References of "Scheen, André"
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See detailEducation on sensor-augmented pump use improves glucose control in type-1 diabetic patients.
Thielen, Vinciane ULg; Place, J.; Gerbaud, S. et al

in Diabètes & Métabolism (2010)

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See detailLa vignette diagnostique de l'etudiant: apprentissage au raisonnement diagnostique.
Moonen, Gustave ULg; Scheen, André ULg

in Revue Médicale de Liège (2010), 65(1), 46-8

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See detailEffects of fibrates on cardiovascular outcomes.
Delanaye, Pierre ULg; Scheen, André ULg

in Lancet (2010), 376(9746), 1051

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See detailAptitude physique versus adiposité : impacts cardio-métaboliques respectifs chez l’enfant/adolescent et chez la personne âgée
Esser, Nathalie ULg; Paquot, Nicolas ULg; Scheen, André ULg

in Médecine des Maladies Métaboliques (2010), 4

Le sujet adulte d’âge moyen en surpoids ou obèse est caractérisé par une adiposité exagérée, généralement combinée à une aptitude physique cardio-respiratoire déficiente. La pratique régulière d’une ... [more ▼]

Le sujet adulte d’âge moyen en surpoids ou obèse est caractérisé par une adiposité exagérée, généralement combinée à une aptitude physique cardio-respiratoire déficiente. La pratique régulière d’une activité physique d’endurance améliore le profil de risque cardio-métabolique dans cette tranche d’âge. Le manque d’activité physique chez les adolescents contribue à augmenter leur masse grasse et à induire des anomalies métaboliques, tandis que la sédentarité marquée des sujets âgés peut conduire à un excès de graisse combiné à une fonte musculaire (obésité sarcopénique). Dans ces deux tranches d’âge, les effets néfastes d’un excès de masse grasse (fatness) pourraient être contrecarrés, voire annulés, par la pratique régulière d’exercices musculaires conduisant à une meilleure aptitude physique (fitness). Cet article décrit les relations entre fitness et fatness, et les impacts cardio-métaboliques respectifs de ces deux composantes, d’une part, dans la population jeune (< 20 ans), d’autre part dans la population âgée (> 60 ans). [less ▲]

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See detailStrategies pour eviter l'inertie et la non-observance dans les essais cliniques.
Jandrain, Bernard ULg; Ernest, Philippe ULg; Radermecker, Régis ULg et al

in Revue Médicale de Liège (2010), 65(5-6), 246-9

Randomised controlled trials play a key role in evidence-based medicine as far as the assessment of both efficacy and safety of drugs is concerned. Various strategies are used to avoid physician's inertia ... [more ▼]

Randomised controlled trials play a key role in evidence-based medicine as far as the assessment of both efficacy and safety of drugs is concerned. Various strategies are used to avoid physician's inertia and to combat patient's non compliance, two pitfalls that may hinder the demonstration of the therapeutic efficacy of the drug. Clinical inertia may be limited by titration, forced or optional, driven by therapeutic targets, or by the use, if necessary, of rescue medications. Compliance may be verified by "pill count". This simple technique allows to exclude non compliant patients when they are detected during the placebo run-in period before randomisation or not to take into account patients with poor compliance in the final evaluation by using a statistical analysis restricted to individuals who have strictly adhered to the study protocol ("per protocol analysis"). Self-monitoring and patient's empowerment in the treatment also contribute to improve drug compliance. Clinicians may take advantage of these approaches derived from clinical trials to improve their daily practice. [less ▲]

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See detailL'éducation thérapeutique: une solution pour vaincre l'inertie clinique et le défaut d'observance.
Scheen, André ULg; Bourguignon, Jean-Pierre ULg; Guillaume, Michèle ULg

in Revue Médicale de Liège (2010), 65(5-6), 250-5

Therapeutic education (TPE) aims to enable the patient suffering from a chronic diseases to manage his/ her illness and treatment, and prevent avoidable complications, while keeping or improving his/her ... [more ▼]

