JAPhA Pharmacotherapy最新文献

{"title":"Beyond glucagon-like peptide-1: The promise of polyagonists in metabolic dysfunction–associated steatotic liver disease and metabolic dysfunction–associated steatohepatitis—A systematic review of randomized trials","authors":"Rachel M. Slaton, Maryam G. Iranikhah, C. Whitney White","doi":"10.1016/j.japhar.2026.100032","DOIUrl":"10.1016/j.japhar.2026.100032","url":null,"abstract":"<div><h3>Background</h3><div>Metabolic dysfunction–associated steatotic liver disease (MASLD), formerly termed nonalcoholic fatty liver disease, is the most prevalent hepatic manifestation of metabolic syndrome, affecting nearly 30% of the global population. Its more severe inflammatory form, metabolic dysfunction–associated steatohepatitis (MASH), affects 3%-6% of U.S. adults and carries a high risk of progression to cirrhosis and hepatocellular carcinoma. Historically, only off-label pharmacologic therapies were available for MASLD and MASH; however, recently, resmetirom and semaglutide were approved by the Food and Drug Administration for the treatment of adults with MASH. Given the shared pathophysiology with type 2 diabetes mellitus and obesity, glucagon-like peptide-1 (GLP-1) receptor agonists (GLP-1RAs) have emerged as promising agents for MASLD and MASH treatment.</div></div><div><h3>Objectives</h3><div>This review aimed to critically evaluate and synthesize existing evidence from randomized controlled trials (RCTs) assessing the efficacy and safety of drugs that affect GLP-1RA plus other incretin hormones (polyagonists) including glucose-dependent insulinotropic polypeptide (GIP) and glucagon in the treatment of MASLD and MASH.</div></div><div><h3>Methods</h3><div>A structured literature review was conducted using PubMed, Google Scholar, and <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> through September 2025 per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The search produced 49 results for author review including 37 eligible studies. Eligible studies included RCTs assessing hepatic and metabolic outcomes in adults with MASLD or MASH treated with GLP-1RAs dual- or triple-incretin agents. Nine key studies met the inclusion criteria.</div></div><div><h3>Results</h3><div>Dual agonists such as tirzepatide, pemvidutide, survodutide, and efinopegdutide demonstrated consistent, dose-dependent reductions in relative liver fat content ranging from 43% to 72.7%. In addition to reducing liver fat, survodutide produced histologic improvements in MASH without fibrosis progression, with nearly half of participants achieving resolution of steatohepatitis. Furthermore, triple agonists targeting GLP-1, glucagon, and GIP receptors—efocipegtrutide and retatrutide—achieved even greater reductions in liver fat of 59.3% and 82.7%, respectively.</div></div><div><h3>Conclusion</h3><div>Incretin-based polyagonists hold tremendous promise in the management of MASLD and MASH. Their ability to reduce hepatic steatosis, improve glycemic and metabolic parameters, and potentially reverse histologic injury positions them as frontrunners in a field urgently in need of effective therapies. As long-term efficacy and safety data accumulate, these agents are likely to transform the therapeutic armamentarium for metabolic liver disease. Now is the time for pharmacists to lead the way in personalized incretin thera","PeriodicalId":100736,"journal":{"name":"JAPhA Pharmacotherapy","volume":"3 3","pages":"Article 100032"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148699183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of obesogenic medications on weight loss potential with glucagon-like peptide-1 receptor agonists","authors":"Hillary Little,&nbsp;Haley Henry,&nbsp;Ashley M. Thomas","doi":"10.1016/j.japhar.2025.100022","DOIUrl":"10.1016/j.japhar.2025.100022","url":null,"abstract":"<div><h3>Background</h3><div>Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have revolutionized weight management. Obesogenic medications can lead to weight gain of 0.3-2.6 kg, complicating the comanagement of obesity. The impact of potential weight loss in patients prescribed GLP-1RAs and concomitant obesogenic medications has yet to be explored.</div></div><div><h3>Objective</h3><div>Investigators compared weight loss experienced in veterans prescribed injectable semaglutide and obesogenic medications with those not prescribed obesogenic medications.