Current Medical Research and Opinion最新文献

{"title":"Assessment of contraceptive use and side effects among women in five countries across the Middle East: a cross-sectional study.","authors":"Azza Ramadan, Anan S Jarab, Ahmad Z Al Meslamani, Hebatallah Ahmed Mohamed Moustafa, Amira B Kassem, Abuelnor Mohammed, Wael Osman, Reem Ibrahim, Karem H Alzoubi","doi":"10.1080/03007995.2025.2472907","DOIUrl":"10.1080/03007995.2025.2472907","url":null,"abstract":"<p><strong>Purpose: </strong>Contraceptive use and associated adverse effects are underreported in the Middle East. This study aimed to investigate contraceptive use and reported side effects in five Middle Eastern countries.</p><p><strong>Methods: </strong>This study, conducted over eight weeks in the UAE, Egypt, Jordan, Syria, and Iraq, utilized an online closed-ended structured questionnaire to extract the study information. Reproductive-age women were surveyed about hormonal and non-hormonal contraceptive usage practices, frequency, types, and severity of contraceptive-associated side effects. Logistic regression analysis was utilized to determine the predictors of the occurrence of side effects associated with contraceptive use.</p><p><strong>Results: </strong>The prevalence of contraceptive use was 81.2% (1069/1317). The most common contraceptive methods were combined oral contraceptive pills (46.6%, 511/1069), mini pills (15.4%, 169/1069), and hormonal loops (13.8%, 151/1069). The prevalence of contraceptive-associated side effects was 41.9% (448/1069). The commonly reported mild-to-moderate side effects were irregular menstrual bleeding (87.9%), headaches (88.2%), and mood changes (93.5%). Interestingly, the participants living in Egypt (AOR: 14.58, 95% CI: 4.67-45.53, <i>p</i> = 0.012) and Iraq (AOR: 25.71, 95% CI: 9.93-66.60, <i>p</i> = 0.001) had greater odds of developing contraceptive-related side effects than did their counterparts. Breastfeeding (AOR: 0.43, 95% CI: 0.20-0.92, <i>p</i> = 0.03), hypertension (AOR: 0.50, 95% CI: 0.26-0.99, <i>p</i> = 0.047), and smoking (AOR: 0.43, 95% CI: 0.20-0.90, <i>p</i> = 0.027) status reduced the risk of side effects. Surprisingly, healthcare follow-ups significantly increased the risk of side effects among contraceptive users (AOR: 3.48, 95% CI: 2.03-5.97; <i>p</i> = 0.001).</p><p><strong>Conclusion: </strong>Many contraceptive users reported experiencing side effects, which are predominantly mild to moderate. This underscores the need for improved patient education and follow-up, especially in Egypt and Iraq.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"569-578"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491166","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":"Adherence to mt-sDNA testing for colorectal cancer screening among new users in a US Black population.","authors":"Mallik Greene, Shrey Gohil, Mark Camardo, A Burak Ozbay, Paul Limburg, Jerry Lovelace","doi":"10.1080/03007995.2025.2475074","DOIUrl":"10.1080/03007995.2025.2475074","url":null,"abstract":"<p><strong>Objective: </strong>Colorectal cancer (CRC) poses significant mortality risks, particularly among Black individuals, who experience the highest CRC incidence and mortality rates in the United States. This study examined adherence to multi-target stool DNA (mt-sDNA) testing in this population.</p><p><strong>Methods: </strong>This retrospective cohort analysis used Exact Sciences Laboratories (ESL)-linked claims data from January 2017 to December 2023 on Black patients in the United States aged 45 and older. High-risk individuals, those with payers other than commercial plans, managed care organizations, Medicare Advantage, Medicaid, or Medicare, and individuals with mt-sDNA prescriptions outside the study period were excluded. Adherence was defined as the percentage of patients returning the test kit with valid results within 365 days of shipment. Logistic regression analysis was used to identify factors associated with adherence.