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simvastatin + triflusal (IRIST stent)

✓ Approved

Palau Pharma · HMGCR · 小分子

什么是 simvastatin + triflusal？

simvastatin + triflusal 是一种小分子，由Palau Pharma研发。该药已获批，用于治疗相关适应症，给药途径：Surgical Implantation。

药物档案

商品名IRIST stent
公司Palau Pharma
药物类别小分子
分子靶点HMGCR, PDE4A, PDE4B, PDE4C, PDE4D, PTGS1, PTGS2
给药途径Surgical Implantation
状态Approved
来源： ClinicalTrials.gov, Palau Pharma

作用机制

分子靶点

simvastatin + triflusal 作用于 7 个分子靶点：

HMGCR3-hydroxy-3-methylglutaryl-CoA reductase (LDLCQ3, MYPLG)
PDE4Aphosphodiesterase 4A (PDE4, DPDE2)
PDE4Bphosphodiesterase 4B (PDEIVB, DPDE4)
PDE4Cphosphodiesterase 4C (DPDE1, PDE21)
PDE4Dphosphodiesterase 4D (PDE43, STRK1)
PTGS1prostaglandin-endoperoxide synthase 1 (PCOX1, COX3)
PTGS2prostaglandin-endoperoxide synthase 2 (PHS-2, GRIPGHS)
需要更深入的分析？Noah AI 可解释复杂机制并与同类药物比较。

治疗适应症

simvastatin + triflusal 针对 1 个适应症，涉及 1 个治疗领域。

治疗领域疾病/病症分期
Injury, poisoning and procedural complicationsRestenosis✓ Approved

相关研究文献

PubMedThe AAPS journal2026-09-10

Verification of a Physiologically-based Pharmacokinetic Model for Predicting CYP3A4-mediated Simvastatin and Simvastatin Acid Drug-drug Interactions.

Morse Bridget L BL, Han Bing B, Alberts Jeffrey J JJ, Posada Maria M MM et al.

Simvastatin is a commonly prescribed medication and a sensitive CYP3A4 substrate requiring dosage modification with CYP3A4 precipitants. Unlike other CYP3A4 substrates, grapefruit juice (GFJ) causes the largest increase in simvastatin exposure of any CYP3A4 inhibitor, leading to misunderstanding of simvastatin fraction escaping CYP3A4 metabolism in the gut (Fg, CYP3A4) and fraction metabolized by CYP3A4 in the liver (fm,CYP3A4). Simvastatin is a prodrug that is converted to the active simvastatin acid, though the mechanisms responsible for in vivo simvastatin acid formation are not well-understood. GFJ also decreases the simvastatin acid:simvastatin exposure ratio, suggesting inhibition of simvastatin acid formation. In the current work, we used a static approach to define simvastatin CYP3A4 parameters, using clinical data with index substrate midazolam; estimated simvastatin Fg,CYP3A4 and fm,CYP3A4 were ~ 0.4 and ~ 0.9, respectively. In vitro data assessing the stability of simvastatin and simvastatin acid demonstrated rapid conversion in gastric fluid that was highly pH-dependent. A simvastatin PBPK model was constructed incorporating these CYP3A4 parameters and simvastatin acid formation in stomach, intestine and plasma. The model reproduced the nonlinear pharmacokinetics of simvastatin and CYP3A4 precipitant effects, thus qualifying the model for prediction of CYP3A4-mediated interactions on both simvastatin and simvastatin acid. Simvastatin overall Fg was estimated as ~ 0.2, lower than the Fg,CYP3A4 due to additional intestinal esterase-mediated formation of simvastatin acid. The simvastatin-GFJ effect was explained by inhibition of this intestinal simvastatin acid formation, along with CYP3A4 inhibition. The unique effect of food on the simvastatin acid:simvastatin exposure ratio could also be replicated using this PBPK model.

PMID 42717157
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PubMedJACC. Case reports2026-09-10

Superficial Femoral Artery Stent Fracture With Pseudoaneurysm Evaluated by Angioscopy.

Nakamura Jun J, Yamada Takahisa T, Asai Mitsutoshi M, Morita Takashi T et al.

Computed tomography, angiography, angioscopy, and intravascular ultrasound demonstrated late superficial femoral artery stent fracture with pseudoaneurysm formation. An 83-year-old man presented with recurrent intermittent claudication 10 years after superficial femoral artery stenting. Imaging showed popliteal artery occlusion and a large pseudoaneurysm at the previously stented segment. Angioscopy demonstrated uncovered stent struts and direct visualization of the pseudoaneurysm cavity. Stent graft implantation excluded the pseudoaneurysm, and symptoms improved. Angioscopy may provide complementary vascular surface information beyond angiography and intravascular ultrasound in late femoropopliteal stent failure.

PMID 42720646
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PubMedAnnals of thoracic surgery short reports2026-09-10

Initial Surgical Experience of a Novel Frozen Elephant Trunk Without Distal Stent for Acute Type A Aortic Dissection.

Fukunaga Naoto N, Takanishi Taiki T, Wakami Tatsuto T, Shimoji Akio A et al.

A novel frozen elephant trunk (FET) has a reduced radial force in the stent graft and a 6-cm stent graft part with a 2-cm non-stent graft part. This study aimed to evaluate the novel FET for acute type A aortic dissection. We collected data of 5 patients who underwent total arch replacement with the novel FET for acute type A aortic dissection. Aortic diameter in the descending aorta was measured at the stent graft part, non-stent graft part, and aortic valve level on computed tomography angiography. The true lumen ratio was calculated by dividing the true lumen diameter by the aortic diameter. Five patients with a mean age of 61.6 ± 10.1 years underwent total arch replacement and FET implantation. Spinal cord injury was not recorded. Postoperative and 6-month true lumen ratios at the stent graft part and aortic valve level significantly increased compared with those preoperatively. Aortic diameter at 6 months showed significant shrinkage at those levels. No evidence of distal stent graft-induced new entry was observed. Initial experience with the novel FET implantation demonstrated favorable aortic remodeling and its safe use.

