Delving into the Latest Updates on Silver sulfadiazine/Cerium nitrate with Synapse

Overview

Basic Info

Drug Type

Small molecule drug

Synonyms

Flammacerium

Target

DHPS

Mechanism

DHPS inhibitors(Dihydropteroate synthase inhibitors)

Therapeutic Areas

Infectious Diseases

Active Indication

Burn infections

Inactive Indication-

Originator Organization

Alliance Pharma France SAS

Active Organization

Alliance Pharma France SAS

Inactive Organization-

Drug Highest PhaseApproved

First Approval Date

FR (15 Jun 1992),

Burn infections

Regulation-

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Structure

Molecular FormulaC10H10AgCeN5O5S

InChIKeyWMIRLQDNRNKZRI-UHFFFAOYSA-N

CAS Registry1338830-13-9

Flammacerium is a topical treatment composed of silver sulfadiazine and cerium nitrate initially used in burns. The objective was to assess the effectiveness of silver sulfadiazine and cerium nitrate on ischemic necrosis wounds of the lower limb as an alternative to amputation for a period of 12 weeks. Patients were prospectively randomized to receive silver sulfadiazine and cerium nitrate or standard care. Patients included adults with an ischemic wound of the lower limb, with necrosis covering over at least 50%. Critical ischemia limb was confirmed by an ankle-brachial index <0.7 or >1.3 with radiological confirmation. Patient demographic data, amputations procedures, wound area, Visual Analogue Scale pain rating, clinical infection, and adverse events were recorded. Fifty patients, 34 males and 16 females, were recruited between January 2010 and April 2014, 25 in each group. The mean age was 75.14 years (±11.64). Nine amputations (36%) occurred in each group. Amputation-free survival was superior in the active treatment group versus the standard group (169 393 days, 95% confidence interval = 134.926-203.861, vs 169 393 days, 95% confidence interval = 134.926-203.861). It was not statistically significant (log-rank, P = .958). Wound area reduction between both groups was not statistically different ( P = .651). Less adverse events of the lower limb occurred in the active treatment group ( P = .001). Our study showed that silver sulfadiazine and cerium nitrate is not inferior to standardized care on ischemic necrotic wounds of the lower extremity. Further studies are still needed to confirm its effectiveness.

01 Jun 2017·BurnsQ3 · MEDICINE

Partial-thickness scalds in children: A comparison of different treatment strategies

Q3 · MEDICINE

Article

Author: Beerthuizen, G I J M ; Hiddingh, J ; van der Vlies, C H ; Scholten-Jaegers, S M H J ; Nieuwenhuis, M K ; Baartmans, M G A ; Eshuis, J ; van Baar, M E ; de Graaf, E

AIMThe aim of this study was to compare the clinical outcomes of different treatment strategies for children with partial-thickness scalds at two burn centers. At the first burn center, these burns were treated with a hydrofiber dressing (Aquacel^®, Convatec, Inc.^®, Princeton, NJ, USA) or silver sulfadiazine (SSD, Flammazine^®, Sinclair IS Pharma, London, UK Pharmaceuticals), while at the second burn center, cerium nitrate-silver sulfadiazine (CN-SSD, Flammacerium^®, Sinclair IS Pharma, London, UK Pharmaceuticals) was used.METHODSA two-center retrospective study was conducted of children admitted between January 2009 and December 2013 for partial-thickness scalds up to 10% TBSA who were treated primarily with a hydrofiber dressing or silver sulfadiazine (Burn Center Rotterdam) vs. cerium nitrate-silver sulfadiazine (Burn Center Groningen). The Dutch Burn Repository R3 and the electronic medical records of the study population were used for data extraction. The primary outcome was the time to wound healing. The secondary outcomes were the length of hospital stay, wound infection, and surgical treatment.RESULTSThe time to wound healing differed between the groups (HR=1.46, 95%CI 1.17-1.82); the shortest time to wound healing was observed in the patients treated with CN-SSD (median 13 days), compared with 15 days for the patients treated with hydrofiber and 16 days for the patients treated with SSD (p<0.01). The length of stay was significantly shorter for the hydrofiber patients (medians: hydrofiber 3 days, SSD 10 days and CN-SSD 7 days; p<0.01), but their outpatient treatment period was significantly longer (medians: hydrofiber 12 days, SSD 6 and CN-SSD 4 days; p<0.01). The proportion of surgeries and the mean time to surgery was similar between the burn centers.CONCLUSIONSThis study compared different burn centers' treatment strategies for children with partial-thickness scalds and found a shorter time to wound healing in the CN-SSD group. Patients treated with hydrofiber had a shorter clinical period in comparison with the SSD and CN-SSD patients. The results of CN-SSD are promising and warrant further study. A prospective study is needed to gain full insight into the merits and drawbacks of the treatment strategies. This will allow clinicians to make full use of the strengths of particular treatments to benefit specific patients.

01 Jan 2017·Journal of Burn Care & ResearchQ4 · MEDICINE

Epidemiology and Outcome of Patients With Burns Treated With Cerium Nitrate Silversulfadiazine

Q4 · MEDICINE

Article

Author: Anuschka S. Niemeijer ; Gerard I. J. M. Beerthuizen ; Sonja M. H. J. Scholten-Jaegers ; Marianne K. Nieuwenhuis ; Jakob Hiddingh ; Magriet E. van Baar

In this study, the outcome of treatment with Flammacerium in burn patients is studied. The retrospective study involved patients with acute burns admitted to the Burn Centre of Martini Hospital, Groningen, The Netherlands, between 2009 and 2014. The outcome parameters were mortality, complications (noninfectious and infectious), need of surgery, and length of stay. The group of patients consisted of 853 patients, of which 554 were male (64.9%). There were 23 patients with a total burn size of 40% TBSA or more (2.7%). In total, 13 of the 853 patients (1.5%) died, and none of them were children (<16 years). The overall mortality in the group of patient with burns >40% TBSA was 30.4%. In the elderly group (>70 years), the mortality rate was 6.3%. Treatment with Flammacerium is applicable in all thermal burn patients. Especially children, elderly patients, and patients with severe burns can benefit from a more conservative treatment with Flammacerium whereby the first operation can be postponed until the patient is stabilized and in which the wounds can be covered directly with skin transplants.

100 Deals associated with Silver sulfadiazine/Cerium nitrate

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