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Article ; Online: Facts about the history of the AE&M.

Chacra, Antonio R

Archives of endocrinology and metabolism

2017 Volume 61, Issue 4, Page(s) 313–315

MeSH term(s)	Brazil ; Endocrinology/history ; History, 20th Century ; History, 21st Century ; Periodicals as Topic/history
Language	English
Publishing date	2017-03-27
Publishing country	Brazil
Document type	Editorial ; Historical Article
ISSN	2359-4292
ISSN (online)	2359-4292
DOI	10.1590/2359-3997000000297
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Article ; Online: Evolving metformin treatment strategies in type-2 diabetes: from immediate-release metformin monotherapy to extended-release combination therapy.

Chacra, Antonio R

American journal of therapeutics

2014 Volume 21, Issue 3, Page(s) 198–210

Abstract: Over the last 40 years, metformin has revolutionized the treatment of type-2 diabetes worldwide and is still the most influential oral antidiabetic drug today. International guidelines now recommend that patients with type-2 diabetes are started on ... ...

Abstract	Over the last 40 years, metformin has revolutionized the treatment of type-2 diabetes worldwide and is still the most influential oral antidiabetic drug today. International guidelines now recommend that patients with type-2 diabetes are started on metformin therapy as soon as they are diagnosed, as it has been shown to improve long-term clinical outcomes compared with initial management with diet alone, without increasing the risk of developing hypoglycemia or weight gain. The older, immediate-release formulation of metformin does have some limitations, with incidence of gastrointestinal adverse effects restricting the dose in some patients, forming a barrier to treatment adherence, and subsequent glycemic control. However, the second-generation extended-release formulation (met XR) has the potential to overcome these challenges. In this review, we provide an overview of the evidence supporting the use of metformin as the first-line gold standard for type-2 diabetes management and the expansion of its potential roles for the future. We also consider the advantages of met XR, in terms of its tolerability and convenient dose regimen, and review therapeutic options for when disease progression inevitably leads to inadequate control with monotherapy. These therapy options include the synergistic potential of combination strategies with met XR and dipeptidyl peptidase 4 inhibitors, a combination that has also been indicated for early-stage use (at diagnosis) as a potential method for preserving β-cell function.
MeSH term(s)	Delayed-Action Preparations ; Diabetes Mellitus, Type 2/drug therapy ; Diabetes Mellitus, Type 2/physiopathology ; Disease Progression ; Drug Design ; Drug Therapy, Combination ; Humans ; Hypoglycemic Agents/administration & dosage ; Hypoglycemic Agents/therapeutic use ; Metformin/administration & dosage ; Metformin/therapeutic use ; Practice Guidelines as Topic
Chemical Substances	Delayed-Action Preparations ; Hypoglycemic Agents ; Metformin (9100L32L2N)
Language	English
Publishing date	2014-05
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	1280786-2
ISSN	1536-3686 ; 1075-2765
ISSN (online)	1536-3686
ISSN	1075-2765
DOI	10.1097/MJT.0b013e318235f1bb
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Article ; Online: Saxagliptin for type 2 diabetes.

Chacra, Antonio R

Diabetes, metabolic syndrome and obesity : targets and therapy

2010 Volume 3, Page(s) 325–335

Abstract: Saxagliptin (Onglyza™) is a potent, selective, once-daily dipeptidyl peptidase-4 (DPP-4) inhibitor indicated for improving glycemic control in patients with type 2 diabetes (T2D). By blocking DPP-4, saxagliptin increases and prolongs the effects of ... ...

