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What is the ECVD?
The European College of Veterinary Dermatology (ECVD) is a non-profit organisation with recognized European Specialists in Veterinary Dermatology. The ECVD is a part of the general scheme for veterinary specialization as advised by the ACVT of the EU. ECVD is supervised by the European Board of Veterinary Specialisation (EBVS) in accordance with current EU legislation.
What is a veterinary dermatologist?
A veterinary dermatologist is a veterinarian who specializes in skin disease. This also includes ear disease, claws, oral and anogenital mucous membranes, hair coat and subcutaneous tissues. It is a large medical speciality with hundreds of knows skin diseases, including infectious, parasitical, allergic, auto-immune, ear disease, seborrhoeic diseases, skin tumors and many other. Some skin diseases may be inherited or have a genetic background, some may be contagious and yet other are acquired or has an unknown background.
What does “Diplomate” or “Board certified” mean?
Qualified veterinarians with a few years of clinical experience (internship or similar) and a strong interest in dermatology can apply for a residency to further develop their competence in this field. A residency provides a minimun of 3 years of intense speciality training including handling clinical cases, participation in many courses and congresses,& doing active research and lecturing. In order to become a Diplomate of the ECVD (often abbreviated DECVD and also known as board certified or European Specialist in Veterinary Dermatology) the resident must pass a rigorous four-part, two–day examination. The Diplomate is re-evaluated regarding professional activity including research and further education every 5 years to make sure he/she keep up with new research and other development in the field.
When should you contact a European Specialist in Veterinary Dermatologist?
The most common way to come in contact with a DECVD is that your primary care veterinarian will refer your animal becauseof skin disease. Reasons for referral include complex skin disease, specialized diagnostic or therapeutic options or simply to obtain judicious advice for a chronic common skin problem. It is common that allergic animals are referred for diagnostic work-up and therapeutic planning. Usually the animal will have a few appointments with the specialist before being referred back to the primary care veterinarian. In this way, primary care veterinarians and specialists work together to provide you and your pet with the best care!
In many cases it is also possible to book an appointment for your animal directly at the specialists clinic without going through a referring veterinarian.
Find a European Specialist in Veterinary Dermatology near you!
If you are a veterinarian wanting to refer a clinical case or if you are a pet owner seeking specialist care for your pet, you may use ! Currently there are almost a hundred Diplomates of ECVD scattered throughout Europe. Some work at universities, others in private practice. Because the limited number of specialists available and depending on where you live, you and your pet may or may not need to travel for the appointment.
Pet owners
The primary objectives of the College are similar to those of the ECVD and ACVD: to advance veterinary dermatology in Asia and increase the competence of those who practice in this field.
The CAVD is the only Canadian organization committed to excellence in veterinary dermatology practice and research. Continuing veterinary and public education in field of the veterinary dermatology is also a major purpose of this academy.
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President: R G HarveyThe Veterinary Centre 207 Daventry Road Cheylesmore Coventry, CV3 5HH UK
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The European College of Veterinary Dermatology
Secretary: Dr. M. Linek Rodigallee 85 22043 HamburgGermanyphone: 88 540 fax: 88 520
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Remember MeKOMBIGLYZE& XR (Saxagliptin and Metformin HCl Extended-Release) Tablets, a New Treatment for Type 2 Diabetes Mellitus in Adults, Now Available in U.S. Pharmacies | Business Wire
KOMBIGLYZE(TM) XR (Saxagliptin and Metformin
HCl Extended-Release) Tablets, a New Treatment for Type 2 Diabetes
Mellitus in Adults, Now Available in U.S. Pharmacies
KOMBIGLYZE(TM) XR (saxagliptin and metformin HCl extended-release) tablets (Photo: Business Wire)
PRINCETON, N.J. & LONDON--()-- (NYSE: BMY), and
(NYSE: AZN) today announced that KOMBIGLYZE(TM) XR (saxagliptin
and metformin HCl extended-release), approved by the U.S. Food and Drug
Administration (FDA) on November 5, 2010, is now available by
prescription in pharmacies across the United States. KOMBIGLYZE XR is
the first and only once-a-day metformin extended-release (XR) plus
dipeptidyl peptidase-4 (DPP-4) inhibitor combination tablet offering
strong glycemic control across glycosylated hemoglobin levels (HbA1c),
fasting plasma glucose (FPG) and post-prandial glucose (PPG).
KOMBIGLYZE XR is indicated as an adjunct to diet and exercise to improve
glycemic control in adults with type 2 diabetes mellitus when treatment
with both saxagliptin and metformin is appropriate. KOMBIGLYZE XR should
not be used for patients with type 1 diabetes or diabetic ketoacidosis
and has not been studied in combination with insulin. Consistent with
the Prescribing Information (PI) for metformin alone, the PI for
KOMBIGLYZE XR contains a boxed warning for lactic acidosis, a rare, but
serious metabolic complication that can occur due to metformin
accumulation during treatment with KOMBIGLYZE XR.
