Combination Therapies 2

Over the past decade many of the key lymphokines, hormones and growth factors that help regulate the immune system have been defined. These molecules, termed biological response modifiers (BRMs) , have been sequenced, synthesized and produced in large enough quantities to test in animals and humans resulting in the development of new approaches to the treatment of human disease, in particular, cancers and infectious diseases. Advances in this area have also led to rethinking therapies against a range of autoimmune disorders and other diseases associated with immune and endocrine imbalances. BRMs currently are being applied clinically as both primary and adjunctive therapy to enhance the effectiveness of traditional treatments by maximizing their activities and to protect critical tissues against intolerable chemotherapeutic and radiation damage. Present constraints against the use of BRMs revolve around the nature of these substances in vivo, where many of their actions and the majority of their interactions and synergies remain to be elucidated. For example, as these molecules are thought to exert their effects locally, the systemic administration of lymphokines, cytokines and growth factors at doses adequate to produce a wanted anti-tumor effect in many instances is intolerably toxic. Efforts to overcome this formidable problem have led scientists to begin to explore the transfer of genes known to encode for these molecules into cells which otherwise inadequately elicit or produce anti-tumor or anti-infective responses.

The 2nd International Symposium on Combination Therapies brought together several hundred of the leading researchers, scientists and clinicians in this area to discuss new and emerging uses for biological response modifiers (BRM's) in the treatment of cancer and infectious diseases. The meeting was held during May 1-3, 1992 in Acireale, Sicily (Italy). It was hosted by Professor G. Nicoletti CU. of Catania) and organized by the Institute for Advanced Studies in Immunology and Aging (Washington, D. C. ) in collaboration with the University of Rome "Tor Vergata," the University of Catania and The George Washington University Medical Center. The synergy exhibited between BRM's and conventional therapies including bone marrow and other lymphoid cell transplants is a rapidly expanding area with significant promise for the treatment of human diseases. Advances in this area of biomedicine are leading to the rapid development of new therapeutic approaches that are being applied clinically as both primary and adjuvant therapy to enhance the effectiveness of conventional treatments. The 2nd International Symposium on Combination Therapy provided a setting for the exchange of new scientific information regarding the emerging uses for BRM's alone or in combination with conventional therapies. The 1st International Symposium on Combination Therapies was held in 1991 in Washington, D. C.

Combination Therapy against Multidrug Resistance explores the potential of combination therapy as an efficient strategy to combat multi-drug resistance. Multidrug resistance (MDR) occurs when microorganisms such as bacteria, fungi, viruses, and parasites are excessively exposed to antimicrobial drugs such as antibiotics, antifungals, or antivirals, and in response the microorganism undergoes mutations or develops different resistance mechanisms to combat the drug for its survival. MDR is becoming an increasingly serious problem in both developed and developing nations. Bacterial resistance to antibiotics has developed faster than the production of new antibiotics, making bacterial infections increasingly difficult to treat, and the same is true for a variety of other diseases. Combination therapy proves to be a promising strategy as it offers potential benefits such as a broad spectrum of efficacy, greater potency than the drugs used in monotherapy, improved safety and tolerability, and reduction in the number of resistant organisms. This book considers how combination therapy can be applied in multiple situations, including cancer, HIV, tuberculosis, fungal infections, and more. Combination Therapy Against Multidrug Resistance gathers the most relevant information on the prospects of combination therapy as a strategy to combat multridrug resistance and helping to motivate the industrial sector and government agencies to invest more in research and development of this strategy as a weapon to tackle the multidrug resistance problem. It will be useful to academics and researchers involved in the development of new antimicrobial or antiinfective agents and treatment strtategies to combat multidrug resistance. Clinicians and medical nurses working in the field of infection prevention and control (IPC) will also find the book relevant Explores strategic methods with investigation of both short- and long-term goals to combat multidrug resistance Presents a broad scope to understand fully the ways to apply combined therapy to multidrug resistance Provides an overview of combination therapy, but also includes specific cases such as cancer, tuberculosis, HIV and malaria

"This book highlights up-to-date and novel information with clinical aspects regarding breast cancer disease. It covers aspects of breast cancer ranging from epidemiology, biology and molecular classification, to currently available and potentially new therapeutic options for breast cancer. It highlights insights into breast cancer at the molecular level with a holistic approach to use combinational strategies involving various therapies for targeting different pathways involved in this particular malignancy. This book contains a range of latest resources, including schematic illustrations, recent reviews, and information for patients with breast cancer. Various novel biomarkers that are under clinical investigation will also be discussed in this book. Furthermore, the relapse and recurrence after treatment with various therapies presents a great problem, as it develops resistance to which combinational strategy may prove to be a promising approach, and in this book, we have discussed all the aspects of combination therapy in breast cancer. People including students, research scholars, educators, pharmaceutical professionals, clinicians, researchers, practitioners and patients as well as their family members will find this book very much useful"--

Combination Drug Delivery Approach as an Effective Therapy for Various Diseases explores the use of bioengineering tools in combination drug delivery approaches to control various diseases at different clinical stages of synergistic action, varying mechanisms of action, and during the suppression of drug resistance. The book presents fundamental knowledge on the experiential and experimental aspects of drug combination approaches in order to equip rational applications in preventing the emergence of resistance during the treatment of various diseases. It provides a holistic understanding of the principles behind formation, characterization, applications, regulations, toxicity, challenges and future perspectives of combination drug delivery approaches. It will be of interest to researchers and advanced graduate students in pharmaceutical science, chemistry, biology and medicine, as well as pharmaceutical companies and scientific organizations. Provides an accounting of vital aspects on various combination drug delivery approaches, presenting next generation diagnostics and therapeutics Discusses the perspectives of current technologies in highly organized tables, illustrative figures and flow charts Defines major gaps in knowledge that can lead to significant scientific discoveries

This book reviews the use of antiepileptic drugs focusing on the interactions between these drugs and between antiepileptics and other drugs. These interactions can be beneficial or can cause harm. The aim of this book is to increase awareness of the possible impact of combination pharmacotherapies. Pharmacokinetic and pharmacodynamic interactions are discussed supported by clinical and experimental data. The book consists of five sections covering the general concepts and advantages of combination therapies, the principles of drug interactions, the mechanisms of interactions, drug interactions in specific populations or in patients with co-morbid health conditions, and concludes with a look at the future directions for this field of research. The book will be of interest to all who prescribe antiepileptics to epileptic and non-epileptic patients, including epileptologists, neurologists, neuro-pediatricians, psychiatrists and general practitioners.

For over 30 years, the stepped care approach has been used in the management and treatment of hypertension. This approach advocates the use of initial monotherapy to reach the desired blood pressure, and the subsequent use of additional drugs with complementary modes of action, until the target BP is achieved. However, current control rates for hypertension suggest that such an approach may be outdated and no longer effective in the management of hypertension. Clinical trials have shown that more than 50% of patients require a combination of drug therapies to achieve their target BP. Some proponents of combination therapy have argued that the risk of adverse side effects and non-compliance will be lower than that compared to monotherapy, which initially requires higher doses to be administered to be effective. Consequently, there have been increasing calls of the necessity for a much more combined approach in the treatment of hypertension. Adding to this, Combination Therapy in Hypertension will cover current control rates of blood pressure worldwide, the benefits of monotherapy and combination therapy, examine the effectiveness, risk of adverse effects, compliance, and cost of the available therapies and will also include information on relevant outcome studies.