Abstract	Saxagliptin (Onglyza™) is a potent, selective, once-daily dipeptidyl peptidase-4 (DPP-4) inhibitor indicated for improving glycemic control in patients with type 2 diabetes (T2D). By blocking DPP-4, saxagliptin increases and prolongs the effects of incretins, a group of peptide hormones released by intestinal cells after meals, which stimulate glucose-dependent insulin secretion to lower blood glucose. In controlled clinical trials, saxagliptin administered as monotherapy or in combination with metformin, glyburide, or a thiazolidinedione improved glycemic control in a clinically significant manner, reflected by significant decreases in glycated hemoglobin (monotherapy, -0.5%; add-on to metformin, thiazolidinedione, or sulfonylurea, -0.6% to 0.9%; initial combination with metformin, -2.5%), fasting plasma glucose, and postprandial glucose compared with controls. Additionally, saxagliptin improved β-cell function, reflected as increases in homeostasis model assessment (HOMA)-2β. Saxagliptin was generally well tolerated; it did not increase hypoglycemia compared with controls, and was weight neutral. A meta-analysis of Phase II and III trials showed that saxagliptin did not increase the risk of major cardiovascular events. Professional organizations have updated their guidelines for T2D to include a DPP-4 inhibitor as an early treatment option-either as initial therapy in combination with metformin, or as add-on therapy for patients whose glycemia is inadequately controlled by a single oral antidiabetic drug.
Language	English
Publishing date	2010-09-22
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2494854-8
ISSN	1178-7007 ; 1178-7007
ISSN (online)	1178-7007
ISSN	1178-7007
DOI	10.2147/DMSOTT.S12241
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Article ; Online: Saxagliptin for type 2 diabetes

Chacra

Diabetes, Metabolic Syndrome and Obesity, Vol Volume 3, Pp 325-

2010 Volume 335

Abstract: Antonio R Chacra, MDDiabetes Center, Federal University of São Paulo, BrazilAbstract: Saxagliptin ...

Abstract	Antonio R Chacra, MDDiabetes Center, Federal University of São Paulo, BrazilAbstract: Saxagliptin (Onglyza™) is a potent, selective, once-daily dipeptidyl peptidase-4 (DPP-4) inhibitor indicated for improving glycemic control in patients with type 2 diabetes (T2D). By blocking DPP-4, saxagliptin increases and prolongs the effects of incretins, a group of peptide hormones released by intestinal cells after meals, which stimulate glucose-dependent insulin secretion to lower blood glucose. In controlled clinical trials, saxagliptin administered as monotherapy or in combination with metformin, glyburide, or a thiazolidinedione improved glycemic control in a clinically significant manner, reflected by significant decreases in glycated hemoglobin (monotherapy, -0.5%; add-on to metformin, thiazolidinedione, or sulfonylurea, -0.6% to 0.9%; initial combination with metformin, -2.5%), fasting plasma glucose, and postprandial glucose compared with controls. Additionally, saxagliptin improved β-cell function, reflected as increases in homeostasis model assessment (HOMA)-2β. Saxagliptin was generally well tolerated; it did not increase hypoglycemia compared with controls, and was weight neutral. A meta-analysis of Phase II and III trials showed that saxagliptin did not increase the risk of major cardiovascular events. Professional organizations have updated their guidelines for T2D to include a DPP-4 inhibitor as an early treatment option—either as initial therapy in combination with metformin, or as add-on therapy for patients whose glycemia is inadequately controlled by a single oral antidiabetic drug.Keywords: saxagliptin, dipeptidyl peptidase-4 (DPP-4) inhibitor, type 2 diabetes
Keywords	saxagliptin ; dipeptidyl peptidase-4 (DPP-4) inhibitor ; type 2 diabetes ; Specialties of internal medicine ; RC581-951
Subject code	610
Language	English
Publishing date	2010-09-01T00:00:00Z
Publisher	Dove Medical Press
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Saxagliptin for type 2 diabetes

Antonio R Chacra / MD

Diabetes, Metabolic Syndrome and Obesity, Vol 2010, Iss default, Pp 325-

2010 Volume 335

Abstract: Antonio R Chacra, MDDiabetes Center, Federal University of São Paulo, BrazilAbstract: Saxagliptin ...

