Current Medical Research and Opinion最新文献

{"title":"Advances in disease management and treatment outcomes for obesity and knee osteoarthritis in primary care practice.","authors":"Amanda E Nelson, Leigh F Callahan, Thomas J Schnitzer, John A Batsis","doi":"10.1080/03007995.2026.2741495","DOIUrl":"https://doi.org/10.1080/03007995.2026.2741495","url":null,"abstract":"<p><p>The lifetime risk of developing knee osteoarthritis (KOA) is approximately doubled in people with obesity compared with those without obesity. Many patients with KOA are treated by primary care physicians in the community setting. We performed a targeted literature search on PubMed to identify relevant literature describing the impact of weight loss in patients with obesity and KOA. A strong body of evidence supports the use of weight loss through lifestyle interventions, including caloric restriction in combination with exercise, as a primary intervention in patients with KOA and obesity. Studies show that these interventions are associated with improvements in pain, physical function, and quality of life; however, adherence to lifestyle interventions can be challenging, even with individually tailored programs. Obesity medications, such as glucagon-like peptide-1 receptor agonists, are emerging as a new addition to weight management approaches in KOA, with a recent phase 3 clinical study demonstrating the benefits of semaglutide for weight loss in adults with KOA and high body mass index. Although initial data are promising, further clinical evidence is required, and perceived barriers to use need to be addressed before obesity medications can be widely adopted into clinical practice for patients with KOA. Specifically, further data are required to guide decisions regarding optimal treatment duration with obesity medications and to establish their tolerability profile associated with longer-term use. The importance of preserving functional muscle mass in patients with KOA and mitigation of weight regain after obesity medication treatment withdrawal are also identified as areas warranting further research. In this narrative review, we provide practical recommendations to primary care physicians on integrating obesity medications into weight-loss programs, including patient screening, risk stratification, communication, use of guidelines, and the benefits of a multidisciplinary approach.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1-14"},"PeriodicalIF":2.8,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of the aggregate index of systemic inflammation (AISI) with myocardial injury markers in patients with coronary heart disease.","authors":"Xuan Liu, Yuchao Wang, Hao Liu, Jingyi Liu, Landi Wang, Jian Cao, Huanming Li, Yong Liu, Dayong Li","doi":"10.1080/03007995.2026.2743357","DOIUrl":"https://doi.org/10.1080/03007995.2026.2743357","url":null,"abstract":"<p><strong>Background: </strong>The Aggregate Index of Systemic Inflammation (AISI) is a potential cardiovascular risk indicator. Its association with contemporaneous myocardial injury in coronary heart disease (CHD) patients remains unclear.</p><p><strong>Objective: </strong>To explore the association between AISI and elevated myocardial injury markers and evaluate its discriminatory performance.</p><p><strong>Methods: </strong>In this single-centre retrospective study of consecutive CHD patients, AISI was calculated at admission. The patients were assessed at admission and before coronary angiography. Elevated cTnT was defined as >0.014 ng/mL and elevated CK-MB as >24 U/L. Logistic regression, subgroup analyses, ROC curves, and restricted cubic splines (RCS) were used.</p><p><strong>Results: </strong>Significant differences across AISI tertiles were observed in adverse profiles. In multivariable-adjusted models, each unit increase in continuous AISI was associated with higher odds of elevated cTnT (OR = 1.30, 95% CI: 1.10, 1.55, <i>p</i> = 0.003) and elevated CK-MB (OR = 1.09, 95% CI: 1.02,1.17, <i>p</i> = 0.01). Compared with T1, T3 showed a significantly increased risk of elevated cTnT (OR = 3.14, 95% CI: 1.93,5.12, <i>p</i> < 0.01). Subgroup analyses revealed that AISI was more strongly associated with cTnT elevation in patients aged <70 years and in men, while the association with CK-MB was more evident in women and those aged ≥70 years. ROC analysis demonstrated moderate predictive value for cTnT (AUC = 0.72, 95% CI: 0.69, 0.75) and limited value for CK-MB (AUC = 0.65). RCS identified a nonlinear relationship with cTnT (P for nonlinearity = 0.0016), with an inflection point at 212.41.