Publications by authors named "Jasper Stevens"

A novel liquid chromatography-tandem mass spectrometry method is described for the quantitative determination of the kidney function markers iothalamate and hippuran in human serum and urine. It is based on protein precipitation with methanol followed by dilution of the supernatant for serum and simple dilution for urine. The polar analytes are chromatographically separated by a 6.

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Noncommunicable Chronic Diseases (NCD) are a socioeconomic burden and considered one of the major health challenges for coming decades. Mitochondrial dysfunction has been implicated mechanistically in their pathophysiology. Therefore, targeting mitochondria holds great promise to improve clinical outcomes in NCDs.

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Background: Keller's arthroplasty, arthrodesis and cheilectomy are well-known surgical interventions for hallux rigidus. This study aimed to evaluate the effects of these surgical interventions on gait, plantar pressure distribution and clinical outcome in patients treated for hallux rigidus 22 years after surgery.

Methods: Spatio-temporal gait parameters and plantar pressure distribution, determined as pressure time integrals (PTIs) and peak pressures (PPs), were analyzed using a 7-foot tone analysis model.

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Sodium-glucose cotransporter-2 (SGLT2) inhibitors improve markers for renal and cardiovascular outcomes in patients with and without type 2 diabetes (T2D). To assess whether individual differences in plasma drug exposure can explain inter-individual response variation, we characterized the exposure-response relationship for two SGLT2 inhibitors on several clinical and kidney hemodynamic variables. Data were obtained from two studies, RED and RECOLAR, assessing the effects of once-daily 10 mg dapagliflozin or empagliflozin, respectively, on kidney hemodynamics in patients with T2D.

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Background: In the Canagliflozin and Renal Events in Diabetes with Established Nephropathy Clinical Evaluation (CREDENCE) trial, the sodium-glucose cotransporter-2 (SGLT2) inhibitor canagliflozin improved kidney and cardiovascular outcomes and reduced the rate of estimated glomerular filtration decline (eGFR slope) in patients with type 2 diabetes and CKD. In other clinical trials of patients with CKD or heart failure, the protective effects of SGLT2 inhibitors on eGFR slope were greater in participants with versus participants without type 2 diabetes. This post hoc analysis of the CREDENCE trial assessed whether the effects of canagliflozin on eGFR slope varied according to patient subgroups by baseline glycated hemoglobin A1c (HbA1c).

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Sodium-glucose co-transporter 2 (SGLT2) inhibitors, including canagliflozin, reduce the risk of cardiovascular and kidney outcomes in patients with and without type 2 diabetes, albeit with a large interindividual variation. The underlying mechanisms for this variation in response might be attributed to differences in SGLT2 occupancy, resulting from individual variation in plasma and tissue drug exposure and receptor availability. We performed a feasibility study for the use of [ F]canagliflozin positron emission tomography (PET) imaging to determine the association between clinical canagliflozin doses and SGLT2 occupancy in patients with type 2 diabetes.

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Background: Suboptimal exposure to antituberculosis (anti-TB) drugs has been associated with unfavourable treatment outcomes. We aimed to investigate estimates and determinants of first-line anti-TB drug pharmacokinetics in children and adolescents at a global level.

Methods: We systematically searched MEDLINE, Embase and Web of Science (1990-2021) for pharmacokinetic studies of first-line anti-TB drugs in children and adolescents.

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The angiotensin receptor blocker telmisartan slows progression of kidney disease in patients with type 2 diabetes (T2D), yet many patients remain at high risk for progressive kidney function loss. The underlying mechanisms for this response variation might be attributed to differences in angiotensin-1 receptor occupancy (RO), resulting from individual variation in plasma drug exposure, tissue drug exposure, and receptor availability. Therefore, we first assessed the relationship between plasma telmisartan exposure and urinary-albumin-to-creatinine-ratio (UACR) in 10 patients with T2D and albuminuria (mean age 66 years, median UACR 297 mg/g) after 4 weeks treatment with 80 mg telmisartan once daily.

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Article Synopsis
  • - The study investigates how hallux rigidus (HR) affects foot joint movement and whether it impacts pressure distribution across the foot during walking.
  • - Compared to healthy controls, patients with HR displayed changes in foot motion, including reduced hallux movements and increased forefoot supination during the push-off phase of walking.
  • - Although these kinematic adjustments were observed in HR patients, no significant differences in plantar pressure were found, indicating that the overall pressure distribution remains unaffected despite altered foot mechanics.
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Sodium-glucose cotransporter-2 inhibitors (SGLT2i) were initially developed to treat diabetes and have been shown to improve renal and cardiovascular outcomes in patients with- but also without diabetes. The mechanisms underlying these beneficial effects are incompletely understood, as is the response variability between- and within patients. Imaging modalities allow quantitative assessment of physiological, pathophysiological, and pharmacological processes at kidney tissue level and are therefore increasingly being used in nephrology.

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  • The study analyzed clinical features and outcomes of 283 children with tuberculous meningitis (TBM) treated at Hasan Sadikin Hospital in Indonesia from 2011 to 2020, with a significant portion being under 5 years old and having advanced stages of TBM.
  • Key predictors for in-hospital death included stage III TBM, hydrocephalus, and a lack of vaccination, while predictors for post-discharge death were hydrocephalus and tuberculomas.
  • The research underscores that many survivors, particularly those with severe neurologic issues, demonstrate the need for improved TBM diagnostics and management strategies to reduce mortality and long-term complications.
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Inhibition of the sodium-glucose cotransporter 2 (SGLT2) by canagliflozin in type 2 diabetes mellitus results in large between-patient variability in clinical response. To better understand this variability, the positron emission tomography (PET) tracer [F]canagliflozin was developed via a Cu-mediated F-fluorination of its boronic ester precursor with a radiochemical yield of 2.0 ± 1.