Abstract	Antonio R Chacra, MDDiabetes Center, Federal University of São Paulo, BrazilAbstract: Saxagliptin (Onglyza™) is a potent, selective, once-daily dipeptidyl peptidase-4 (DPP-4) inhibitor indicated for improving glycemic control in patients with type 2 diabetes (T2D). By blocking DPP-4, saxagliptin increases and prolongs the effects of incretins, a group of peptide hormones released by intestinal cells after meals, which stimulate glucose-dependent insulin secretion to lower blood glucose. In controlled clinical trials, saxagliptin administered as monotherapy or in combination with metformin, glyburide, or a thiazolidinedione improved glycemic control in a clinically significant manner, reflected by significant decreases in glycated hemoglobin (monotherapy, -0.5%; add-on to metformin, thiazolidinedione, or sulfonylurea, -0.6% to 0.9%; initial combination with metformin, -2.5%), fasting plasma glucose, and postprandial glucose compared with controls. Additionally, saxagliptin improved β-cell function, reflected as increases in homeostasis model assessment (HOMA)-2β. Saxagliptin was generally well tolerated; it did not increase hypoglycemia compared with controls, and was weight neutral. A meta-analysis of Phase II and III trials showed that saxagliptin did not increase the risk of major cardiovascular events. Professional organizations have updated their guidelines for T2D to include a DPP-4 inhibitor as an early treatment option—either as initial therapy in combination with metformin, or as add-on therapy for patients whose glycemia is inadequately controlled by a single oral antidiabetic drug.Keywords: saxagliptin, dipeptidyl peptidase-4 (DPP-4) inhibitor, type 2 diabetes
Keywords	Specialties of internal medicine ; RC581-951
Subject code	610
Language	English
Publishing date	2010-09-01T00:00:00Z
Publisher	Dove Medical Press
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Exploratory Study on Lercanidipine Hydrochloride Polymorphism: pH-Dependent Solubility Behavior and Simulation of its Impact on Pharmacokinetics.

Repin, Ilia Alekseevich / Loebenberg, Raimar / DiBella, John / Conceição, António C L / Minas da Piedade, Manuel E / Ferraz, Humberto G / Issa, Michele G / Bou-Chacra, Nadia A / Ermida, Catharine F M / de Araujo, Gabriel L B

AAPS PharmSciTech

2021 Volume 22, Issue 2, Page(s) 54

Abstract: This work describes an exploratory experimental and in silico study of the influence of polymorphism, particle size, and physiology on the pharmacokinetics of lercanidipine hydrochloride (LHC). Equilibrium and kinetic solubility studies were performed on ...

Abstract	This work describes an exploratory experimental and in silico study of the influence of polymorphism, particle size, and physiology on the pharmacokinetics of lercanidipine hydrochloride (LHC). Equilibrium and kinetic solubility studies were performed on LHC forms I and II, as a function of pH and buffer composition. GastroPlus® was used to evaluate the potential effect of solubility differences due to polymorphism, particle size, and physiological conditions, on the drug pharmacokinetics. The results indicated that solubilities of LHC polymorphs are strongly dependent on the composition and pH of the buffer media. The concentration ratio (C
MeSH term(s)	Biological Availability ; Dihydropyridines/chemistry ; Dihydropyridines/pharmacokinetics ; Humans ; Hydrogen-Ion Concentration ; Particle Size ; Solubility
Chemical Substances	Dihydropyridines ; lercanidipine (V7XTJ4R0BH)
Language	English
Publishing date	2021-01-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	2052070-0
ISSN	1530-9932 ; 1530-9932
ISSN (online)	1530-9932
ISSN	1530-9932
DOI	10.1208/s12249-021-01923-0
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Article ; Online: Updated risk factors should be used to predict development of diabetes.

Bethel, Mary Angelyn / Hyland, Kristen A / Chacra, Antonio R / Deedwania, Prakash / Fulcher, Gregory R / Holman, Rury R / Jenssen, Trond / Levitt, Naomi S / McMurray, John J V / Boutati, Eleni / Thomas, Laine / Sun, Jie-Lena / Haffner, Steven M

Journal of diabetes and its complications

2017 Volume 31, Issue 5, Page(s) 859–863

Abstract: Aims: Predicting incident diabetes could inform treatment strategies for diabetes prevention, but the incremental benefit of recalculating risk using updated risk factors is unknown. We used baseline and 1-year data from the Nateglinide and Valsartan in ...