</p><p><strong>Results: </strong>Among 434,951 patients included in the study, the overall adherence to mt-sDNA testing was 62.0% (<i>N</i> = 266,981), with a mean time to adherence of 27.6 days (SD = 44.17). Females, older adults (76+ years), and non-metropolitan residents had higher adherence than males, younger adults, and metropolitan patients (all <i>p</i> < 0.001), respectively. Patients with orders from GI specialists had higher adherence than other prescribing clinicians (NP/PA: OR = 0.39, OB/GYN: OR = 0.54, Other: OR = 0.38, PCP: OR = 0.50; all <i>p</i> < 0.001). Digital outreach, especially SMS and email combination, was also associated with higher adherence (OR = 1.25, <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>This large, national study found a 62.0% adherence rate to mt-sDNA testing among Black individuals. Higher adherence was associated with being female, older age, non-metropolitan residence, and digital outreach. While the findings highlight the promise of mt-sDNA, further research is needed to explore its full potential in improving CRC screening adherence across different demographic groups.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"513-520"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540326","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":"Letter to the editor: author response for \"why fexofenadine is considered as a truly non-sedating antihistamine with no brain penetration: a systematic review\".","authors":"Ignacio J Ansotegui, Jean Bousquet, Giorgio Walter Canonica, Pascal Demoly, Rene Maximiliano Gómez, Eli O Meltzer, Margarita Murrieta-Aguttes, Robert M Naclerio, Nelson Rosario Filho, Glenis K Scadding","doi":"10.1080/03007995.2025.2488951","DOIUrl":"10.1080/03007995.2025.2488951","url":null,"abstract":"","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"457-459"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794715","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":"Safety and efficacy analysis of ciprofol combined with low-dose alfentanil in sedation of patients during transesophageal echocardiography: a randomized double-blind controlled study.","authors":"Lulu Jiang, Pianpian Yan, Shengwen Guo, Jiarong Ma, Yiting Huang, Yanqing Zhou, Liping Wu","doi":"10.1080/03007995.2025.2487102","DOIUrl":"10.1080/03007995.2025.2487102","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To evaluate the anesthetic effects and safety of ciprofol combined with low-dose alfentanil in sedation of patients during Transesophageal Echocardiography (TEE).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Subjects and methods: &lt;/strong&gt;This is a single-center, prospective, randomized, double-blind controlled clinical trial of 121 patients, aged 18-90 years, classified as ASA II-IV with a body mass index (BMI) ranging from 18-30 kg/m&lt;sup&gt;2&lt;/sup&gt; scheduled for elective outpatient transesophageal echocardiography. These patients were randomly divided into two groups: the ciprofol group and the propofol group. Each patient received a bolus injection of alfentanyl 5 ug/kg intravenously, followed by either 0.5 mg/kg ciprofol or 2 mg/kg propofol over 30 s. The Transesophageal Echocardiography procedure began when the patient's Modified Observer's Assessment of Alertness/Sedation Scale (MOAA/S) score was ≤1. Intraoperative data such as the lowest blood pressure, lowest oxygen saturation, lowest respiratory rate, occurrence of new arrhythmias, need for assisted ventilation, use of vasopressors and their doses, patient movement, venous injection pain, and cough reflex were recorded. Prior to the recruitment of participants, the study was registered on a clinical research registration website under the title \"Application of Intravenous Cipofol Combined with Low-Dose Alfentanil in Painless Transesophageal Echocardiography in Outpatient Settings,\" with the registration number ChiCTR2400081723.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The incidence of respiratory and circulatory adverse events was significantly lower in the ciprofol group than in the propofol group (30.4% vs. 66.7%, &lt;i&gt;p&lt;/i&gt; &lt; 0.001). The incidence of adverse respiratory events in the ciprofol group was significantly lower than that in the propofol group (&lt;i&gt;p&lt;/i&gt; &lt; 0.001). The incidence rates of respiratory adverse events in the two groups were 18 (32.1%) and 45 (68.2%), respectively, indicating a statistically significant difference (&lt;i&gt;p&lt;/i&gt; &lt; 0.001). The incidence rates of circulatory adverse events were 15 (26.8%) and 33 (50.0%) in the ciprofol and propofol groups, respectively, with a statistically significant difference (&lt;i&gt;p&lt;/i&gt; = 0.015). The rate of vasopressor use (&lt;i&gt;p&lt;/i&gt; = 0.035) and occurrence of systolic blood pressure &lt;90 mmHg (&lt;i&gt;p&lt;/i&gt; &lt; 0.001) were significantly lower in the ciprofol group than in the propofol group. There was no statistically significant difference in the incidence of heart rates less than 40 beats per minute or new-onset arrhythmias between the two groups. Additionally, the incidence of venous injection pain was significantly lower in the ciprofol group than in the propofol group [3 (5.4%) vs. 25 (37.9%), &lt;i&gt;p&lt;/i&gt; &lt; 0.001].