</p><p><strong>Conclusion: </strong>Elevated AISI is independently associated with myocardial injury biomarkers in CHD patients, particularly for cTnT elevation, with a nonlinear threshold effect near 212.4. This association varies by age and sex, suggesting that AISI may serve as a simple, cost-effective adjunctive marker for identifying CHD patients at risk of myocardial injury.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1-11"},"PeriodicalIF":2.8,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149180112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient and caregiver burden after hospitalization with severe viral lower respiratory tract disease: results from a real-world survey in Europe, the US and Japan.","authors":"Anthony C Gordon, Lynda Draffan, Yao Qiao, Olive Fulton, Mia Harvey, Susan Johnson, Josefine Persson, Drahomir Kolencik, Rebecca Hardy-Woods, Mark Small, Lieuwe Dj Bos, Ekaterina Maslova","doi":"10.1080/03007995.2026.2741493","DOIUrl":"https://doi.org/10.1080/03007995.2026.2741493","url":null,"abstract":"<p><strong>Objective: </strong>To describe the care planning, post-discharge health and health-related quality of life in severe viral lower respiratory tract disease (LRTD) patients and their caregivers.</p><p><strong>Methods: </strong>Data were derived from the Adelphi Real World LRTD Disease Specific Programme, a cross-sectional survey of physicians, patients hospitalized with LRTD 6-24 months prior to survey and their caregivers, conducted in in France, Germany, Italy, Spain, United Kingdom, the United States, and Japan in 2024.</p><p><strong>Results: </strong>Physicians (<i>n</i> = 273) reported data for 1071 patients. Patient median (IQR) age was 69.0 (59.0, 76.0), 59.2% were male and 88.6% were White. Patients had a mean of 2.4 ± 2.0 comorbidities at admission, with 27.4% having pneumonia, 27.1% COPD and 25.0% cardiovascular disease. The most common viral etiologies were SARS-CoV2 (46.0%) and influenza A (21.7%) and 34.9% of patients received a post-discharge care plan, most commonly including bronchodilators and anti-inflammatory medication (53.7%) and oxygen therapy (31.6%). In total, 212 patients provided self-reported data. Patients reported an impact on their ability to move/exercise (62.3%), physical health (52.8%), and mental health (66.0%). Mean EQ-5D-5L and VAS scores were 0.72 ± 0.20 and 67.0 ± 20, respectively. Overall work impairment was 23.7 ± 25.5%, and activity impairment was 34.8 ± 24.6%. A quarter (25.0%) of caregivers (<i>n</i> = 104) reported a moderate-to-severe impact of caring on their physical health, and 50.0% reported moderate-to-extreme impact on their sleep. Mean WHO-5 wellbeing score was 58.5 ± 24.8, Zarit Burden Interview score was 15.0 ± 10.2. Caregiver work impairment was 27.8 ± 27.3%, with an overall activity impairment of 31.9 ± 28.2%.</p><p><strong>Conclusion: </strong>Patients and their caregivers continue to experience notable physical and mental health burdens following hospitalization for LRTD, with impacts on HRQoL, wellbeing, and productivity. Our data highlights the need for more adequate care adequate support for patients and caregivers after discharge.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1-16"},"PeriodicalIF":2.8,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149126857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Authors' response to the letter to the editor regarding \"Carbon dioxide equivalent emissions and cost impact of non-clinically driven inhaler initiation or switch for COPD\".","authors":"Krishnali Parsekar, Georgios Xydopoulos, Abdelhamid Yousef, George Agathangelou, Richard Fordham, Magnus Köping-Höggård, Jonathan Marshall, Dorthe Petersen, Isabella Rustignoli, Juan Soto, John P Bell, Deniz Tansey-Dwyer, Omar S Usmani","doi":"10.1080/03007995.2026.2736356","DOIUrl":"https://doi.org/10.1080/03007995.2026.2736356","url":null,"abstract":"","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1-3"},"PeriodicalIF":2.8,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149135374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dapagliflozin and ventricular repolarization across heart failure phenotypes.","authors":"Gülüzar Traş, Fuat Polat, Melike Saday Bozkurt, İsmail Altıntaş","doi":"10.1080/03007995.2026.2741494","DOIUrl":"https://doi.org/10.1080/03007995.2026.2741494","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes mellitus (T2DM) is associated with abnormal ventricular repolarization and increased arrhythmic risk. Sodium-glucose cotransporter-2 (SGLT-2) inhibitors may exert electrophysiological effects beyond glycemic control. We investigated changes in electrocardiographic (ECG) markers of ventricular repolarization after dapagliflozin initiation in SGLT-2 inhibitor-naïve patients with T2DM according to heart failure (HF) phenotype.