Chemotherapy-induced peripheral neuropathy (CIPN) reduces patient quality of life, but there is little evidence of preexisting supportive care drugs. Mirogabalin is a novel drug with indications for peripheral neuropathic pain, and its mechanism of action involves strong and selective binding to the voltage-gated calcium channel α2δ subunit. We examined the effects of mirogabalin on CIPN. We followed up 21 patients with CIPN caused by taxanes or platinum-based anticancer drugs who started mirogabalin. A numerical rating scale (NRS) was used for the evaluation, and pharmacists evaluated the mirogabalin dose at its initiation by creatinine clearance in all patients, and no overdoses occurred. Mirogabalin significantly reduced NRS scores from a median of 6 to 2 (P < 0.001), and the median number of days of mirogabalin administration until determination of the best effect was 29.5 days. Furthermore, the median NRS significantly decreased by administration of mirogabalin in both the taxanes-based anticancer drug group and the platinum-based anticancer drug group. In the safety investigation, a somnolence grade of 1 or 2 was observed in 4 patients, an edema grade of 1 or 2 in 4 patients, and an edema grade of 3 was observed in 1 patient. There were no serious side effects that required hospitalization. Our study suggests mirogabalin has a palliative effect on CIPN and may be an important supportive care drug for chemotherapy. Simultaneously, it’s considered that pharmacists evaluate renal function and contribute to proper use, so that patients can expect the maximum drug efficacy after the introduction of mirogabalin.

The present nested case-control study aimed to clarify the type of patients with type 2 diabetes mellitus that required concentrated pharmaceutical management in health insurance pharmacies by detecting factors associated with the calculation of chouhukutouyaku-sougosayoutou-boushi-kasan. We detected the factors of patients on the JMDC claims database who met the eligibility criteria between April 1, 2018, and August 31, 2019, by using the multiple logistic regression model. For the analyses detecting the factors, 63,642 patients (case, 4,987; control, 58,655) were included. Regarding the calculation other than the adjustment of leftover drugs, 12 factors were statistically detected. Polypharmacy was most related to the calculation (odds ratio, 1.50; 95％ confidence interval, 1.35 - 1.66). The drugs concerned were mainly for lifestyle diseases (biguanides, dipeptidyl peptidase-4 inhibitors, glinides, glucagon-like peptide-1 agonists, alpha-glucosidase inhibitors, and hypolipidemic drugs). Regarding the calculation related to the adjustment of leftover drugs, 15 factors were statistically detected. Polypharmacy was most related to the calculation (odds ratio, 2.36; 95％ confidence interval, 2.02 - 2.76). The drugs concerned were mainly for non-lifestyle diseases (proton-pump inhibitors, H2 blockers, H1 blockers, antipsychotics, antidepressants, non-steroidal anti-inflammatory drugs, antimicrobial drugs, steroids, probiotics, and vitamins). Moreover, the increases in the detected factors positively possessed by the subject correlated with the calculations. The present study suggests, for patients with type 2 diabetes mellitus, that more attention should be paid to the interactions and duplicated prescriptions when increasing drugs for chronic diseases, and that more attention should be paid to leftover drugs when increasing drugs for temporary symptoms.

In order to prevent a crisis due to the increasing elderly population in 2025, home medical care should be enforced and promoted. Therefore, pharmacists are expected to play their roles in home medical care. However, pharmacists’ involvement in home medical care remains inadequate in Japan. In this study, a nationwide questionnaire survey was conducted on the awareness of visiting nurses about the roles of pharmacists in home medical care, and data were analyzed using the text mining method. A request letter was posted to 47 prefectural branches of the Japanese Nursing Association and 28 prefectural branches of The National Association for Visiting Nurse Service. Only members of these associations who agreed to participate in this survey responded. As a result, a total of 103 visiting nurses completed the questionnaires. “Distribution of medicines to the medication calendar” was one of the main medicine-related jobs performed by visiting nurses during home medical care. The majority of them (95％ of visiting nurses replied “it is necessary”) indicated that pharmacists’ activity was required for home medical care. According to visiting nurses, the job expected from pharmacists in home medical care was the “centralized unitary management of medicines in collaboration with medical doctors.” In summary, our survey results suggest that an active intervention to polypharmacy by pharmacists in collaboration with home medical doctors is important for home medical care.