Abstract	Aims: Predicting incident diabetes could inform treatment strategies for diabetes prevention, but the incremental benefit of recalculating risk using updated risk factors is unknown. We used baseline and 1-year data from the Nateglinide and Valsartan in Impaired Glucose Tolerance Outcomes Research (NAVIGATOR) Trial to compare diabetes risk prediction using historical or updated clinical information. Methods: Among non-diabetic participants reaching 1year of follow-up in NAVIGATOR, we compared the performance of the published baseline diabetes risk model with a "landmark" model incorporating risk factors updated at the 1-year time point. The C-statistic was used to compare model discrimination and reclassification analyses to demonstrate the relative accuracy of diabetes prediction. Results: A total of 7527 participants remained non-diabetic at 1year, and 2375 developed diabetes during a median of 4years of follow-up. The C-statistic for the landmark model was higher (0.73 [95% CI 0.72-0.74]) than for the baseline model (0.67 [95% CI 0.66-0.68]). The landmark model improved classification to modest (<20%), moderate (20%-40%), and high (>40%) 4-year risk, with a net reclassification index of 0.14 (95% CI 0.10-0.16) and an integrated discrimination index of 0.01 (95% CI 0.003-0.013). Conclusions: Using historical clinical values to calculate diabetes risk reduces the accuracy of prediction. Diabetes risk calculations should be routinely updated to inform discussions about diabetes prevention at both the patient and population health levels.
Language	English
Publishing date	2017-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	1105840-7
ISSN	1873-460X ; 1056-8727
ISSN (online)	1873-460X
ISSN	1056-8727
DOI	10.1016/j.jdiacomp.2017.02.012
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Zs.A 2225: Show issues

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Article ; Online: Safety and efficacy of saxagliptin in combination with submaximal sulphonylurea versus up-titrated sulphonylurea over 76 weeks.

Chacra, Antonio R / Tan, Gerry H / Ravichandran, Shoba / List, James / Chen, Roland

Diabetes & vascular disease research

2011 Volume 8, Issue 2, Page(s) 150–159

Abstract: To assess the long-term efficacy and safety of saxagliptin in patients with type 2 diabetes mellitus inadequately controlled on sulphonylurea monotherapy, 768 patients were randomised to saxagliptin 2.5 or 5 mg in combination with glyburide 7.5 mg versus ...