</div></div><div><h3>Methods</h3><div>Investigators performed a single-center, retrospective chart review. The primary outcome was the difference in percentage weight change from baseline to 6 months. The secondary outcomes included percentage change in body mass index (BMI), weight loss in pounds (lbs), change in BMI, number of obesogenic medications discontinued during the study period, and stratification of weight loss by number of obesogenic medication exposures, type of obesogenic medication exposure, and maximum dose of injectable semaglutide achieved.</div></div><div><h3>Results</h3><div>Patients in the nonobesogenic cohort experienced a median (interquartile range [IQR]) weight loss of 8.1% (−6%) compared with 6.9% (−8.8%) in the obesogenic cohort, with a median weight loss of 21.6 lbs (−15.8) versus 17.4 lbs (−23.8), respectively. The median change in BMI was −8.1 (−6) in the nonobesogenic cohort compared with −6.9 (−8.9) in the obesogenic cohort. Patients prescribed up to 5 obesogenic medications experienced weight loss up to 12.5% (−3.6%). Patients prescribed 6 obesogenic medications experienced a 14.5% weight gain (11.4%). The least weight gain was seen in patients prescribed antidiabetics (0.87%, IQR −5.6%), with the highest loss in those prescribed contraceptives (23.6%, IQR 0%). Patients titrated to 1.7 mg experienced the most weight loss of 9.8% (−19.9%). A range of 0-4 medications were discontinued.</div></div><div><h3>Conclusions</h3><div>Using obesogenic medications in patients prescribed injectable semaglutide for obesity led to numerically lower weight loss than patients not prescribed obesogenic medications. However, patients prescribed obesogenic medications were able to achieve a large total body weight loss.</div></div>","PeriodicalId":100736,"journal":{"name":"JAPhA Pharmacotherapy","volume":"3 3","pages":"Article 100022"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148699182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Honoring our authors and peer reviewers","authors":"Pamela C. Heaton BSPharm, PhD, FAPhA","doi":"10.1016/j.japhar.2026.100030","DOIUrl":"10.1016/j.japhar.2026.100030","url":null,"abstract":"","PeriodicalId":100736,"journal":{"name":"JAPhA Pharmacotherapy","volume":"3 2","pages":"Article 100030"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147740312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disparities in sodium-glucose cotransporter-2 inhibitor usage between patients with and without cancer: A retrospective study","authors":"Michael Sayer,&nbsp;Ali Naqvi,&nbsp;Misako Nagasaka,&nbsp;Pranav M. Patel,&nbsp;Joseph Chang,&nbsp;Victor Lao,&nbsp;Aya F. Ozaki","doi":"10.1016/j.japhar.2026.100027","DOIUrl":"10.1016/j.japhar.2026.100027","url":null,"abstract":"<div><h3>Background</h3><div>Although cardiovascular and kidney protective properties of sodium-glucose cotransporter-2 inhibitors (SGLT2is) have lead to their increased use in recent years, these trends among patients with cancer are poorly understood.</div></div><div><h3>Objective</h3><div>We evaluated the temporal trends of SGLT2i usage in patients with or without cancer.</div></div><div><h3>Methods</h3><div>Our study population included patients 18 and older having 1 of the following diagnoses: heart failure with reduced ejection fraction (HFrEF), heart failure with preserved ejection fraction, chronic kidney disease (CKD), and cardiovascular disease (CVD) with diabetes (DM). The annual incidence of SGLT2i use was measured within patients with and without cancer within each cohort from 2016 to 2023.</div></div><div><h3>Results</h3><div>Among all study cohorts, the observed yearly incidence of SGLT2i use was considerably lower from 2016 to 2019, never exceeding 2%. Differences in utilization between patient cohorts with and without cancer became visible from 2020 onward, highlighted by differences in 2023 incidence for HFrEF (13.1% noncancer vs. 10.7% cancer), CKD (10.0% noncancer vs. 3.8% cancer), and CVD with DM (7.6% noncancer vs. 5.2% cancer).</div></div><div><h3>Conclusion</h3><div>Observed incidence rates suggest that patients with cancer were less likely to be prescribed SGLT2i compared with patients without cancer. Further research is needed to understand the barriers to the use of cardiorenal protective agents in the cancer patient population.