</p><p><strong>Methods: </strong>In this prospective, non-randomized, controlled observational study, 700 patients with T2DM were enrolled between June 2023 and February 2026. Patients initiating dapagliflozin (<i>n</i> = 350) were classified as HFrEF (LVEF <50%, <i>n</i> = 87), HFpEF (LVEF ≥50% with HF, <i>n</i> = 93), or no HF (LVEF ≥50% without HF, <i>n</i> = 170); 350 controls continued pre-existing antidiabetic therapy. Twelve-lead ECG and echocardiography were performed at baseline and 3 months. Prespecified endpoints included QT, QTc, QT dispersion, Tp-e, Tp-e/QT, and Tp-e/QTc. Inverse probability of treatment weighting and Holm-Bonferroni correction were applied.</p><p><strong>Results: </strong>Dapagliflozin was associated with greater reductions in all prespecified ECG parameters than controls (all between-group <i>p</i> <0.001; Cohen's d = 0.48-1.08), with consistent findings after IPTW. Reductions were greatest in HFrEF (QTc = -14.3 ms; Tp-<i>e</i> = -9.1 ms), followed by HFpEF (-11.2 and -7.4 ms) and no HF (-7.6 and -3.8 ms); all between-subgroup comparisons <i>p</i> <0.001. HFrEF independently predicted greater QTc reduction (β = -4.8 ms vs no HF, <i>p</i> < 0.001). Change in Tp-e correlated weakly with HbA1c change (r = -0.145, <i>p</i> = 0.037). LVEF increased in HFrEF (+3.2%) and HFpEF (+0.9%).</p><p><strong>Conclusions: </strong>Dapagliflozin initiation was associated with reductions in multiple ECG markers of ventricular repolarization, with the greatest changes observed in HFrEF. These findings concern surrogate ECG measures and do not establish a reduction in clinical arrhythmic events. Confirmation in prospective randomized trials is warranted.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1-10"},"PeriodicalIF":2.8,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149126879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of PD-1 and PD-L1 inhibitors on patient-reported outcomes in esophageal squamous cell carcinoma: a systematic review of clinical trials.","authors":"Sun A Choi, Wesley J Wong, Frederick B Barnes, Philip O Buck, Jason C Allaire","doi":"10.1080/03007995.2026.2740280","DOIUrl":"https://doi.org/10.1080/03007995.2026.2740280","url":null,"abstract":"<p><strong>Objectives: </strong>Esophageal squamous cell carcinoma (ESCC) carries a poor prognosis and is associated with symptoms such as dysphagia that substantially impair patients' health-related quality of life (HRQoL). The combination of chemotherapy with an immune checkpoint inhibitor is widely used in real-world practice and is a recommended treatment for unresectable, recurrent, or metastatic ESCC. This systematic literature review assessed patient-reported outcomes (PROs) in clinical trials evaluating PD-1/PD-L1 inhibitors in ESCC.</p><p><strong>Methods: </strong>A comprehensive search of PubMed, Embase, and the Cochrane Library, supplemented by Elicit, was conducted to identify clinical trial publications reporting PROs in ESCC patients treated with PD-1/PD-L1 inhibitors. Eligible studies were published through July 20, 2025, and were included if they met the following criteria: (1) enrolled ESCC patients; (2) reported PROs, including HRQoL, in randomized clinical trials of PD-1/PD-L1 inhibitors; and (3) were published in English.</p><p><strong>Results: </strong>Thirteen clinical trial publications met the inclusion criteria. Investigated agents included nivolumab, tislelizumab, camrelizumab, sintilimab, and pembrolizumab. PROs were measured using the EORTC QLQ-C30 and QLQ-OES18, EQ-5D-5L, EQ-5D-3L, and FACT-E questionnaires, with follow-up ranging from 8 to 60 weeks. The EORTC QLQ-C30 and QLQ-OES18 were the most frequently used instruments. While results varied by treatment and setting, PD-1/PD-L1 inhibitor-based regimens generally maintained or improved PROs compared with chemotherapy, including overall HRQoL and esophageal cancer-specific symptoms such as pain, reflux, and eating and swallowing difficulties.</p><p><strong>Conclusions: </strong>Across trials, PD-1/PD-L1 inhibitors were associated with maintenance or improvement in PROs compared with chemotherapy in ESCC, especially in global health status, functional domains, and key ESCC-related symptoms.