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The preclinical evaluation of novel therapies for chronic kidney disease requires a simple method for the assessment of kidney function in a uremic large animal model. An intravenous bolus of iohexol was administered to goats (13 measurements in = 3 goats) and pigs (23 measurements in = 5 pigs) before and after induction of kidney failure, followed by frequent blood sampling up to 1440 min. Plasma clearance (CL) was estimated by a nonlinear mixed-effects model (CL) and by a one-compartmental pharmacokinetic disposition model using iohexol plasma concentrations during the terminal elimination phase (CL).

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Article Synopsis
  • * It analyzed data from 14 anti-diabetic drugs across three classes and found that while numerous off-target effects (like body weight and cholesterol levels) were reported, they were largely ignored in dose justification processes.
  • * The research concludes that regulatory dose selection primarily focuses on glycaemic outcomes, indicating that including off-target effects could lead to better optimization of anti-diabetic drug dosages.
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  • HTL0009936 is being tested as a treatment for cognitive dysfunction in Alzheimer's disease, focusing on its safety, tolerability, and pharmacokinetics in elderly patients with below average cognitive functioning.
  • The study involved two parts: one evaluated HTL0009936's effects on healthy elderly subjects, while the second part used a randomized approach to assess its effects in subjects with cognitive impairments, measuring cognitive and electrical brain responses.
  • Results indicate that HTL0009936 is generally safe and well-tolerated, showing some effects on brain activity (P300), but no conclusive evidence of significant cognitive improvement due to design changes that limited optimal drug exposure during testing.
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Background: Arthrodesis and metallic hemiarthroplasty are two surgical interventions for the treatment of end-stage osteoarthritis of the first metatarsophalangeal (MTP1) joint. This systematic review and meta-analysis aims to compare the two operations with regards to patient-reported outcomes, pain reduction, complications and revision rates.

Methods: A systematic literature search identified all relevant studies.

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The quantitative description of individual observations in non-linear mixed effects models over time is complicated when the studied biomarker has a pulsatile release (e.g. insulin, growth hormone, luteinizing hormone).

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Article Synopsis
  • Dapagliflozin is a medication initially designed for type 2 diabetes that is showing potential benefits for cardiovascular and kidney health in non-diabetic patients, prompting research on its pharmacokinetics in chronic kidney disease (CKD) patients without diabetes.* -
  • A study (DIAMOND trial) involving 53 participants found that dapagliflozin's plasma levels followed a two-compartment model, with important parameters like clearance and volume of distribution being measured, indicating how the drug behaves in the body.* -
  • Results indicated that lower kidney function increased the drug's plasma exposure, which correlated with positive effects such as decreased urinary albumin levels, improved glomerular filtration rates, and lowered blood pressure.*
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Background: Previous research showed that hallux rigidus (HR) affects foot and ankle kinematics during gait. It is unclear if HR affects lower limb kinematics as well.

Research Question: Does HR affect lower limb kinematics, and if so, is gait deviation correlated with patient-reported outcome?

Methods: This was a retrospective case-control study, including 15 HR patients and 15 healthy controls who underwent three-dimensional gait analysis by using the Plug-in Gait lower body model.

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Atrasentan, an endothelin receptor antagonist, showed clinically significant albuminuria reduction with minimal signs of fluid retention in phase II trials. We evaluated whether plasma exposure was associated with long-term outcomes for kidney protection and heart failure in the phase III SONAR trial (n = 3668) in type 2 diabetics with chronic kidney disease. A population pharmacokinetic model was used to estimate plasma exposure of atrasentan 0.

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Aim: To evaluate whether atrasentan plasma exposure explains between-patient variability in urinary albumin-to-creatinine ratio (UACR) response, a surrogate for kidney protection, and B-type natriuretic peptide (BNP) response, a surrogate for fluid expansion.

Methods: Type 2 diabetic patients with chronic kidney disease (n = 4775) received 0.75 mg atrasentan for 6 weeks in the active run-in period.

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Objectives: To evaluate the pharmacokinetics and clinical effectiveness of IV and oral fosfomycin treatment in patients with recurrent urinary tract infection (rUTI) with Escherichia coli.

Patients And Methods: Patients with rUTI treated with 3 g of oral fosfomycin every 72 h for at least 14 days were included in a prospective open-label single-centre study. Serum samples were taken after oral and IV administration of fosfomycin.

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Iohexol plasma clearance is used as an indicator of kidney function in clinical and preclinical settings. To investigate the pharmacokinetic profile of iohexol, a rapid, simple method for measurement of iohexol in different matrices and species was needed. Iohexol was separated on an Accucore C18 column (Thermo Fisher Scientific, CA, USA).

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Background: Several operative interventions are available to alleviate pain in hallux rigidus, and the optimal operative technique is still a topic of debate among surgeons. Three of these are arthrodesis, cheilectomy, and Keller's arthroplasty. Currently, it is unclear which intervention yields the best long-term result.

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