</div></div>","PeriodicalId":100736,"journal":{"name":"JAPhA Pharmacotherapy","volume":"3 2","pages":"Article 100027"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146175505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Journal of the American Pharmacists Association reviewers—2025","authors":"","doi":"10.1016/j.japhar.2026.100031","DOIUrl":"10.1016/j.japhar.2026.100031","url":null,"abstract":"","PeriodicalId":100736,"journal":{"name":"JAPhA Pharmacotherapy","volume":"3 2","pages":"Article 100031"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147740311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of bradycardia and syncope associated with the use of cholinesterase inhibitors in patients with Alzheimer disease and related dementias: A systematic review and meta-analysis","authors":"Chijioke M. Okeke,&nbsp;Tenia Slade,&nbsp;Sarah Beth Tucker,&nbsp;Olivia Whitworth,&nbsp;Amey Rane,&nbsp;Bryan L. Love,&nbsp;Ibraheem M. Karaye,&nbsp;Saud Alsahali,&nbsp;Nasim Maleki,&nbsp;Nawaf M. Alotaibi,&nbsp;J. Douglas Thornton,&nbsp;Karen McGee,&nbsp;Ismaeel Yunusa","doi":"10.1016/j.japhar.2026.100028","DOIUrl":"10.1016/j.japhar.2026.100028","url":null,"abstract":"<div><h3>Background</h3><div>Cholinesterase inhibitors (ChEIs) may potentiate acetylcholine’s effect on vagal stimulation of the heart, potentially leading to bradycardia and syncope. Evidence for this association is limited, and clinicians may be unaware of the risk.</div></div><div><h3>Objective</h3><div>This study aimed to systematically review and perform an up-to-date meta-analysis of the risk of bradycardia and syncope among patients with Alzheimer disease and related dementias (ADRD) treated with ChEIs.</div></div><div><h3>Methods</h3><div>PubMed, Embase, Cochrane Library, and reference lists were searched from inception to June 15, 2024. Eligible studies included randomized controlled trials (RCTs) and observational studies. Three reviewers independently extracted data per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and assessed quality using National Heart, Lung, and Blood Institute tools. Random-effects modeling was used to estimate pooled relative risks (RRs) and 95% CIs. Outcomes were bradycardia and syncope.</div></div><div><h3>Results</h3><div>Of 310 records screened, 25 studies (16 RCTs, 7 cohorts, 1 case-control study, 1 pragmatic trial; n = 258,388) were included. The median participant age was 76.3 years (range 70–89.2), and females comprised more than half in 18 studies. Eighteen studies (72%) specifically included patients with Alzheimer disease. The pooled absolute risk of bradycardia was 4.63% (95% CI 1.80–8.55; 16 studies, n = 97,165) and of syncope was 2.31% (95% CI 1.18–3.77; 16 studies, n = 134,162). ChEI use was associated with a statistically significant increase in the risk of bradycardia (RR 1.23 [95% CI 1.14–1.33]; 6 studies, n = 97,396) and syncope (RR 1.40 [95% CI 1.20–1.64]; 9 studies, n = 85,169).</div></div><div><h3>Conclusions</h3><div>ChEI treatment in ADRD is associated with an elevated risk of bradycardia and syncope. Clinicians should weigh these risks against therapeutic benefits when managing patients with ADRD.</div></div>","PeriodicalId":100736,"journal":{"name":"JAPhA Pharmacotherapy","volume":"3 2","pages":"Article 100028"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146175504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the use of dyes at a tertiary academic medical center","authors":"Nandini Patel,&nbsp;Salima Amiji,&nbsp;Kenneth E. Lupi,&nbsp;Charles V. Pollack,&nbsp;Paul M. Szumita","doi":"10.1016/j.japhar.2025.100023","DOIUrl":"10.1016/j.japhar.2025.100023","url":null,"abstract":"<div><h3>Background</h3><div>Medical dyes are used in the hospital setting for various diagnostic, procedural, and treatment indications. In some cases, they are used for indications that are not approved by the Food and Drug Administration (FDA).</div></div><div><h3>Objective</h3><div>This study aimed to assess the real-world utilization of the following commonly used dyes: methylene blue, indigotindisulfonate sodium, fluorescein, isosulfan blue, and indocyanine green.</div></div><div><h3>Methods</h3><div>This was a single-center, retrospective study including adults who were administered methylene blue, indigotindisulfonate sodium, fluorescein, isosulfan blue, or indocyanine green between March 2023 and August 2023 at a tertiary academic medical center. No exclusion criteria were applied. The primary outcome was the percentage of dye administrations with an FDA-approved indication, both total and stratified by each dye. The indication for each administration was identified via chart review using procedure and progress notes.