1.Analysis and prediction of global burden of stroke diseases from 1990 to 2049
Hujuan SHI ; Yihang XIA ; Yiran CHENG ; Mingmei CHENG ; Zhen LIANG ; Yanzhong WANG ; Wanqing XIE
China Medical Equipment 2024;21(11):141-150
Objective:To analyze the current status of the global burden of stroke disease from 1990 to 2019,to predict the development trend of stroke disease burden in the 30 years from 2020 to 2049,and to provide a basis for formulating national health policies on stroke diseases.Methods:The Global Burden of Disease Study 2019(GBD 2019)database was searched to extract global stroke disease incidence,prevalence,case fatality,and disability-adjusted life years(DALYs)disease burden indicators from 1990-2019,the trends over time were modeled using linear,Poisson,and exponential regressions,prediction and study of the relationship between stroke and sociodemographic index(SDI)based on per capita gross domestic product(GDP)were conducted.Results:The global burden of stroke disease increased significantly from 1990-2019 and is predicted to continue to rise over the next 30 years(2020-2049).In 2049,the global stroke incidence,prevalence,case fatality,and DALYs will increase by 8.53 million(63%),119.83 million(109%),7.79 million(118%)and 118.92 million person-years(79%),respectively,compared with 2019,with a significant increase in the burden of stroke in the elderly population.In the next 30 years,the age-standardized incidence rates of stroke in men and women will be similar,while the age-standardized rates of prevalence in women will be relatively higher,and age-standardized case fatality rates and DALYs in men will be relatively higher.The disease burden of stroke was negatively correlated with SDI.The burden of stroke disease was significantly higher in regions with a low SDI than in regions with a high SDI.Conclusion:The global burden of stroke will increase in the next 30 years,which may be related to the aging of population and closely related to the development of economy.It is necessary to strengthen the prevention of stroke and formulate targeted strategies targeted strategies according to different SDI regions.
2.Population pharmacokinetics of Ainuovirine and exposure-response analysis in human immunodeficiency virus-infected individuals
Xiaoxu HAN ; Jin SUN ; Yihang ZHANG ; Taiyi JIANG ; Qingshan ZHENG ; Haiyan PENG ; Yao WANG ; Wei XIA ; Tong ZHANG ; Lijun SUN ; Xinming YUN ; Hong QIN ; Hao WU ; Bin SU
Chinese Medical Journal 2024;137(20):2473-2482
Background::Ainuovirine (ANV) is a new generation of non-nucleoside reverse transcriptase inhibitor for the treatment of human immunodeficiency virus (HIV) type 1 infection. This study aimed to evaluate the population pharmacokinetic (PopPK) profile and exposure-response relationship of ANV among people living with HIV.Methods::Plasma concentration-time data from phase 1 and phase 3 clinical trials of ANV were pooled for developing the PopPK model. Exposure estimates obtained from the final model were used in exposure-response analysis for virologic responses and safety responses.Results::ANV exhibited a nonlinear pharmacokinetic profile, which was best described by a two-compartment model with first-order elimination. There were no significant covariates correlated to the pharmacokinetic parameters of ANV. The PopPK parameter estimate (relative standard error [%]) for clearance adjusted for bioavailability (CL/F) was 6.46 (15.00) L/h, and the clearance of ANV increased after multiple doses. The exposure-response model revealed no significant correlation between the virologic response (HIV-RNA <50 copies/mL) at 48 weeks and the exposure, but the incidence of adverse events increased with the increasing exposure ( P value of steady-state trough concentration and area under the steady-state curve were 0.0177 and 0.0141, respectively). Conclusions::Our PopPK model supported ANV 150 mg once daily as the recommended dose for people living with HIV, requiring no dose adjustment for the studied factors. Optimization of ANV dose may be warranted in clinical practice due to an increasing trend in adverse reactions with increasing exposure.Trial registration::Chinese Clinical Trial Registry https://www.chictr.org.cn (Nos. ChiCTR1800018022 and ChiCTR1800019041).