Therapeutic education (TPE) aims to enable the patient suffering from a chronic diseases to manage his/ her illness and treatment, and prevent avoidable complications, while keeping or improving his/her quality of life. It comprises a set de practical tools aiming the patient to acquire skills to manage himself/herself the disease, its care and supervision, in partnership with healthcare providers. TPE may contribute to improve therapeutic compliance and to reduce clinical inertia, two drawbacks frequently encountered in the management of patients with chronic diseases. As an illustration, we briefly present EDUDORA ("Education therapeutique et preventive face au diabete et a l'obesite a risque chez l'adulte et l'adolescent" = "Preventive and therapeutic education for diabetes and at risk obesity in adults and adolescents"), an ongoing original project in three frontier regions (Wallonia - Grand-Duchy of Luxembourg - Lorraine). [less ▲]

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See detailPrevention cardio-vasculaire: la "polypill", une solution pour vaincre l'inertie clinique et le manque d'observance?
Scheen, André ULg; Lefebvre, Pierre ULg; Kulbertus, Henri ULg

in Revue Médicale de Liège (2010), 65(5-6), 267-72

The concept of "polypill" for cardiovascular prevention was introduced in 2003 in a landmark paper of the British Medical Journal. A model based on results provided by evidence-based medicine suggested ... [more ▼]

The concept of "polypill" for cardiovascular prevention was introduced in 2003 in a landmark paper of the British Medical Journal. A model based on results provided by evidence-based medicine suggested that a "polypill", that contains a statin, three blood pressure lowering drugs (each at half standard dose), aspirin and folic acid, would result in an 80% reduction in the incidence of coronary and cerebrovascular events, while being associated with a good tolerance profile and offering a favourable cost-effectiveness ratio. The present paper aims at presenting the new advances dealing with this new paradigm in cardiovascular prevention. We will present the progresses of the "polypill" concept since 2003, the results of a first controlled clinical trial, the pharmaceutical feasibility for routine clinical use and the potential pharmaco-economical impacts of such a strategy. The "polypill" may offer a solution to avoid physician's clinical inertia and reduce patients's lack of compliance, two drawbacks in the field of cardiovascular prevention. [less ▲]

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See detailComment optimaliser le traitement hypolipidemiant: ne pas oublier la problematique du defaut d'observance.
Radermecker, Régis ULg; Scheen, André ULg

in Revue Médicale de Liège (2010), 65(5-6), 311-7

The pharmacological treatment of dyslipidaemia, essentially by statins, should take place in a global strategy of prevention of cardiovascular diseases. Treating a risk factor, asymptomatic by definition ... [more ▼]

The pharmacological treatment of dyslipidaemia, essentially by statins, should take place in a global strategy of prevention of cardiovascular diseases. Treating a risk factor, asymptomatic by definition, which imposes an early constraint for a potential late benefit, exposes to patient's noncompliance. Besides physician's clinical inertia to initiate and adjust the lipid-lowering therapy in at risk patients, such lack of patient's compliance is one of the key elements that may explain the failure to reach or maintain therapeutic targets, and represents a major pharmacoeconomical concern. This article analyses first the main reasons explaining the poor compliance to lipid-lowering therapy and, then, describes some approaches to improve patient's adherence to medications in order to better prevent cardiovascular diseases. [less ▲]

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See detailInertie clinique dans la prise en charge du patient diabetique de type 2: quelles solutions proposer?
Philips, Jean-Christophe ULg; Scheen, André ULg

in Revue Médicale de Liège (2010), 65(5-6), 318-25

Although strict glucose control can prevent or delay the onset of complications in patients with diabetes, optimal control frequently is not achieved. A partial explanation for this phenomenon can be ... [more ▼]

Although strict glucose control can prevent or delay the onset of complications in patients with diabetes, optimal control frequently is not achieved. A partial explanation for this phenomenon can be attributed to so-called clinical inertia of physicians, defined as "recognition of the problem but failure to act". Such therapeutic inertia may result from patient's reluctance, difficulties inherent to available treatments and physician's attitudes. Clinical inertia may be present at each successive step in the management of type 2 diabetes. This article describes some solutions to help physicians reducing therapeutic inertia and improving patient care. [less ▲]

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See detailDiabete et grossesse: impact de l'inertie medicale et de l'observance therapeutique.
Pintiaux, Axelle ULg; Chabbert-Buffet, N.; Philips, Jean-Christophe ULg et al

in Revue Médicale de Liège (2010), 65(5-6), 399-404

Pregnancy and infant outcomes are related to maternal blood glucose profile. Managing preexisting diabetes and achieving euglycaemia before and during the pregnancy reduce the risk for complications ... [more ▼]

