Pcv86 Flushing Assessment Tool (Fast): Psychometric Properties of a New Measure Assessing Flushing Symptoms

Kawata, AK; Thakkar, Reema; Davidson, MH; Punzi, HA; Jiang, Pingjun; Li, D; Krause, Stephen; Padley, Robert J.; Revicki, D.

doi:10.1016/s1098-3015(10)73844-4

Cited by 13 publications

(22 citation statements)

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“…Importantly, objective hyperemia demonstrated that mice lacking GPR109A did not "flush" after niacin and that PGD2 and PGE2 are major NASTy mediators, and elucidated the biphasic primary response (26). In humans, the incidence and severity of NASTy are usually assessed by subjective patient-reported questionnaires (27,28), and vary widely. Though distinguishing placebo from niacin, these are not sensitive/quantitative enough to differentiate niacin doses (29), making them semi-quantitative at best.…”

Section: Mechanism Of Nasty and The Need To Quantify Niacin-induced Pmentioning

confidence: 99%

“…The flushing assessment tool (FAST © ) was developed to provide detailed and semi-quantitative assessment of individual NASTy symptoms of redness, warmth, tingling, and itching, as well as the overall troublesomeness of these symptoms (27). The symptoms are quantified on a 10 point scale where a score of 1-3 is rated as mild, 4-6 as moderate, and 7-10 as severe.…”

Section: Semi-quantitative Nasty Symptom Perception: the Flushing Assmentioning

confidence: 99%

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Measuring niacin-associated skin toxicity (NASTy) stigmata along with symptoms to aid development of niacin mimetics

Dunbar

Goel

Tuteja

et al. 2017

Journal of Lipid Research

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better predict clinical tolerability in larger clinical trials. Measuring cutaneous stigmata may also aid investigations of vasospastic, ischemic, and inflammatory skin conditions. We present methods to measure NASTy physical stigmata to facilitate research into novel niacin mimetics/analogs, detailing characteristics of each technique following niacin, and how NASTy stigmata relate to symptom perception. We gave niacin orally and measured rubor by colorimetry and white-light spectroscopy, plethora by laser Doppler flowmetry, and calor/frigor by thermometry. Surprisingly, each stigma's abruptness predicted symptom perception, whereas peak intensity did not. These methods are adaptable to study other rubefacient drugs or dermatologic and vascular disorders. Abstract Though cardioprotective, niacin monotherapy is limited by unpleasant cutaneous symptoms mimicking dermatitis: niacin-associated skin toxicity (NASTy). Niacin is prototypical of several emerging drugs suffering off-target rubefacient properties whereby agonizing the GPR109A receptor on cutaneous immune cells provokes vasodilation, prompting skin plethora and rubor, as well as dolor, tumor, and calor, and systemically, heat loss, frigor, chills, and rigors. Typically, NASTy effects are described by subjective patientreported perception, at best semi-quantitative and bias-prone. Conversely, objective, quantitative, and unbiased methods measuring NASTy stigmata would facilitate research to abolish them, motivating development of several objective methods. In early drug development, such methods might

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Section: Mechanism Of Nasty and The Need To Quantify Niacin-induced Pmentioning

confidence: 99%

Section: Semi-quantitative Nasty Symptom Perception: the Flushing Assmentioning

confidence: 99%

Measuring niacin-associated skin toxicity (NASTy) stigmata along with symptoms to aid development of niacin mimetics

Dunbar

Goel

Tuteja

et al. 2017

Journal of Lipid Research

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“…Despite, however, the broad beneficial effects of niacin on lipid metabolism, artherosclerosis and cardiovascular outcomes, its clinical use has been limited mainly due to ADRs that include gastrointestinal symptoms, such as nausea and diarrhea, hepatoxicity and a flushing response characterized by cutaneous vasodilation that is accompanied by a burning sensation [277,278]. The HM74A receptor for nicotinic acid was recently found to be a critical mediator of flushing, the major side effect of nicotinic acid, a finding that provides new insights into the mechanism of nicotinic acid-induced flushing [279].…”

Section: Nicotinic Acidmentioning

confidence: 99%

Pharmacogenetically Tailored Treatments for Heart Disease

Vafiadaki¹,

Arvanitis²,

Kranias³

et al. 2010

CPD

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Heart disease represents the primary cause of death worldwide, with mortality rates being predicted to remain constant within the next couple of decades. Cardiac disease treatment currently includes the administration of drugs, predominantly aiming at improving heart performance, through controlling heart rhythm, blood pressure, as well as reducing cholesterol and blood clotting. Despite, however, the medical advances that have lead towards a better understanding of heart disease pathophysiology and the development of new therapeutic approaches, the degree of success of the available drug therapies varies among patients. The existence of polymorphisms in a number of genes has been shown to result in differences in pharmacokinetics, pharmacodynamics and drug metabolism and have therefore been associated with response to drug treatment. The occurrence of adverse drug reactions that may lead to drug-induced toxicity represents another factor influencing outcome of therapeutic treatment. While the influence of genetic polymorphisms in patient's response to heart disease drugs is being unveiled, the rapidly evolving field of pharmacogenetics is promising to aid clinicians in choosing the best suited drug/dose for each patient and the pharmaceutical companies in the design of better targeted, more effective new chemical compounds. In the near future individualized, targeted therapy will become part of clinical care routine maximizing patient therapeutic benefits and minimizing risks of adverse effects.

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“…Taking NSAIDs, such as aspirin, 30 minutes prior to administration of niacin can reduce flushing. [4,19,20] In a double-blind, 5-week trial, [20] aspirin 325 mg 30 minutes before niacin ER (titrated from 500 or 1000 mg to 2000 mg once daily) reduced the severity and incidence of flushing (assessed using the validated Flushing ASsessment Tool [FAST ª ] [21] ), but did not affect overall tolerability. At week 1, the proportion of patients with flushing episodes of moderate or greater intensity was 15% in aspirin recipients versus 29% in placebo recipients (p = 0.01; primary endpoint); the between-group difference was also significant (p < 0.001) at weeks 2, 3, and 4, and overall.…”

Section: How Can Flushing Be Managed?mentioning

confidence: 99%