</div></div><div><h3>Results</h3><div>A total of 616 administrations were analyzed. Of these administrations, 19 (3.1%) had an FDA-approved indication, whereas 597 (96.9%) did not. Methylene blue and indocyanine green were the most commonly used dyes outside of their FDA-approved indication. A total of 351 methylene blue administrations (57.0%) and 233 indocyanine green administrations (37.8%) were off-label.</div></div><div><h3>Conclusion</h3><div>In the hospital setting, medical dyes may be used for various indications, some of which may not be FDA approved. Establishing institutional policies and procedures surrounding the use of dyes may help guide their use in the hospital setting.</div></div>","PeriodicalId":100736,"journal":{"name":"JAPhA Pharmacotherapy","volume":"3 1","pages":"Article 100023"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147396286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nutrition support team impact on critically ill patients receiving parenteral nutrition","authors":"Cassandra Falk,&nbsp;Amanda Roberts,&nbsp;Vince Procopio","doi":"10.1016/j.japhar.2025.100018","DOIUrl":"10.1016/j.japhar.2025.100018","url":null,"abstract":"<div><h3>Background</h3><div>Parenteral nutrition (PN) increases risk of metabolic complications. Limited literature assesses multidisciplinary nutrition support team (NST) impact on critically ill patients receiving PN.</div></div><div><h3>Objective</h3><div>This study aimed to evaluate safety outcomes and guideline concordance of macronutrients prescribed for intensive care unit (ICU) patients on PN with and without an NST.</div></div><div><h3>Methods</h3><div>This was a dual-center, retrospective cohort study of adult ICU patients initiated on PN between June 1, 2018, and June 30, 2023. The primary outcome was the proportion of patients who experienced an electrolyte abnormality (EA) in the first 72 hours of PN.</div></div><div><h3>Results</h3><div>An NST reduced the proportion of patients experiencing EAs in the first 72 hours of PN by 16% (90% vs. 74% [95% CI 8–24], <em>P</em> &lt; 0.001). Multivariate logistic regression further identified a lack of an NST as an independent risk factor for EA (odds ratio 3.35 [1.74–6.46]). In the first 72 hours of PN, patients with an NST had a greater proportion of patients experience hyperglycemia (67.3% vs. 79.3%, −12% difference [−22.7 to −2.7], <em>P</em> = 0.019) and hypoglycemia (6% vs. 24%, −18% difference [−25.3 to −9.3], <em>P</em> &lt; 0.001). Finally, no differences were observed in macronutrient prescription concordance with guideline recommendations.</div></div><div><h3>Conclusion</h3><div>In our study, an NST had a mixed impact on PN metabolic complications. It significantly reduced EAs, but increased hyper- and hypoglycemic events. Larger studies including more locations and NSTs are needed to confirm these findings and further evaluate NST impact on patient outcomes such as length of stay and mortality.</div></div>","PeriodicalId":100736,"journal":{"name":"JAPhA Pharmacotherapy","volume":"3 1","pages":"Article 100018"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147396285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leveraging real-world data to create vancomycin population pharmacokinetic models in younger adults and patients with low serum creatinine","authors":"Jordan T. Brooks,&nbsp;Maria-Stephanie A. Hughes,&nbsp;Jonathan D. Faldasz,&nbsp;Ron J. Keizer,&nbsp;Jasmine H. Hughes","doi":"10.1016/j.japhar.2025.100026","DOIUrl":"10.1016/j.japhar.2025.100026","url":null,"abstract":"<div><h3>Background</h3><div>Vancomycin population pharmacokinetic (popPK) models are essential for precision dosing but can perform poorly in underrepresented populations, including younger adults and patients with low serum creatinine (sCr). These 2 populations show altered pharmacokinetics (PK) compared with the general population; younger patients exhibit faster clearance (CL), whereas low sCr often reflects body composition rather than renal function, leading to implausible CL estimates.</div></div><div><h3>Objectives</h3><div>This study aimed to develop 2 vancomycin popPK models on large, real-world data sets and compare model predictive performance in historically underrepresented populations of individuals: young adults and individuals with low sCr.