenges.
Shareef Abdullah Ali AA, MacLeod Rachel R, Keinath Alexandra A
Methicillin resistant Staphylococcus aureus (MRSA) nasal polymerase chain reaction (PCR) testing can support early de-escalation of empiric vancomycin in patients with suspected pneumonia; however, data evaluating electronic medical record (EMR) based enhancement interventions are limited. To evaluate the impact of an EMR-integrated MRSA PCR-based vancomycin hold or discontinuation option for suspected pneumonia or sepsis from a pneumonia source. This single-center, retrospective, pre-post study evaluated adults with a pharmacy vancomycin dosing consult before and after implementation of an EMR-integrated MRSA PCR-based hold or discontinuation intervention. The primary outcome was duration of vancomycin therapy between the pre-implementation and post-implementation groups. Secondary outcomes included acute kidney injury (AKI), same-day vancomycin discontinuation, reinitiation during the same visit, hospital length of stay, number of vancomycin levels obtained, and estimated pharmacist time. In total, 398 patients were included: 200 in the pre-implementation group and 198 in the post-implementation group. Both the initial vancomycin duration and the total vancomycin duration, including reinitiation duration, was significantly reduced in the post-implementation group, with a median of 2 days versus 1 day (P = 0.013) and 2 days versus 2 days (P = 0.036), respectively. There were no significant differences in AKI, same-day vancomycin discontinuation, reinitiation during the same visit, hospital length of stay, and estimated pharmacist time. Total vancomycin levels obtained were significantly reduced in the post-implementation group (P = 0.0165). Implementation of an EMR-based MRSA nasal PCR hold or discontinuation option modestly decreased vancomycin duration without negatively affecting patient outcomes.
Wallace Meagan A MA, Vance Mary Kathryn MK, McMinn Caleb C, Curry Brent B et al.
Trough-based monitoring was previously the primary way to monitor vancomycin; however, 2020 vancomycin consensus guidelines recommend area under the curve (AUC)-based monitoring as the preferred strategy. Data regarding this approach remain limited in the pediatric population. To compare the proportion of pediatric patients achieving therapeutic vancomycin serum concentrations using AUC vs trough-based monitoring and evaluate the safety and efficacy of both strategies. This is a single-center retrospective cohort study comparing trough- and Bayesian AUC-based vancomycin monitoring. Patients aged 28 days to 18 years on vancomycin with at least 2 appropriately obtained levels were included. Patients were excluded for suspected or confirmed central nervous system infection, renal dysfunction at vancomycin initiation, neonate or postmenstrual age <44 weeks, or use of continuous vancomycin. The primary outcome was the proportion of patients achieving therapeutic vancomycin serum concentrations. Secondary outcomes included proportion of patients achieving therapeutic goal by the second pharmacokinetic evaluation, time to therapeutic goal, 30- and 90-day all-cause mortality, number of dose adjustments, number of serum concentrations collected, proportion of appropriately timed serum concentrations, and incidence of acute kidney injury (AKI). Eighty-six patients were included: 49 AUC and 37 trough. Overall target attainment was higher in the AUC group (95.9% vs 51.4%; P < .001). The AUC group had a lower final vancomycin dose (P < .001), fewer dose adjustments (P = .004), serum concentrations obtained (P = .02), and more appropriately timed serum concentrations (P = .02). Incidence of AKI and 30- and 90-day all-cause mortality did not differ between groups. Area under the curve monitoring was associated with higher therapeutic goal attainment, lower final vancomycin doses, higher percentage of appropriately timed serum concentrations, fewer serum concentrations drawn, and fewer dosage adjustments. These findings add pediatric-specific evidence supporting 2020 guideline recommendations and indicate Bayesian area under the curve monitoring is a feasible, resource-efficient strategy in this population.
Fujita Kohei K, Yamamoto Kazuhiro K, Itohara Kotaro K, Ogihara Takashi T et al.
Vancomycin dosing guided by the area under the time-concentration curve (AUC) has been reported to lower the incidence of acute kidney injury (AKI) compared with dosing guided by trough concentration in patients with normal renal function and mild-to-moderate renal impairment. In this retrospective study, we aimed to evaluate the safety of model-based AUC-guided dosing compared with conventional trough-guided dosing in patients with severe renal impairment. Patients with an estimated glomerular filtration rate <30 mL/min/1.73m2 who have been receiving vancomycin for at least 4 d were included, whereas patients undergoing dialysis were excluded. A total of 44 and 20 patients were included in the trough- and AUC-guided groups, respectively. AKI within 14 d occurred in 10 patients (22.7%) in the trough-guided group and in 2 patients (10.0%) in the AUC-guided group; no significant difference was observed in the cumulative incidence of AKI between the groups (p = 0.29). In univariate Cox proportional hazards regression analysis, the observed trough concentration and estimated steady-state AUC (eAUCss) at the first measurement were significantly associated with the cumulative incidence of AKI. In conclusion, no statistically significant difference was observed between model-based AUC-guided dosing and conventional trough-guided dosing in terms of safety, although the results should be interpreted with caution because of the small sample size. Considering that AKI incidence within 14 d was associated with the vancomycin trough concentration and eAUCss at the first measurement, model-informed precision dosing during the early phase of treatment may be warranted in this population.
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