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Biomedical subjects

L Craps

Publications and source records attributed to L Craps.

13 recordsLinked to original sources
PubMed1983

Prophylaxis of asthma with ketotifen in children and adolescents: a review.

The therapeutic efficacy of ketotifen in the prophylactic treatment of asthmatic children and adolescents is reviewed, based on the results from 4 double-blind placebo-controlled trials involving 194 patients, 2 double-blind clemastine-controlled trials involving 86 patients, and 5 double-blind double-dummy comparative studies with disodium cromoglycate involving 136 patients. In long-term administration, oral ketotifen enabled the consumption of corticosteroids and bronchodilators to be reduced while improving the clinical symptomatology and maintaining respiratory function. Optimal results were obtained after 8 to 12 weeks. Tolerance did not develop and there was no rebound effect when treatment was interrupted. Comparative studies with clemastine, a specific H1-blocking agent, have shown that the antihistaminic properties of ketotifen are not responsible for its prophylactic action in bronchial asthma. It has been further established that a double dose, in mg/kg body weight calculated on the basis of the dose used in adults, or that the adult dose may be required in children in order to obtain optimal results. These clinical observations are in agreement with pharmacokinetic findings in children, suggesting a more rapid metabolism without alteration in the pattern of biotransformation. Comparative trials between ketotifen and disodium cromoglycate have demonstrated comparable efficacy, although this does not mean that the responder pattern is identical for the two drugs. Long-term treatment with oral ketotifen was as well tolerated in children as it was in adults. The major adverse effect was transient sedation occurring in 6% of the children at the beginning of treatment.

Adolescent↗
PubMed1982

Ketotifen in the prophylaxis of bronchial asthma.

The pharmacodynamic effects of ketotifen, a benzocycloheptathiophene derivative, on several partly interdependent biological pathways (calcium fluxes in excitable cells, production and release of mediators, mainly SRS-A, smooth-muscle contractility, density and sensitivity of adrenergic receptors) may be relevant to its antianaphylactic and asthma-prophylactic properties. Pharmacological investigations in humans of various target organs (skin, nasal mucosa, bronchi) have shown that ketotifen has strong antihistaminic and antianaphylactic effects. Its inhibiting action on bronchial responsiveness is not limited to bronchospasm induced by allergens but includes certain types of bronchial hyper-reactivity in which known mediators of allergy do not seem to be involved. Some important features of oral asthma prophylaxis with ketotifen are underlined. These include responder rate in both extrinsic and intrinsic asthma, pharmacokinetics and dosage in children, reduction in the consumption of corticosteroids and bronchodilators, and avoidance of side effects.

Asthma↗
PubMed1981

Criteria for the clinical evaluation of prophylactic agents in bronchial asthma.

The clinical investigation of prophylactic agents for bronchial asthma is at once simple and laborious: simple because provocation tests are available for measuring the bronchial reactivity of the asthma patient to numerous stimuli and his response to treatment; but laborious because some of these methods are poorly standardised and above all because bronchial spasticity varies greatly from patient to patient and in the same patient at different times. The fluctuating pattern of asthma, is, moreover, an obstacle to clinical investigation. It has to be taken into account in devising trial protocols. Besides bias associated with the disorder itself, there are other difficulties inherent in the prophylactic nature of the treatment. It is a simple enough matter to evaluate the activity of a bronchodilator since the effect of such a compound is directly measurable. Evaluation of the efficacy of a prophylactic agent is more difficult since the fluctuations in episodes of bronchoconstriction and in the bronchodilator treatment needed for these episodes have to be evaluated jointly. We shall have occasion to revert to the practical consequences of this later.

Asthma↗
PubMed1981

Ketotifen in the oral prophylaxis of bronchial asthma: a review.

The experimental data providing the rationale for the use of ketotifen as a prophylactic drug in asthma (inhibition of release of the mediators of anaphylaxis, particularly SRS-A, prevention of the bronchospasm induced by SRS-A in vivo, calcium antagonist effect) are briefly discussed, and the results of experimental and therapeutic trials carried out over 6 years in a number of countries in several thousand patients are reviewed. Some important features of oral asthma prophylaxis with ketotifen are underlined, namely the effect of ketotifen on the characteristic bronchial hyperreactivity of asthma, the types of asthma which respond best to ketotifen treatment, the effect of ketotifen in reducing the concomitant use of corticosteroids and bronchodilators, a comparison of ketotifen with specific antihistamines, theophylline derivatives and sodium cromoglycate, and the side-effects and long-term safety of ketotifen.

Asthma↗
PubMed1980

[Ketotifene: experimental and clinical data].

Some important pharmacodynamic and clinical data on ketotifen, a benzocycloheptathiophene used in the prophylaxis of allergic asthma, are provided as an introduction to papers discussing the therapeutic use of this substance in adults and children. Ketotifen, which is active when administered orally, has a therapeutic efficacy comparable to that of cromoglycate but characterized by a somewhat different mechanism of action. The therapeutic efficacy of ketotifen appears to be associated with a progressive diminution of bronchial hyper-reactivity to various specific or nonspecific spasmogenic factors (allergens, histamine, exercise). An antagonistic action to, and an inhibitory effect on, the activation and release of the principal mediators of anaphylactic hypersensibility (SRS-A, histamine) have been demonstrated in several experimental models both in animals and in man.

Administration, Oral↗
PubMed1978

Clinical investigation of agents with prophylactic anti-allergic effects in bronchial asthma.

To determine the efficacy of ketotifen as an oral anti-asthmatic agent, experimental and therapeutic long-term trials were carried out. Four models were used in the expirmental therapeutic trials nad the antihistaminic agent clemastine and disodium cromoglycate were used as comparative substances. It was demonstrated that ketotifen provides protection against bronchopasm induced by allergens, histamine and exercise, but not against that induced by acetylcholine. In the therapeutic long-term trials, the efficacy and tolerance of ketotifen were compared with that of clemastine and disodium cromoglycate for a period of 6 months. In another study ketotifen was administered for 1 year. Ketotifen proved very effective in decreasing the frequency and duration of asthmatic attacks, concomitant medication could be reduced and the patients improved subjectively. From these trials it can be concluded that ketotifen is a safe and effective oral anti-anaphylactic agent for use in the long-term treatment of bronchial asthma.

Acetylcholine↗