Abstract	To assess the long-term efficacy and safety of saxagliptin in patients with type 2 diabetes mellitus inadequately controlled on sulphonylurea monotherapy, 768 patients were randomised to saxagliptin 2.5 or 5 mg in combination with glyburide 7.5 mg versus placebo added to up-titrated glyburide over 76 weeks (24 weeks plus 52-week extension) in this phase 3, double-blind, placebo-controlled trial; 557 patients completed the study, 142 without being rescued. At 76 weeks, adjusted mean changes from baseline HbA(1C) (repeated measures model) (95% confidence interval) for saxagliptin 2.5 mg, saxagliptin 5 mg, and up-titrated glyburide were 0.11% (-0.05, 0.27), 0.03% (-0.14, 0.19), and 0.69% (0.47, 0.92), respectively (post hoc and nominal p < 0.0001 for saxagliptin 2.5 and 5 mg vs. up-titrated glyburide). Adverse event frequency was similar in all treatment groups; reported hypoglycaemia event rates were 24.2%, 22.9%, and 20.6% with saxagliptin 2.5 mg, saxagliptin 5 mg, and up-titrated glyburide, respectively. Saxagliptin plus glyburide provided sustained incremental efficacy compared with up-titrated glyburide over 76 weeks, and was generally well tolerated.
MeSH term(s)	Adamantane/administration & dosage ; Adamantane/adverse effects ; Adamantane/analogs & derivatives ; Aged ; Biomarkers/blood ; Blood Glucose/drug effects ; Diabetes Mellitus, Type 2/blood ; Diabetes Mellitus, Type 2/drug therapy ; Dipeptides/administration & dosage ; Dipeptides/adverse effects ; Dipeptidyl-Peptidase IV Inhibitors/administration & dosage ; Dipeptidyl-Peptidase IV Inhibitors/adverse effects ; Double-Blind Method ; Drug Therapy, Combination ; Female ; Glyburide/administration & dosage ; Glyburide/adverse effects ; Glycated Hemoglobin A/metabolism ; Humans ; Hypoglycemia/chemically induced ; Hypoglycemic Agents/administration & dosage ; Hypoglycemic Agents/adverse effects ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Time Factors ; Treatment Outcome
Chemical Substances	Biomarkers ; Blood Glucose ; Dipeptides ; Dipeptidyl-Peptidase IV Inhibitors ; Glycated Hemoglobin A ; Hypoglycemic Agents ; hemoglobin A1c protein, human ; saxagliptin (9GB927LAJW) ; Adamantane (PJY633525U) ; Glyburide (SX6K58TVWC)
Language	English
Publishing date	2011-04
Publishing country	England
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	2250793-0
ISSN	1752-8984 ; 1479-1641
ISSN (online)	1752-8984
ISSN	1479-1641
DOI	10.1177/1479164111404574
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Article ; Online: Update of the Brazilian Guideline for Familial Hypercholesterolemia - 2021.

Izar, Maria Cristina de Oliveira / Giraldez, Viviane Zorzanelli Rocha / Bertolami, Adriana / Santos Filho, Raul Dias Dos / Lottenberg, Ana Maria / Assad, Marcelo Heitor Vieira / Saraiva, José Francisco Kerr / Chacra, Ana Paula M / Martinez, Tania L R / Bahia, Luciana Ribeiro / Fonseca, Francisco Antonio Helfenstein / Faludi, Andre Arpad / Sposito, Andrei C / Chagas, Antônio Carlos Palandri / Jannes, Cinthia Elim / Amaral, Cristiane Kovacs / Araújo, Daniel Branco de / Cintra, Dennys Esper / Coutinho, Elaine Dos Reis /

Cesena, Fernando / Xavier, Hermes Toros / Mota, Isabela Cardoso Pimentel / Giuliano, Isabela de Carlos Back / Faria Neto, José Rocha / Kato, Juliana Tieko / Bertolami, Marcelo Chiara / Miname, Marcio Hiroshi / Castelo, Maria Helane Costa Gurgel / Lavrador, Maria Sílvia Ferrari / Machado, Roberta Marcondes / Souza, Patrícia Guedes de / Alves, Renato Jorge / Machado, Valeria Arruda / Salgado Filho, Wilson

Arquivos brasileiros de cardiologia

2021 Volume 117, Issue 4, Page(s) 782–844

Title translation	Atualização da Diretriz Brasileira de Hipercolesterolemia Familiar – 2021.
MeSH term(s)	Brazil ; Humans ; Hyperlipoproteinemia Type II/diagnosis ; Hyperlipoproteinemia Type II/therapy ; Risk Assessment
Language	Portuguese
Publishing date	2021-05-06
Publishing country	Brazil
Document type	Journal Article
ZDB-ID	730261-7
ISSN	1678-4170 ; 0066-782X
ISSN (online)	1678-4170
ISSN	0066-782X
DOI	10.36660/abc.20210788
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Article ; Online: Qual é o real valor da dosagem da hemoglobina glicada (A1C)?

Antonio Roberto Chacra

Jornal Brasileiro de Patologia e Medicina Laboratorial, Vol 44, Iss 3, p

2008

Keywords	Pathology ; RB1-214 ; Medicine ; R ; DOAJ:Pathology ; DOAJ:Medicine (General) ; DOAJ:Health Sciences
Language	English
Publishing date	2008-06-01T00:00:00Z
Publisher	Sociedade Brasileira de Patologia Clínica
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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