Pregnancy and infant outcomes are related to maternal blood glucose profile. Managing preexisting diabetes and achieving euglycaemia before and during the pregnancy reduce the risk for complications. Screening, diagnosis and treatment of gestational diabetes are important issues from a public health point of view, more particularly because of the progression of this disease due to obesity epidemics among young people. Pregnancy in a diabetic woman is a critical situation where neither clinical inertia nor patient's non-compliance could be accepted. [less ▲]

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See detailInertie therapeutique dans la pratique medicale: causes, consequences, solutions.
Scheen, André ULg; Giet, Didier ULg

in Revue Médicale de Liège (2010), 65(5-6), 232-8

Therapeutic inertia is one of the components of clinical inertia. It mainly concerns the management of chronic diseases. It may be defined as the attitude of health care providers who do not initiate or ... [more ▼]

Therapeutic inertia is one of the components of clinical inertia. It mainly concerns the management of chronic diseases. It may be defined as the attitude of health care providers who do not initiate or intensify therapy appropriately despite recognition of the problem. Multiple causes may be identified, related to the physician but also to the patient and to the health care system. The consequences may be dramatic, both for the patient, in terms of quality of life and/or life expectancy, and for the society, because of the huge cost resulting from complications due to therapeutic inertia. Thus, various solutions should be proposed to help solving this important public health problem, focusing the actions on the physician, the patient and/or the health care system. [less ▲]

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See detailManagement of metabolic syndrome and associated cardiovascular risk factors.
De Flines, Jenny ULg; Scheen, André ULg

in Acta Gastro-Enterologica Belgica (2010), 73(2), 261-6

Patients with metabolic syndrome have a 1.5- to 3-fold increase in the risk of coronary heart disease and stroke. The association between metabolic syndrome and cardiovascular diseases raises important ... [more ▼]

Patients with metabolic syndrome have a 1.5- to 3-fold increase in the risk of coronary heart disease and stroke. The association between metabolic syndrome and cardiovascular diseases raises important questions about the underlying pathological processes, especially for designing targeted therapeutic interventions. Cardiovascular risk reduction in individuals with metabolic syndrome should include at least three levels of interventions: 1) control of obesity, unhealthy diet and lack of physical activity; 2) control of the individual components of metabolic syndrome, especially atherogenic dyslipidaemia, hypertension, dysglycaemia and prothrombotic state; and 3) control of insulin resistance, a defect closely linked to metabolic syndrome. Metabolic syndrome generally precedes and is often associated with type 2 diabetes. Because of this intimate relationship, appropriate management of metabolic syndrome should be able to prevent the progression from impaired glucose tolerance to frank diabetes and thus to prevent type 2 diabetes, another important cardiovascular risk factor. The importance of prevention of diabetes in high-risk individuals (such as people with metabolic syndrome are) is highlighted by the substantial and worldwide increase in the prevalence of type 2 diabetes in recent years. Owing to the complex pathophysiology and phenotypic expression of metabolic syndrome, lifestyle changes are crucial as they are able to positively and simultaneously influence almost all components of the syndrome. If such measures are not sufficient or not adequately followed, a pharmacological intervention may be considered. However, no official guidelines are available yet concerning the pharmacological management of individuals with metabolic syndrome. [less ▲]

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See detailDipeptidylpeptitase-4 inhibitors (gliptins): focus on drug-drug interactions.
Scheen, André ULg

in Clinical Pharmacokinetics (2010), 49(9), 573-88

Patients with type 2 diabetes mellitus (T2DM) are generally treated with many pharmacological compounds and are exposed to a high risk of drug-drug interactions. Indeed, blood glucose control usually ... [more ▼]