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1-14"},"PeriodicalIF":2.8,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Secondary bacterial, fungal, and viral infections in patients with liver diseases: from immune dysfunction to clinical management.","authors":"Yimin Lin, Liang Wang, Juanxia Wang, Xueni Ma","doi":"10.1080/03007995.2026.2738269","DOIUrl":"https://doi.org/10.1080/03007995.2026.2738269","url":null,"abstract":"<p><strong>Background: </strong>Compromised hepatic function and dysregulated immune responses render individuals with liver pathology highly vulnerable to pathogenic bacterial invasion. Consequently, the elevated morbidity and mortality rates associated with these infections have emerged as a critical challenge in clinical practice. Within the cohort of patients suffering from acute and chronic liver conditions, there is a pronounced prevalence of bacterial, viral, and fungal infections, alongside frequent coinfections; notably, these infectious agents exhibit substantial heterogeneity regarding their distinct characteristics, pathogenic mechanisms, and clinical presentations.</p><p><strong>Methods: </strong>This review synthesizes contemporary literature focusing on the epidemiological profiles, pathogen taxonomy, immunopathological underpinnings, diagnostic modalities, and therapeutic interventions for secondary infections in patients with advanced liver disease, particularly decompensated cirrhosis. Furthermore, it specifically addresses existing gaps in research concerning post-liver transplantation infection risk factors and management strategies, as well as the detrimental impact of emerging viruses and viral coinfections on hepatic integrity.</p><p><strong>Results: </strong>Current scholarship has predominantly elucidated the foundational aspects of infection epidemiology and treatment, yet remains sparse in its exploration of specific risk determinants following liver transplantation and the nuanced effects of novel viral pathogens. This paper introduces recent advancements in these underexplored domains.</p><p><strong>Conclusion: </strong>By integrating these novel findings, this work aims to furnish robust theoretical support for the clinical diagnosis and management of secondary infections in patients with decompensated cirrhosis. Ultimately, these insights are intended to facilitate the earlier detection of secondary infections in susceptible patients and enable more precise, targeted therapeutic management.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1-19"},"PeriodicalIF":2.8,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mortality in generalized myasthenia gravis among Medicare beneficiaries in the United States.","authors":"Louis Jackson, Maryia Zhdanava, Jacqueline Pesa, Porpong Boonmak, Grace Chen, Daisy Liu, Dominic Pilon, Raghav Govindarajan","doi":"10.1080/03007995.2026.2740307","DOIUrl":"https://doi.org/10.1080/03007995.2026.2740307","url":null,"abstract":"<p><strong>Background: </strong>Data on mortality risk and its predictors among elderly patients with generalized myasthenia gravis (gMG) in the United States remain limited.</p><p><strong>Methods: </strong>A prevalent cohort of Medicare Fee-for-Service beneficiaries with gMG and those without MG were identified using data from 01/2018 to 12/2023. Patients without MG were matched 10:1 to the gMG cohort on age and index year. Cohorts were weighted using overlap propensity scores on demographic and clinical characteristics. Mortality was assessed using Kaplan-Meier and Cox proportional hazards models from the index date (gMG cohort: random gMG-related visit; non-MG cohort: random medical visit) until death, end of data, or loss of eligibility. Predictors of all-cause mortality were evaluated among the gMG cohort using multivariable Cox regression.</p><p><strong>Results: </strong>The study included 37,321 patients with gMG and 373,210 patients without MG (mean age: 74 years; 47% female). Patients with gMG had 8% higher mortality risk at 12 months and 7% higher risk at 24 and 36 months than those without MG (all <i>p</i> < 0.001). Among patients with gMG, mortality risk increased with older age (by 430% for ages ≥85 vs <65 years), male sex (by 25%), dual Medicare-Medicaid eligibility (by 17%), MG exacerbation (by 15%) and crisis (by 16%), and most comorbidities (all <i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>Mortality risk is elevated in Medicare beneficiaries with gMG relative to those without MG. In gMG, mortality risk is higher among men and increases with age, disease severity, and comorbidities. Findings underscore the complexity of managing gMG alongside comorbidities in elderly patients.