Once-a-day KOMBIGLYZE XR combines saxagliptin (also known as ONGLYZA(TM)),
a DPP-4 inhibitor, and metformin XR, a biguanide, in one tablet for the
treatment of type 2 diabetes. KOMBIGLYZE XR should generally be
administered once a day with the evening meal, with gradual dose
titration to reduce the gastrointestinal side effects associated with
metformin. The maximum daily recommended dose is 5 mg for saxagliptin
and 2,000 mg for metformin extended-release.
“Type 2 diabetes is a chronic, progressive and multi-factorial disease,
and over time, patients often require more than one medication to
address the multiple defects associated with the disease,” said Matthew
Mintz, M.D., FACP, The George Washington University School of Medicine.
“KOMBIGLYZE XR (saxagliptin and metformin HCl extended-release) now
provides patients with the first once-a-day DPP-4 inhibitor and
metformin XR combination tablet containing two complementary therapies
that can improve key measures of glucose control including glycosylated
hemoglobin levels, fasting plasma glucose and postprandial glucose, in a
convenient once-a-day treatment regimen.”
KOMBIGLYZE XR is contraindicated in patients with renal impairment,
metabolic acidosis including diabetic ketoacidosis, and hypersensitivity
to metformin. KOMBIGLYZE XR should be temporarily discontinued in
patients undergoing radiologic studies with iodinated contrast materials.
The Centers for Disease Control and Prevention (CDC) estimate that
approximately one in every 11 adults in the United States has diagnosed
diabetes. Type 2 diabetes accounts for approximately 90 to 95% of all
cases of diagnosed diabetes in adults.
Indication and Important Limitations of Use for
KOMBIGLYZE XR (saxagliptin and metformin HCl extended-release) tablets
KOMBIGLYZE XR is indicated as an adjunct to diet and exercise to improve
glycemic control in adults with type 2 diabetes mellitus when treatment
with both saxagliptin and metformin is appropriate.
KOMBIGLYZE XR should not be used for the treatment of type 1 diabetes
mellitus or diabetic ketoacidosis.
KOMBIGLYZE XR has not been studied in combination with insulin.
Important Safety Information
WARNING: LACTIC ACIDOSIS
Lactic acidosis is a rare, but serious, complication that can
occur due to metformin accumulation. The risk increases with
conditions such as sepsis, dehydration, excess alcohol intake,
hepatic impairment, renal impairment, and acute congestive heart
The onset of lactic acidosis is often subtle, accompanied only
by nonspecific symptoms such as malaise, myalgias, respiratory
distress, increasing somnolence, and nonspecific abdominal
Laboratory abnormalities include low pH, increased anion gap,
and elevated blood lactate.
If acidosis is suspected, KOMBIGLYZE XR should be discontinued
and the patient hospitalized immediately. [See Warnings and
Precautions]
Contraindications
Renal impairment (e.g., serum creatinine levels ≥1.5 mg/dL for men,
≥1.4 mg/dL for women, or abnormal creatinine clearance)
Hypersensitivity to metformin hydrochloride
Acute or chronic metabolic acidosis, including diabetic ketoacidosis
KOMBIGLYZE XR (saxagliptin and metformin HCl extended-release) should
be temporarily discontinued in patients undergoing radiologic studies
involving intravascular administration of iodinated contrast materials
because use of such products may result in acute alteration of renal
Warnings and Precautions
The reported incidence of lactic acidosis in patients receiving
metformin is very low (approximately 0.03 cases/1000 patient-years).
When it occurs, it is fatal in approximately 50% of cases. Reported
cases of lactic acidosis have occurred primarily in diabetic patients
with significant renal insufficiency.
Patients with congestive heart failure requiring pharmacologic
management, in particular those with unstable or acute congestive
heart failure who are at risk of hypoperfusion and hypoxemia, are at
increased risk of lactic acidosis.
Lactic acidosis risk increases with the degree of renal dysfunction
and patient age. The risk may be significantly decreased by use of
minimum effective dose of metformin and regular monitoring of renal
function. Careful renal monitoring is particularly important in the
elderly. KOMBIGLYZE XR should not be initiated in patients ≥80 years
of age unless measurement of creatinine clearance demonstrates that
renal function is not reduced.
Withhold KOMBIGLYZE XR (saxagliptin and metformin HCl
extended-release) in the presence of any condition associated with
hypoxemia, dehydration, or sepsis.
Before initiation of KOMBIGLYZE XR, and at least annually thereafter,
renal function should be assessed and verified as normal.
KOMBIGLYZE XR is not recommended in patients with hepatic impairment.
Metformin may lower vitamin B12 levels. Measure hematological
parameters annually.
Warn patients against excessive alcohol intake.
KOMBIGLYZE XR should be suspended for any surgical procedure (except
minor procedures not associated with restricted intake of food and
fluids), and should not be restarted until patient’s oral intake has
resumed and renal function is normal.
Use of saxagliptin or metformin with medications known to cause
hypoglycemia
Saxagliptin: Insulin secretagogues, such as sulfonylureas, cause
hypoglycemia. Therefore, a lower dose of the insulin secretagogue may
be required to reduce the risk of hypoglycemia if used in combination
with KOMBIGLYZE XR.
