Healio Rheuminations

By: Adam J. Brown MD
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  • Summary

  • Rheumatology is an incredibly fast-moving and exciting field of medicine that can be difficult to keep up with. This Healio podcast provides busy clinicians with quick updates in the field of autoimmunity, with emphasis on new medications, treatment guidelines and explorations into the pathophysiology of diseases. The show will also feature historical perspectives in the field of rheumatology, as well as fascinating case presentations of medical mysteries complete with discussions from experts in the field.
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Episodes
  • NSAIDs, Part 3: The rise, fall and rise again of COX-2 inhibition

    NSAIDs, Part 3: The rise, fall and rise again of COX-2 inhibition
    Aug 29 2024

    In the third episode of the NSAIDs saga, we focus on COX-2 inhibition! Did the hopes and dreams of selective COX-2 inhibition pan out? What can the rise and fall of VIOXX teach us about physiology?

    • Intro 0:11
    • Recap of part 1 & 2 0:28
    • In this episode 1:44
    • Cyclooxygenase 2 (COX-2) and the rat experiment 3:12
    • What do we know about the prostaglandins? And what about COX-2 7:54
    • What does prostacyclin do? 10:33
    • The first COX-2 inhibitor: VIOXX 10:56
    • What is COX-2 doing?: Pfizer and Merck 12:15
    • Two more NSAID studies: colon cancer, Alzheimer’s disease and COX-2 inhibitors 18:41
    • VIOXX: Why is myocardial infarction risk occurring? 22:34
    • Animal models and the Goldilocks theory of thromboxane and prostacyclin 23:49
    • PRECISION trial 30:25
    • Rheum + Boards 37:14
    • Thanks for listening 37:32

    We’d love to hear from you! Send your comments/questions to Dr. Brown at rheuminationspodcast@healio.com. Follow us on Twitter @HRheuminations @AdamJBrownMD @HealioRheum.

    References:

    Anderson GD, et al. J Clin Invest. 1996;doi:10.1172/JCI118717.

    Funk CD, et al. J Cardiovasc Pharmacol. 2007;doi:10.1097/FJC.0b013e318157f72d.

    Hennan JK, et al. Circulation. 2001;doi:10.1161/hc3301.092790.

    Krumholz HM, et al. BMJ. 2007;doi:10.1136/bmj.39024.487720.68.

    Nissen SE, et al. N Engl J Med. 2016;doi:10.1056/NEJMoa1611593.

    Disclosures: Brown reports no relevant financial disclosures.
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    38 mins
  • NSAIDs, Part 2: The Dawn of the Anti-Inflammatories