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1-10"},"PeriodicalIF":2.8,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Latent profiles of quality of life and psychological distress in colorectal cancer patients: a cross-sectional study.","authors":"Chunju Yang, Lu Wang, Yuanxia Liu, Jiang Zeng, Weirong Zhou","doi":"10.1080/03007995.2026.2740839","DOIUrl":"10.1080/03007995.2026.2740839","url":null,"abstract":"<p><strong>Purpose: </strong>This study used latent profile analysis (LPA) to classify colorectal cancer (CRC) patients into distinct profiles of quality of life (QoL) and psychological distress, and to explore the demographic and clinical factors associated with these profiles.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted from May 2023 to January 2024, recruiting 537 CRC patients from three tertiary grade A hospitals in Zhejiang Province, China. Data were collected using a general information questionnaire, the Functional Assessment of Cancer Therapy-Colorectal (FACIT-CR), and the Distress Thermometer (DT). Latent profile analysis (LPA) was performed using Mplus 8.3 to identify patient profiles, with the optimal model selected based on fit indices. Subsequently, univariate and multivariate logistic regression analyses were conducted to explore associated factors.</p><p><strong>Results: </strong>Four profiles emerged: \"low QoL-high distress\" (25.3%), \"moderate QoL-low distress\" (22.0%), \"moderate QoL-moderate distress\" (36.1%), and \"high QoL-low distress\" (16.6%). Univariate analysis revealed significant differences across the four profiles in gender (<i>p</i> < 0.001), marital status (<i>p</i> < 0.001), residence (<i>p</i> = 0.044), monthly household income (<i>p</i> = 0.020), duration of illness (<i>p</i> < 0.001), cancer stage (<i>p</i> < 0.001), family history of cancer (<i>p</i> < 0.001), and metastasis status (<i>p</i> < 0.001). Multivariate regression confirmed that profile membership was significantly associated with being married, male, earlier cancer stage, lower household income, family history of cancer, and metastasis presence (<i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>Significant heterogeneity exists in QoL and distress among CRC patients. These findings suggest that clinicians could consider prioritizing personalized psychological interventions for patients with advanced disease, prolonged illness, or financial difficulties; prospective validation is needed before routine adoption.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1-14"},"PeriodicalIF":2.8,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Levothyroxine adherence in primary hypothyroidism: clinical impact, measurement challenges, and opportunities for personalized care.","authors":"Salman Razvi","doi":"10.1080/03007995.2026.2740285","DOIUrl":"https://doi.org/10.1080/03007995.2026.2740285","url":null,"abstract":"<p><p>Primary hypothyroidism, most commonly caused by Hashimoto's thyroiditis, is a highly prevalent chronic condition typically managed with lifelong levothyroxine therapy. Although treatment is generally straightforward, a substantial proportion of patients do not achieve stable biochemical control or continue to report persistent symptoms. Suboptimal adherence may contribute to these challenges, but should be distinguished from other causes of treatment instability, including administration-related factors, drug and food interactions, and gastrointestinal malabsorption. This narrative review examines current evidence on the prevalence, determinants, clinical consequences and assessment of suboptimal adherence to levothyroxine therapy in primary hypothyroidism. Reported adherence estimates vary substantially according to the populations studied, definitions used and methods of assessment, while biochemical instability alone should not be regarded as evidence of non-adherence. Patient-, treatment- and healthcare system-related factors may all influence medication-taking behaviour. Practical strategies to identify and address suboptimal adherence include patient-centred discussion, education, simplification of administration where appropriate, and targeted use of alternative dosing strategies or formulations. Integrating adherence assessment into routine clinical care may help identify modifiable contributors to unstable treatment and support more individualized levothyroxine management.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1-13"},"PeriodicalIF":2.8,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}