PMID 42719639
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PubMedAnnals of thoracic surgery short reports2026-09-10

Surgical Aortic Valve Replacement With Nicks Annular Enlargement and Partial Trimming of a Protruding Left Main Coronary Stent.

Kobayashi Takuma T, Kawajiri Hidetake H, Manabe Kaichiro K, Gondai Tatsuro T et al.

Protrusion of a coronary stent into the aortic root is rare and can complicate aortic valve replacement and future coronary access. We report the case of a 76-year-old woman with severe aortic stenosis and a left main coronary stent protruding approximately 1 cm into the aortic root. Given the small aortic annulus and the risk of mechanical interference, surgical aortic valve replacement with the Nicks annular enlargement was performed. The protruding stent segment was selectively trimmed while preserving the intraluminal portion, with concomitant coronary bypass grafting. The postoperative course was uneventful.

PMID 42719640
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PubMedFrontiers in neuroscience2026-09-10

Preliminary study on optimizing head position for endovascular treatment of anterior communicating artery aneurysms.

Zhang Jin-Rong JR, Li Jing-Yu JY, Liu Shu-Gai SG, Wu Zheng-Jun ZJ et al.

To evaluate the effects of optimized head positioning on procedural efficiency, device utilization, safety, and short-term postoperative activities of daily living in patients undergoing endovascular treatment for anterior communicating artery aneurysms (ACoAA), compared with conventional head positioning, and thereby assess its clinical value. In this single-center randomized controlled study, 86 patients with ACoAAs scheduled for endovascular treatment at Guangyuan Central Hospital, Affiliated to North Sichuan Medical College, between September 2022 and September 2025 were randomly assigned to a conventional-position group or an optimized-position group. One patient in the conventional group did not undergo the procedure; therefore, 85 patients were included in the final analysis (conventional group, n = 42; optimized group, n = 43). Outcomes included total procedure time, stent-delivery catheter placement time, embolization catheter placement time, coil embolization time, number of coils used, stent use, perioperative complications, and short-term neurological and functional outcomes. The final analysis included 85 patients. The baseline data of the two groups were comparable. Compared with the conventional group, the optimized group had shorter total procedure times for both stent-assisted coil embolization and standalone coil embolization, shorter catheter-placement and coil-embolization times, and a lower stent-use rate (44.2% vs. 66.7%, p = 0.037). No statistically significant between-group differences were observed in the number of coils used, the perioperative complication rate, postoperative modified Rankin Scale (mRS) scores, or changes in mRS. Several other short-term neurological and functional measures favored the optimized group. Optimized head positioning was associated with shorter procedure times and lower stent use, without an evident increase in perioperative complications. Several short-term neurological and functional measures also favored the optimized position. This strategy is simple and readily implementable, supporting its potential for broader clinical application.

PMID 42718577
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PubMedCirculation. Cardiovascular interventions2026-09-10

Contemporary Trends for the Treatment of In-Stent Restenosis in the United States, 2009 to 2024.

Salah Husam M HM, Allan Tess T, Gillikin Tyler T, Marks Angel A et al.

In-stent restenosis (ISR) remains an important cause of repeat revascularization despite advances in drug-eluting stent technology. Contemporary adoption patterns and outcomes of adjunctive plaque-modification strategies for ISR are incompletely characterized. We evaluated national trends and in-hospital outcomes of ISR percutaneous coronary intervention treated with adjunctive plaque-modification devices versus conventional plain old balloon angioplasty. All ISR percutaneous coronary intervention procedures in the National Cardiovascular Data Registry CathPCI Registry from July 2009 to June 2024 were analyzed. Adjunctive ISR therapy was defined as use of excimer laser atherectomy, intravascular lithotripsy, cutting/scoring balloon angioplasty, or rotational/orbital atherectomy with or without stent implantation. Conventional plain old balloon angioplasty included balloon angioplasty with or without stent placement and no adjunctive devices. Multivariable logistic regression clustered by operator was used to assess adjusted in-hospital outcomes. Among 1 065 354 ISR admissions (1 182 599 lesions), adjunctive devices were used in 26.5% of cases, increasing from 20.8% in 2018 Q1 to 40.7% by 2024 Q2. Intravascular lithotripsy showed the most rapid adoption, reaching 16.1% of ISR cases within 4 years of US introduction. Adjunctive therapy was associated with higher odds of in-hospital mortality (odds ratio, 1.25 [95% CI, 1.19-1.31]), myocardial infarction (odds ratio, 1.30 [95% CI, 1.24-1.35]), bleeding (odds ratio, 1.29 [95% CI, 1.26-1.33]), and stroke (odds ratio, 1.11 [95% CI, 1.02-1.22]). Recurrent ISR (14.3%) was more often managed with adjunctive therapy (34.2% versus 25.0% for initial ISR) yet had lower absolute complication rates. ISR remains a major contributor to percutaneous coronary intervention volume. Use of adjunctive plaque-modification devices, especially intravascular lithotripsy, has risen sharply. Adjunctive therapy was associated with higher in-hospital event rates, likely reflecting lesion complexity.

PMID 42717907
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