Incidence of discontinuation of angiotensin-converting enzyme inhibitors due to cough, in a primary healthcare centre in Singapore

Ng, Lai Peng; P, Goh

doi:10.11622/smedj.2014034

Cited by 34 publications

(32 citation statements)

References 10 publications

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“…While therapeutic kinase inhibitors frequently inhibit cancer cell proliferation, apoptosis is required for regression of solid tumors (41). Dual p110α/β inhibition induced more apoptosis than single-isoform inhibition (Fig.…”

Section: Resultsmentioning

confidence: 99%

Combined Inhibition of Both p110α and p110β Isoforms of Phosphatidylinositol 3-Kinase Is Required for Sustained Therapeutic Effect in PTEN-Deficient, ER+ Breast Cancer

Hosford

Dillon

Bouley

et al. 2017

Clinical Cancer Research

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Purpose Determine the roles of the phosphatidylinositol 3-kinase (PI3K) isoforms p110α and p110β in PTEN-deficient, estrogen receptor α (ER)-positive breast cancer, and the therapeutic potential of isoform-selective inhibitors. Experimental Design Anti-estrogen-sensitive and -resistant PTEN-deficient, ER+ human breast cancer cell lines, and mice bearing anti-estrogen-resistant xenografts were treated with the anti-estrogen fulvestrant, the p110α inhibitor BYL719, the p110β inhibitor GSK2636771, or combinations. Temporal response to growth factor receptor-initiated signaling, growth, apoptosis, predictive biomarkers, and tumor volumes were measured. Results p110β primed cells for response to growth factor stimulation. While p110β inhibition suppressed cell and tumor growth, dual targeting of p110α/β enhanced apoptosis and provided sustained tumor response. The growth of anti-estrogen-sensitive cells was inhibited by fulvestrant, but fulvestrant inconsistently provided additional therapeutic effects beyond PI3K inhibition alone. Treatment-induced decreases in phosphorylation of AKT and Rb were predictive of therapeutic response. Short-term drug treatment induced tumor cell apoptosis and proliferative arrest to induce tumor regression, while long-term treatment only suppressed proliferation to provide durable regression. Conclusions p110β is the dominant PI3K isoform in PTEN-deficient, ER+ breast cancer cells. Upon p110β inhibition, p110α did not induce significant reactivation of AKT, but combined targeting of p110α/β most effectively induced apoptosis in vitro and in vivo and provided durable tumor regression. Since apoptosis and tumor regression occurred early but not late in the treatment course, and proliferative arrest was maintained throughout treatment, p110α/β inhibitors may be considered short-term cytotoxic agents and long-term cytostatic agents.

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Section: Resultsmentioning

confidence: 99%

Combined Inhibition of Both p110α and p110β Isoforms of Phosphatidylinositol 3-Kinase Is Required for Sustained Therapeutic Effect in PTEN-Deficient, ER+ Breast Cancer

Hosford

Dillon

Bouley

et al. 2017

Clinical Cancer Research

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“…One gene region (XPNPEP2) was associated with angioedema (but not cough) in some studies [75]. The incidence of ACEI cough and withdrawal may be influenced by ethnicity [76]; the cough is more common in females and African Americans [77].…”

Section: Angiotensin-converting Enzyme Inhibitors and Angiotensin Recmentioning

confidence: 99%

Tolerability of Antihypertensive Medications in Older Adults

Dharmarajan

2015

Drugs Aging

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Several guidelines for hypertension have recently undergone revisions to incorporate an approach providing choices of medications based on age, race, and specific situations where hypertension may co-exist with disorders such as diabetes, coronary artery disease, heart failure and chronic kidney disease. Initial recommendations include diuretics, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and calcium channel blockers; beta blockers are favored in some guidelines and are a choice in specific settings. Within the classes of drugs, several antihypertensive agents provide options. This review discusses antihypertensive drugs by class, including adverse effects and tolerability, with preferences in older adults and specific settings. Adverse drug events from antihypertensive medications are discussed by class and where applicable for specific agents. Data from select studies pertinent to tolerability and adverse effects are presented in tables for several classes of drugs. The rationale for nonadherence to medication is reviewed, including the roles played by tolerability and adverse drug effects. Antihypertensive therapy in typical settings in older adults is discussed; they include hypertension in association with impaired cognition, depression, diabetes, sexual dysfunction, and falls. The key to successful therapy and tolerability is to promote a healthy lifestyle in conjunction with medications as the approach, thereby also lowering the adverse drug effects. The eventual choice of the specific drug(s) is based on risks, benefits, and patient preferences, and is best tailored for each older adult.

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“…In terms of medication side effects deterring medication adherence, angiotensin-converting enzyme inhibitors, a common class of medication used in the treatment of hypertension, has been associated with higher incidence of a cough among Chinese populations. [38][39][40] It is, thus, crucial that such pharmacogenetic variations are taken into consideration and managed appropriately in the treatment of hypertensive Asians.…”

Section: Factors Resulting In Poor Hypertension Controlmentioning

confidence: 99%

Hypertension Trends in Asia

Chua¹,

Wong²,

amudi³

et al. 2018

johtn

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Hypertension is an often silent yet modifiable risk factor of cardiovascular morbidity and mortality. Despite increasing recognition of its adverse health impacts, global prevalence remains on the rise and hypertension control remains suboptimal. A similar trend has been observed in South-East Asia, particularly in less-affluent areas, where hypertension prevalence is rising but awareness and control rates are dismal. Contributory factors identified include accessibility of healthcare, different health-seeking behaviour, lifestyle factors such as dietary salt intake, and lack of individual recognition of potential downstream complications. Strategies employed in the fight against hypertension in South-East Asia will need to address these different needs, taking into consideration the interplay of differing socioeconomic status and education level amidst varying racial and cultural beliefs and traditions.

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Incidence of discontinuation of angiotensin-converting enzyme inhibitors due to cough, in a primary healthcare centre in Singapore

Cited by 34 publications

References 10 publications

Combined Inhibition of Both p110α and p110β Isoforms of Phosphatidylinositol 3-Kinase Is Required for Sustained Therapeutic Effect in PTEN-Deficient, ER+ Breast Cancer

Combined Inhibition of Both p110α and p110β Isoforms of Phosphatidylinositol 3-Kinase Is Required for Sustained Therapeutic Effect in PTEN-Deficient, ER+ Breast Cancer

Tolerability of Antihypertensive Medications in Older Adults

Hypertension Trends in Asia

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