Patients with type 2 diabetes mellitus (T2DM) are generally treated with many pharmacological compounds and are exposed to a high risk of drug-drug interactions. Indeed, blood glucose control usually requires a combination of various glucose-lowering agents, and the recommended global approach to reduce overall cardiovascular risk generally implies administration of several protective compounds, including HMG-CoA reductase inhibitors (statins), antihypertensive compounds and antiplatelet agents. New compounds have been developed to improve glucose-induced beta-cell secretion and glucose control, without inducing hypoglycaemia or weight gain, in patients with T2DM. Dipeptidylpeptidase-4 (DPP-4) inhibitors are novel oral glucose-lowering agents, which may be used as monotherapy or in combination with other antidiabetic compounds, metformin, thiazolidinediones or even sulfonylureas. Sitagliptin, vildagliptin and saxagliptin are already on the market, either as single agents or in fixed-dose combined formulations with metformin. Other compounds, such as alogliptin and linagliptin, are in a late phase of development. This review summarizes the available data on drug-drug interactions reported in the literature for these five DDP-4 inhibitors: sitagliptin, vildagliptin, saxagliptin, alogliptin and linagliptin. Possible pharmacokinetic interferences have been investigated between each of these compounds and various pharmacological agents, which were selected because there are other glucose-lowering agents (metformin, glibenclamide [glyburide], pioglitazone/rosiglitazone) that may be prescribed in combination with DPP-4 inhibitors, other drugs that are currently used in patients with T2DM (statins, antihypertensive agents), compounds that are known to interfere with the cytochrome P450 (CYP) system (ketoconazole, diltiazem, rifampicin [rifampin]) or with P-glycoprotein transport (ciclosporin), or agents with a narrow therapeutic safety window (warfarin, digoxin). Generally speaking, almost no drug-drug interactions or only minor drug-drug interactions have been reported between DPP-4 inhibitors and any of these drugs. The gliptins do not significantly modify the pharmacokinetic profile and exposure of the other tested drugs, and the other drugs do not significantly alter the pharmacokinetic profile of the gliptins or exposure to these. The only exception concerns saxagliptin, which is metabolized to an active metabolite by CYP3A4/5. Therefore, exposure to saxagliptin and its primary metabolite may be significantly modified when saxagliptin is coadministered with specific strong inhibitors (ketoconazole, diltiazem) or inducers (rifampicin) of CYP3A4/5 isoforms. The absence of significant drug-drug interactions could be explained by the favourable pharmacokinetic characteristics of DPP-4 inhibitors, which are not inducers or inhibitors of CYP isoforms and are not bound to plasma proteins to a great extent. Therefore, according to these pharmacokinetic findings, which were generally obtained in healthy young male subjects, no dosage adjustment is recommended when gliptins are combined with other pharmacological agents in patients with T2DM, with the exception of a reduction in the daily dosage of saxagliptin when this drug is used in association with a strong inhibitor of CYP3A4/A5. It is worth noting, however, that a reduction in the dose of sulfonylureas is usually recommended when a DPP-4 inhibitor is added, because of a pharmacodynamic interaction (rather than a pharmacokinetic interaction) between the sulfonylurea and the DPP-4 inhibitor, which may result in a higher risk of hypoglycaemia. Otherwise, any gliptin may be combined with metformin or a thiazolidinedione (pioglitazone, rosiglitazone), leading to a significant improvement in glycaemic control without an increased risk of hypoglycaemia or any other adverse event in patients with T2DM. Finally, the absence of drug-drug interactions in clinical trials in healthy subjects requires further evidence from large-scale studies, including typical subjects with T2DM - in particular, multimorbid and geriatric patients receiving polypharmacy. [less ▲]

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See detailPulsatile stress in middle-aged patients with Type 1 or Type 2 diabetes compared to nondiabetic controls.
Philips, Jean-Christophe ULg; Marchand, Monique ULg; Scheen, André ULg

in Diabetes Care (2010), 33(11), 2424-2429

AbstractBackground: Arterial pulse pressure (PP) is considered as an independent cardiovascular risk factor. We compared PP during an active orthostatic test in middle-aged patients with type 1 diabetes ... [more ▼]

AbstractBackground: Arterial pulse pressure (PP) is considered as an independent cardiovascular risk factor. We compared PP during an active orthostatic test in middle-aged patients with type 1 diabetes and with type 2 diabetes, and corresponding nondiabetic controls. Methods: 40 patients with type 1 diabetes (mean age 50 years, diabetes duration 23 years, BMI 23.0 kg/m(2)) were compared to 40 non hypertensive patients with type 2 diabetes (respectively, 50 years, 8 years, 29.7 kg/m(2)). Patients taking antihypertensive agents or with renal insufficiency were excluded. All patients were evaluated with a continuous noninvasive arterial blood pressure monitoring (Finapres(R)) in standing (1 min), squatting (1 min) and again standing position (1 min). Patients with type 1 or type 2 diabetes were compared with two groups of 40 age-, sex- and BMI-matched healthy subjects. Results: Patients with type 1 diabetes and patients with type 2 diabetes showed significantly higher PP, heart rate (HR) and PPxHR double product (type 1 : 5263 vs 4121 mmHg/min, p=0.0004; type 2 : 5359 vs 4321 mmHg, p=0.0023) levels than corresponding controls. There were no significant differences between patients with type 1 diabetes and type 2 diabetes regarding PP (59 vs 58 mmHg), HR (89 vs 88/min), and PPxHR product (5263 vs 5359 mmHg/min). Conclusion: Patients with type 1 diabetes have comparable increased levels of peripheral PP, an indirect marker of arterial stiffness, and PPxHR, an index of pulsatile stress, as non-hypertensive patients with type 2 diabetes at similar mean age of 50 years. [less ▲]