</div></div><div><h3>Methods</h3><div>Two new vancomycin popPK models were developed using retrospective InsightRX Nova platform data. The model for young adults was trained on patients aged 18-35 years (n = 6080), whereas the low sCr model included adults of all ages with sCr values of less than 0.8 mg/dL (n = 2354). Predictive performance was evaluated using mean percent error, normalized root mean square error (nRMSE), and accuracy (within 15% or 2.5 mg/dL of observed concentrations). Predictive performance was compared across 5 established models using both holdout internal validation data sets and a large, broad adult population external validation data set.</div></div><div><h3>Results</h3><div>Both models used 2-compartment structures with combined proportional and additive error. The young adult model incorporated fat-free mass (FFM) and estimated glomerular filtration rate via Chronic Kidney Disease Epidemiology Collaboration 2021, whereas the low sCr model used FFM, raw sCr, age, and sex. The young adult model showed superior accuracy and lower nRMSE across prediction types compared with established models in the internal validation data set. For modeling low sCr, application of rounding sCr rules did not improve model performance. External validation on 384,876 patients confirmed both models generalized well beyond their development populations, with the young adult model performing across age groups and the low sCr model maintaining performance for sCr of less than 1.0 mg/dL.</div></div><div><h3>Conclusions</h3><div>Developing population-specific vancomycin popPK models improves predictive performance for underrepresented groups. Using measured sCr without imposing clinically common sCr rounding rules optimizes performance. These findings support continued refinement of targeted PK models.</div></div>","PeriodicalId":100736,"journal":{"name":"JAPhA Pharmacotherapy","volume":"3 1","pages":"Article 100026"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medication adherence after transition to emicizumab in patients with severe hemophilia A: Results from the ADHEMI study","authors":"Laurie Pagnot,&nbsp;Teddy Novais,&nbsp;Véronique Cahoreau,&nbsp;Isabelle Lopez,&nbsp;Christelle Prudent,&nbsp;Marie Hamon,&nbsp;Estelle Leroy,&nbsp;Anne Cécile Gérout,&nbsp;Elise Toguyeni,&nbsp;Ludovic Sylvestre,&nbsp;Julien Jouglen,&nbsp;Rémi Varin,&nbsp;Valérie Chamouard","doi":"10.1016/j.japhar.2025.100025","DOIUrl":"10.1016/j.japhar.2025.100025","url":null,"abstract":"<div><h3>Background</h3><div>Hemophilia A (HA) is a rare X-linked congenital bleeding disorder characterized by a deficiency in coagulation factor VIII (FVIII). Standard treatment includes regular intravenous (IV) injections of clotting factor concentrates, known as prophylaxis. Recent advances, such as subcutaneous nonfactor replacement therapy like emicizumab, have had an impact on management strategies for patients with HA, notably by reducing the burden of IV injections.</div></div><div><h3>Objectives</h3><div>This study aimed to assess the change in medication adherence after the HA treatment modality switch from FVIII or bypassing agents (BPAs) in the case of inhibitors to subcutaneous emicizumab for patients with severe HA.</div></div><div><h3>Methods</h3><div>A multicenter retrospective study was conducted across 11 French reference centers for hemophilia. The study included 187 patients with severe HA treated with emicizumab for at least 12 months after a minimum of 12 months with FVIII or BPA prophylaxis. Medication adherence was measured using the medication possession ratio (MPR), calculated for both periods, accounting or not for the inclusion of emergency doses (EDs). These doses were prescribed in addition to the prophylactic regimen in the case of hemorrhage.</div></div><div><h3>Results</h3><div>Medication adherence statistically significant increased after switching to emicizumab (mean ± SD) (MPR 0.99 ± 0.07) compared with the previous period with FVIII or BPAs (MPR 0.85 ± 0.23 without EDs, 0.91 ± 0.24 with EDs, <em>P</em> &lt; 0.001). The proportion of adherent patients (MPR ≥ 90%) rose from 44.4% (without EDs) and 54.5% (with EDs) to 92.0% after the switch (<em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Switching to emicizumab improves medication adherence in patients with hemophilia A.</div></div>","PeriodicalId":100736,"journal":{"name":"JAPhA Pharmacotherapy","volume":"3 1","pages":"Article 100025"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145791506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}