    NSAIDs, Part 2: The Dawn of the Anti-Inflammatories
    Jun 26 2024
    In this episode, we dive into the story of aspirin and the development of ibuprofen, ending with the experiments that showed the mechanism of how aspirin actually works. Intro 0:12Review of part 1 0:28In this episode 1:04Blocking prostaglandins and willow leaves 2:26Edward Stone 3:45Johann Andreas Buchner 4:16The chemical structure of salicylic acid and creating the synthetic compound 4:44Dr. TJ MacLagan: The first trial in 1876 and treating acute rheumatism 5:16Felix Hoffmann: manipulating salicylic acid and aspirin 8:47How widespread was the use of aspirin for rheumatoid arthritis? 12:041938: problems with aspirin and endoscopies 14:581950s: long-term use of aspirin and chronic renal impairment 17:12Dr. Lawrence Craven: the use of aspirin to treat myocardial infarction 18:13Overview of what we’ve learned so far 20:48Stewart Adams: the development of ibuprofen 21:40A paper lost to time 23:29How do you test if a drug is anti-inflammatory? 25:25How do you make better aspirin? 26:551960: a trial comparing ibuprofen, baby aspirin and prednisone in patients with rheumatoid arthritis 30:03Aspirin, ibuprofen and other NSAIDs 32:49Nobel Prize winner Dr. John Vane 33:40Dr. Vane: what triggered prostaglandin production? 35:42Another guinea pig experiment 37:37Nobel Prize winner Dr. Bengt Samuelsson 39:00Interesting tidbits: early studies looking at the side effects of NSAIDs 40:011968: gastric ulcer formation and prostaglandins in rats 40:251973: renal blood flow and prostaglandins in dogs 41:531974: aspirin vs ibuprofen vs indomethacin for the heart 44:03Aspirin vs ibuprofen vs indomethacin 44:20On the next episode 46:09Thanks for listening 46:37 We’d love to hear from you! Send your comments/questions to Dr. Brown at rheuminationspodcast@healio.com. Follow us on Twitter @HRheuminations @AdamJBrownMD @HealioRheum. References: Adams SS. Inflammopharmacology. 1999;doi:10.1007/s10787-999-0002-3. https://www.aspirin-foundation.com/history/the-aspirin-story/. Buchanan WW, et al. J Rheumatol. 2002;29(6):1321-3. Cryer B, et al. Gastroenterology. 1999;doi:10.1016/s0016-5085(99)70545-7. Desborough MJR, et al. Br J Haematol. 2017;doi:10.1111/bjh.14520. Halford GM, et al. Platelets. 2012;doi:10.3109/09537104.2011.632032. Harris SC, Fosdick LS. Theoretical considerations of the mechanisms of antipyretic analgesia. NWU Bull. 1952;53: 6–9. Jasani MK, et al. Ann Rheum Dis. 1968;doi:10.1136/ard.27.5.457. Robert A, et al. Gastroenterology. 1968;55(4):481-7. Disclosures: Brown reports no relevant financial disclosures.
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    47 mins
  • The Discovery of Non-Steroidal Anti-inflammatory Drugs (NSAIDs), Part 1

    The Discovery of Non-Steroidal Anti-inflammatory Drugs (NSAIDs), Part 1
    May 16 2024

    Humans have had an insatiable appetite for inhibiting production of prostaglandins for centuries! This series delves into the history of aspirin and NSAIDs, looking at the understanding of the prostaglandin pathway.

    · Intro 0:12

    · In this episode 0:23

    · What are NSAIDs? 0:53

    · Prostaglandins 5:50

    · What are prostaglandins? 7:19

    · Where do prostaglandins come from? 8:45

    · So, what do we do with prostaglandins? 13:15

    · How did they figure out prostaglandins? 13:55

    · Naming the prostaglandin 21:25

    · Phospholipids 24:46

    · Arachidonic acid 25:28

    · Arachidonic acid into prostaglandins: how do you prove it? 26:32

    · How does arachidonic acid turn into prostaglandins? 27:27

    · Cyclo-oxygenase 28:36

    · mRNA and COX-2 32:50

    · On the next episode 35:55

    · Summary 36:38

    · Thanks for listening 37:49

    Disclosures: Brown reports no relevant financial disclosures.

    We’d love to hear from you! Send your comments/questions to Dr. Brown at rheuminationspodcast@healio.com. Follow us on Twitter @HRheuminations @AdamJBrownMD @HealioRheum.

    References:

    Botting RM. Pharmacol Rep. 2010;doi:10.1016/s1734-1140(10)70308-x.

    Flower RJ. Br J Pharmacol. 2006;doi:10.1038/sj.bjp.0706506.

    Flower RJ. Br J Pharmacol. 2019;doi:10.1111/bph.14588.

    Kurzrok R, et al. Exp Biol Med. 1930;doi:10.3181/00379727-28-5265.

    https://www.nobelprize.org/prizes/medicine/1970/euler/biographical/.

    von Euler US. J Physiol. 1936;doi:10.1113/jphysiol.1936.sp003433.
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    38 mins
Physical Illness & Disease Hygiene & Healthy Living Biological Sciences
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