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See detailNon-observance thérapeutique: causes, conséquences, solutions.
Scheen, André ULg; Giet, Didier ULg

in Revue Médicale de Liège (2010), 65(5-6), 239-45

Compliance is defined as the extent to which a patient's behaviour coincides with medical or health advice. Medication adherence seems to be rather low as 30 to 60% of patients with chronic disease may be ... [more ▼]

Compliance is defined as the extent to which a patient's behaviour coincides with medical or health advice. Medication adherence seems to be rather low as 30 to 60% of patients with chronic disease may be categorised as being poorly or not adherent to drug therapy. Numerous factors may influence compliance among which patient's characteristics, disease peculiarities, drug treatment modalities, physician's attitudes and health system organisation. The consequences of non-compliance to drug therapy may not only be harmful for patient's health, but could also negatively impact the financial cost of public health services. Thus, all efforts should be focused to improve drug compliance, if possible by targeting all causes responsible for poor adherence to medications. [less ▲]

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See detailézétimibe (Ezetrol®) chez le patient diabétique
Scheen, André ULg; Radermecker, Régis ULg

in Revue Médicale de Liège (2009), 64(12), 606-611

L’ézétimibe (Ezetrol®) inhibe sélectivement l’absorption intestinale du cholestérol et des phytostérols apparentés. Son mécanisme d’action résulte en un effet hypocholestérolémiant synergique en ... [more ▼]

L’ézétimibe (Ezetrol®) inhibe sélectivement l’absorption intestinale du cholestérol et des phytostérols apparentés. Son mécanisme d’action résulte en un effet hypocholestérolémiant synergique en combinaison avec une statine, inhibant la synthèse hépatique de cholestérol, ce qui a conduit à la commercialisation d’une combinaison fixe ézétimibe-simvastatine (Inegy®). L’ézétimibe a été plus spécifiquement étudié chez les personnes avec un diabète de type 2 qui sont confrontées à un risque cardio-vasculaire particulièrement élevé. Le but de cet article est de présenter les avancées et les particularités en ce qui concerne l’utilisation de l’ézétimibe dans la population diabétique de type 2. [less ▲]

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See detailLa vignette thérapeutique de l'étudiant. Prise en charge d'une personne obèse avec syndrome métabolique
Rorive, Marcelle ULg; De Flines, Jenny ULg; Paquot, Nicolas ULg et al

in Revue Médicale de Liège (2009), 64(12), 651-656

The management of an obese person requires a careful evaluation first, a multidisciplinary approach and a stepwise therapeutic strategy. The latter should favour lifestyle modifications, eventually the ... [more ▼]

The management of an obese person requires a careful evaluation first, a multidisciplinary approach and a stepwise therapeutic strategy. The latter should favour lifestyle modifications, eventually the use pharmacological agents in good responders, and reserve bariatric surgery to well selected cases, refractory to medical treatment. Continuous motivational reinforcement is crucial for long-term success. In obese individuals at high metabolic risk, such strategy should aim at reducing the incidence of new-onset type 2 diabetes. [less ▲]

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See detailLa 11β-hydroxystéroïde déshydrogénase de type 1 – 2e partie Inhibition sélective pour traiter les anomalies métaboliques associées à l’obésité
Iovino, A.; Scheen, André ULg

in Médecine des Maladies Métaboliques (2009), 3(6), 595-600

La 11β-hydroxystéroïde déshydrogénase de type 1 (11HSD1), qui convertit la cortisone (inactive) en cortisol (actif) dans les tissus cibles, est surexprimée dans certains tissus en présence d’une obésité ... [more ▼]