Metformin: Hypoglycemia does not occur in patients receiving metformin
alone under usual circumstances of use, but could occur when caloric
intake is deficient, when strenuous exercise is not compensated by
caloric supplementation, during concomitant use with other
glucose-lowering agents (such as sulfonylureas or insulin), or with
use of ethanol. Elderly, debilitated, or malnourished patients and
those with adrenal or pituitary insufficiency or alcohol intoxication
are particularly susceptible to hypoglycemic effects.
Intravascular contrast studies with iodinated materials can lead to
acute alteration of renal function and have been associated with
lactic acidosis in patients receiving metformin. KOMBIGLYZE XR should
be temporarily discontinued at the time of or prior to the procedure,
and withheld for 48 hours after the procedure and reinstituted only
after renal function is normal.
There have been no clinical studies establishing conclusive evidence
of macrovascular risk reduction with KOMBIGLYZE XR or any other
anti-diabetic drug.
Adverse Reactions
Adverse reactions reported in &5% of patients treated with metformin
extended-release and more commonly than in patients treated with
placebo were: diarrhea (9.6% vs 2.6%) and nausea/vomiting (6.5% vs
Adverse reactions reported in ≥5% of patients treated with saxagliptin
and more commonly than in patients treated with placebo were: upper
respiratory tract infection (7.7% vs 7.6%), urinary tract infection
(6.8% vs 6.1%), and headache (6.5% vs 5.9%).
Adverse reactions reported in ≥5% of treatment-naive patients treated
with coadministered saxagliptin and metformin immediate-release (IR)
and more commonly than in patients treated with metformin IR alone
were: headache (7.5% vs 5.2%) and nasopharyngitis (6.9% vs 4.0%).
Drug Interactions: Because ketoconazole, a strong CYP3A4/5
inhibitor, increased saxagliptin exposure, limit KOMBIGLYZE XR
(saxagliptin and metformin HCl extended-release) to 2.5 mg/1000 mg once
daily when coadministered with a strong CYP3A4/5 inhibitor (e.g.,
atazanavir, clarithromycin, indinavir, itraconazole, ketoconazole,
nefazodone, nelfinavir, ritonavir, saquinavir, and telithromycin).
Use in Specific Populations
Pregnant and Nursing Women: There are no adequate and
well-controlled studies in pregnant women. KOMBIGLYZE XR should be
used during pregnancy only if clearly needed. It is not known whether
saxagliptin or metformin are secreted in human milk. Because many
drugs are secreted in human milk, caution should be exercised when
KOMBIGLYZE XR is administered to a nursing woman.
Pediatric Patients: Safety and effectiveness of KOMBIGLYZE XR
in pediatric patients have not been established.
for US Full Prescribing Information for KOMBIGLYZE XR
(5/500o5//1000 mg tablets), including Boxed WARNING about
lactic acidosis
Bristol-Myers Squibb and AstraZeneca Collaboration
Bristol-Myers Squibb and AstraZeneca entered into a collaboration in
January 2007 to enable the companies to research, develop and
commercialize select investigational drugs for type 2 diabetes. The
Bristol-Myers Squibb/AstraZeneca Diabetes collaboration is dedicated to
global patient care, improving patient outcomes and creating a new
vision for the treatment of type 2 diabetes.
About Bristol-Myers Squibb
Bristol-Myers Squibb is a global biopharmaceutical company whose mission
is to discover, develop and deliver innovative medicines that help
patients prevail over serious diseases. For more information about
Bristol-Myers Squibb, visit
follow us on Twitter at .
About AstraZeneca
AstraZeneca is a global, innovation-driven biopharmaceutical business
with a primary focus on the discovery, development and commercialization
of prescription medicines. As a leader in gastrointestinal,
cardiovascular, neuroscience, respiratory and inflammation, oncology and
infectious disease medicines, AstraZeneca generated global revenues of
$32.8 billion in 2009. In the United States, AstraZeneca is a $14.8
billion healthcare business.
For more information about AstraZeneca in the US or our AZ&Me(TM)
Prescription Savings programs, please visit:
or call 1-800-AZandMe (292-6363).
KOMBIGLYZE XR is a trademark of the Bristol-Myers Squibb Company.
Photos/Multimedia Gallery Available:
Media:Bristol-Myers SquibbKen Dominski, 609-252-5251orAstraZenecaCorey
Windett, 302-885-0034orInvestors:Bristol-Myers
SquibbJohn Elicker, 609-252-4611orAstraZenecaKarl
Hard, +44-20-
Release Summary
KOMBIGLYZE& XR (SAXAGLIPTIN AND METFORMIN HCl EXTENDED-RELEASE) TABLETS, A NEW TREATMENT FOR TYPE 2 DIABETES MELLITUS IN ADULTS, NOW AVAILABLE IN U.S. PHARMACIES
Media:Bristol-Myers SquibbKen Dominski, 609-252-5251orAstraZenecaCorey
Windett, 302-885-0034orInvestors:Bristol-Myers
SquibbJohn Elicker, 609-252-4611orAstraZenecaKarl
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