amlodipine besilate + irbesartan (DSP8153)

Removal of organic micropollutants in granular activated carbon filters - review of long-term and full-scale experiences from municipal wastewater treatment.

Cimbritz Michael M, Falås Per P, Betsholtz Alexander A, Edefell Ellen E et al.

Granular activated carbon (GAC) filtration is increasingly used for quaternary treatment of municipal wastewater to remove organic micropollutants, in line with the revised EU Urban Wastewater Treatment Directive (Directive (EU) 2024/3019). This review compiles and synthesises available, peer-reviewed, and long-term pilot- and full-scale studies and, in contrast to previous reviews, particularly addresses breakthrough of Urban Wastewater Treatment Directive (UWWTD) relevant indicator compounds in relation to operational lifespan and regulatory compliance. Most studies were conducted at pilot scale, with considerable variation in empty bed contact time, filtration rate, and GAC type. Breakthrough of indicator compounds varied widely, but citalopram, metoprolol, benzotriazole, and methylbenzotriazole generally showed relatively late breakthrough, indicating potential for longer filter lifespan, whereas candesartan and irbesartan more often showed early breakthrough. The available data further indicate that the selection of indicator compounds strongly affects the operational lifespan over which compliance with the UWWTD may be maintained. However, the limited number of long-term full-scale studies and the large variability in pre-treatment, filter design, carbon type, and operating conditions prevent robust quantitative assessment of these relationships. The findings highlight the need for more large-scale, long-term studies using a systematic evaluation framework to support the effective implementation of GAC filtration for UWWTD compliance.

Publisher Correction: Randomized-controlled trial of sacubitril/valsartan and amlodipine combination in Japanese uncontrolled hypertensive patients (J-SAMIT).

Kario Kazuomi K, Rakugi Hiromi H, Ito Chiyo C, Sayyed Sarfaraz S et al.

Fatal amlodypine overdose: forensic and clinical features - a systematic review.

Mariowska Agnieszka A, Nowicki Filip F, Horwat Paulina P, Rzepczyk Szymon S

Amlodipine is one of the basic drugs used in the treatment of hypertension. It belongs to the dihydropyridine calcium channel blocker and is one of the most frequently used drugs, which translates into its widespread use in the clinic and popularity. Amlodipine overdose may be associated with life-threatening complications, but fatal overdoses have not been well described and pose significant challenges in post-mortem diagnosis. The aim of the study was to analyze cases of fatal amlodipine overdose with particular attention to the circumstances of the events and the diagnostics performed. As a result of the literature review using relevant keywords and boolean operators, 13 articles were identified that met the study inclusion criteria. The articles included in the study were published between 1997 and 2024 and were mostly from Europe. There were 17 cases described, 9 of which were men. The average age in the group included in the study was 43.8 years. Most cases were suicidal overdoses, and the events usually occurred at home. The most common finding at autopsy was passive congestion and edema in the lungs. No specific histopathological findings were revealed except for the confirmation of autopsy gross findings. The most frequently analyzed material for toxicological tests to assess amlodipine content was blood. An important role in the assessment of cases of fatal overdose is the assessment of the place where the body was found. Due to the widespread availability of the drug, further research is needed on fatal overdose, especially regarding post-mortem diagnosis.

Bridging pathogenesis and therapy in focal segmental glomerulosclerosis: the rise of dual receptor blockade with sparsentan.

Abid Muhammad Ali MA, Abid Muhammad Hafi MH, Hasan Abdul Haseeb AH, Afzal Muhammad Daniyal MD

Focal segmental glomerulosclerosis (FSGS) represents a heterogeneous clinicopathological entity characterized by podocyte injury, progressive glomerular scarring, and a high risk of progression to end-stage renal disease. Despite advances in understanding its pathophysiology, therapeutic options have remained limited, largely centered on supportive care and immunosuppression, with inconsistent efficacy and significant adverse effects. The recent approval of sparsentan, a dual endothelin type A and angiotensin II type 1 receptor antagonist, marks a significant advancement in the management of FSGS by targeting key hemodynamic and molecular pathways implicated in disease progression. This article provides a comprehensive overview of the pathogenesis of FSGS, emphasizing the central role of podocyte injury and maladaptive responses to mechanical stress. It further reviews current treatment strategies and examines the clinical evidence underpinning the approval of sparsentan, particularly findings from the DUPLEX trial. Although sparsentan did not demonstrate a statistically significant benefit in preserving estimated glomerular filtration rate, it achieved a clinically meaningful reduction in proteinuria compared with irbesartan. The safety profile was generally acceptable, with manageable adverse effects, including hyperkalemia and hypotension. While sparsentan introduces a novel, non-immunosuppressive therapeutic option, its long-term impact on renal outcomes remains to be fully established. Ongoing research will be critical to defining its role within combination regimens and optimizing patient selection in this complex disease spectrum.