Precautionary warnings for rhabdomyolysis from the coadministration of HMG-CoA reductase inhibitors (statins) and fibric acid derivatives (fibrates) have been well publicized so far. However, contraindications for the coadministration of statins and fibrates were lifted in October 2018. We report a case of rhabdomyolysis that might be associated with the combination use of rosuvastatin and bezafibrate in a female patient with unilateral kidney resection for her renal cancer. A 60-year-old female patient was prescribed rosuvastatin (5 mg/day) and bezafibrate (400 mg/day) for hyperlipidemia in a clinic. She was immediately hospitalized in our hospital 22 days after starting the combination use. She had muscle pain and weakness in addition to abnormally high levels of serum creatine kinase and blood myoglobin. Discontinuation of both medications and initiation of rehydration therapy improved the symptoms. This is the first report of a case of rhabdomyolysis caused by the coadministration of rosuvastatin and bezafibrate and moderate renal impairment in a single kidney patient. Physicians and pharmacists should pay attention to single kidney as risk factors for statin/fibrate induced rhabdomyolysis, as well as renal impairment and diabetes complications.

Streptococcus faecalis is the primary ingredient of medical probiotics. It has now been identified as an enterococcal species, after being reclassified as Enterococcus faecalis. Despite this reclassification, most package inserts and drug interview sheets have maintained the name S. faecalis. Meanwhile, reports of results from drug susceptibility tests using medical probiotics that contain S. faecalis commonly refer to this species of bacterium as E. faecalis. In this study, we used biochemical identification testing, mass spectrometry and 16S ribosomal RNA gene sequencing to verify whether the seven strains of S. faecalis, which is present in various medical probiotics, could be identified as the strain currently classified as E. faecalis. All strains were identified as E. faecium by all techniques.

We retrospectively studied recombinant human soluble thrombomodulin (rTM) administration duration and survival rate and the clinical factors affecting rTM administration duration in patients with infection-induced disseminated intravascular coagulation (DIC). We included patients with infection-induced DIC at Kushiro City General Hospital who met the Japanese Association for Acute Medicine DIC criteria and received rTM between April 2014 and March 2018. Sixty-four patients were categorized into two groups according to rTM administration duration: administration within six days (n = 49) and administration over seven days (n = 15). The 28-day survival rate of the two groups, stratified by rTM administration duration, was compared using Kaplan-Meier analysis to investigate the association between rTM administration duration and survival rate. Multiple regression analysis was used to examine clinical factors affecting rTM administration duration. There was no significant association between rTM administration duration and survival rate (P = 0.549). but a combination of immunoglobulins was significantly associated with prolonged rTM administration duration (P < 0.01). Furthermore, a higher white blood cell (WBC) count and higher creatinine clearance (CCr) were significantly associated with a shorter rTM administration duration (P < 0.01 and P = 0.023, respectively). Given the high cost, an rTM administration duration of within six days may be an option. Additionally, a higher WBC count or higher CCr before rTM administration is expected to shorten rTM administration duration. Because of the small sample size and single-center retrospective observational design of this study, a multicenter prospective study is needed to robustly validate our results.

Lonsurf^® combination tablet (TAS102) is indicated for the treatment of patients with curatively unresectable, advanced, or recurrent colorectal cancer, and it is a pharmacological treatment option for later-line therapy. The dose intensity of TAS102 is affected by patients’ medication adherence. This study aimed to determine the relationship between the relative dose intensity (RDI) and treatment efficacy of TAS102. We analyzed the factors influencing progression free survival (PFS) with TAS102 treatment and found significant differences in PFS between those with an RDI ≥ 80％ and those with an RDI < 80％ and between those living with their family and those living alone. The median PFS was 49 days (95％ confidence interval [CI], 7 - 87) for those with an RDI < 80％ and 103 days (95％ CI, 63 - 133) for those with an RDI ≥ 80％, and the hazard ratio was 0.72 (95％ CI, 0.33 - 0.94; P = 0.03). The median PFS was 59 days (95％ CI, 21 - 116) for those living alone and 90 days (95％ CI, 58 - 124) for those living with their families, and the hazard ratio was 1.70 (95％ CI, 1.10 - 2.86; P = 0.04). RDI ≥ 80％ contributed to the prolongation of PFS. Our results also suggest that patients living alone need more drug administration guidance and support from healthcare providers.