La 11β-hydroxystéroïde déshydrogénase de type 1 (11HSD1), qui convertit la cortisone (inactive) en cortisol (actif) dans les tissus cibles, est surexprimée dans certains tissus en présence d’une obésité, surtout abdominale, et pourrait jouer un rôle dans les anomalies métaboliques associées. Des inhibiteurs non sélectifs de la 11HSD1 ont déjà été testés chez l’homme et se sont révélés peu efficaces. Le développement de nouveaux inhibiteurs, plus puissants et plus sélectifs, est en cours. Des résultats préliminaires obtenus avec divers inhibiteurs sont prometteurs, avec une diminution de l’insulinorésistance, une amélioration de la tolérance au glucose ou du contrôle glycémique et une correction de certaines anomalies liées au syndrome métabolique. Si ces résultats se confirment, les inhibiteurs sélectifs de la 11HSD1 pourraient représenter à l’avenir une nouvelle classe pharmacologique d’antidiabétiques oraux. Cet article donne au lecteur un aperçu des différentes étapes de réflexion et d’expérimentations humaines qui ont mené au développement d’inhibiteurs de la 11HSD1 à visée thérapeutique. [less ▲]

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See detailAvancées concernant l’Aliskiren (Rasilez®), inhibiteur direct de la rénine, et l’Aliskiren-hydrochlorothiazide (Rasilez HCT ®)
Boxho, G.; Krzesinski, Jean-Marie ULg; Scheen, André ULg

in Revue Médicale de Liège (2009), 64(11), 560-565

Aliskiren (Rasilez®), a direct renin inhibitor, is currently indicated for the treatment of essential hypertension, as monotherapy or in combination, especially with hydrochlorothiazide (Rasilez HCT®). It ... [more ▼]

Aliskiren (Rasilez®), a direct renin inhibitor, is currently indicated for the treatment of essential hypertension, as monotherapy or in combination, especially with hydrochlorothiazide (Rasilez HCT®). It may also be use to obtain a more complete blockade of the renin-angiotensin-aldosterone system (RAAS) when it is associated with an angiotensin converting enzyme inhibitor (ACEI) (or an AT1 angiotensin receptor antagonist) (ARA). There is some room for agents that may be more efficacious in reducing the progression of diabetic nephropathy than ACEI or ARA. In this context, the dual blockade of RAAS most probably offers a better efficacy than the simple blockade, but also exposes to a higher risk. Should ongoing trials confirm the preliminary favourable results, aliskiren might reach a forefront position among the armamentarium now available to optimize the RAAS blockade. The present article will summarize advances concerning the biochemical effects of the specific mode of action of aliskiren, especially the potential interferences related to increased renin/pro-renin levels, as well as results of recent clinical trials, not only in hypertension, but also in the fields of diabetes, renal insufficiency and cardiology. The objectives and design of the landmark study ALTITUDE will also be briefly presented. [less ▲]

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See detailLa 11β-hydroxystéroïde déshydrogénase de type 1 – 1re partie Rôle de l’exposition tissulaire au cortisol dans le risque métabolique lié à l’obésité
Iovino, A.; Scheen, André ULg

in Médecine des Maladies Métaboliques (2009), 3

Abdominal obesity plays a key role in the development of metabolic syndrome. Similarities between metabolic syndrome and Cushing disease suggest that excessive local tissue exposition to glucocorticoids ... [more ▼]

Abdominal obesity plays a key role in the development of metabolic syndrome. Similarities between metabolic syndrome and Cushing disease suggest that excessive local tissue exposition to glucocorticoids, despite normal circulating plasma levels, might contribute to the pathophysiology of metabolic syndrome. To this respect, 11β-hydroxysteroid dehydrogenase type 1 (11HSD1), the enzyme which converts cortisone (inactive) to cortisol (active) in target tissues, raises much interest. Indeed, several studies showed both increased expression and activity of this enzyme in adipose tissues in presence of obesity. Even more striking, experimental data in rodents showed a direct link between increased 11HSD1 activity and the development of metabolic abnormalities. Furthermore, studies in mice KO for 11HSD1 confirmed the potential of inhibiting this enzyme to attenuate metabolic abnormalities related to visceral adiposity. Selective inhibitors of 11HSD1 are currently in development, and preliminary results obtained in rodents appear promising, with significant improvements in glucose and lipid profiles. The development of potent and selective 11HSD1 inhibitors may open new prospects in the treatment of metabolic syndrome or type 2 diabetes associated with abdominal obesity in humans. [less ▲]

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