&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Ciprofol combined with low-dose alfentanil demonstrated a more favorable safety profile compared to Cpropofol, with significantly reduced rates of adverse events and injection pain.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Registration","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"397-402"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751196","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":"Quantifying the economic impact of premature mortality from cirrhosis in Spain.","authors":"Josep Darbà, Meritxell Ascanio","doi":"10.1080/03007995.2025.2480187","DOIUrl":"10.1080/03007995.2025.2480187","url":null,"abstract":"<p><strong>Objectives: </strong>Excessive alcohol consumption is a major contributor to illness and mortality on a global scale. Per-capita alcohol consumption rose from 5.5 litres in 2005 to 6.4 litres in 2016 and is projected to reach 7.6 litres by 2030. In 2019, alcohol was associated with roughly a quarter of all cirrhosis-related deaths worldwide. The aim of this study is to assess the economic impact of premature mortality due to cirrhosis in Spain.</p><p><strong>Methods: </strong>To estimate the economic impact of premature mortality due to cirrhosis, we utilized the human capital method. This method involved collecting data on mortality rates, average salaries, and unemployment rates. Our objective was to quantify the financial implications of cirrhosis-related deaths, offering valuable insights for policymakers and healthcare professionals.</p><p><strong>Results: </strong>In 2022, 45% of cirrhosis deaths occurred among individuals of working age. This resulted in the loss of 20,190 years of potential life lost (YPLL), contributing to productivity losses totalling €20.4 billion over a decade. These statistics highlight the significant economic and societal burdens associated with cirrhosis mortality.</p><p><strong>Conclusions: </strong>Over the past two decades, there has been a global increase in alcohol consumption, a trend expected to persist and possibly escalate through 2030. As a direct consequence, projections indicate a corresponding increase in cirrhosis-related deaths over the coming decade. This anticipated rise underscores the ongoing public health challenge posed by alcohol-related liver diseases worldwide.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"441-446"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647605","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":"Unravelling the pandemic: impaired bone metabolism and risk of SARS-CoV-2 infection.","authors":"Emilio Pariente, Marta Martín-Millán, Daniel Nan, Daniel Martínez-Revuelta, Hector Basterrechea, Javier Pardo, Merelyn Bonome, Sandra Solares, Carmen Ramos, Jose-Manuel Olmos-Martinez, Raquel Pascua, Victor M Martínez-Taboada, José Luis Hernández","doi":"10.1080/03007995.2025.2479782","DOIUrl":"10.1080/03007995.2025.2479782","url":null,"abstract":"<p><strong>Introduction: </strong>While the impact of COVID-19 on bone metabolism has been extensively studied, the inverse relationship remains less understood. This study investigates whether impaired bone metabolism is associated with an increased risk of COVID-19 infection.</p><p><strong>Methods: </strong>We conducted a nested case-control study within a population-based cohort, incorporating Kaplan-Meier analysis (KMA) to assess time to infection (TTI) differences. Propensity score matching (1:2) was performed and validated through standardized mean differences (<0.10), variance ratio (=1), and McFadden's pseudo-<i>R</i>² (=0), ensuring balanced covariates. Bone status was evaluated using a composite index (AOMI), which included five components: P1NP and CTX (bone turnover markers), total hip bone mineral density (BMD-TH), trabecular bone score (TBS), and integral volumetric BMD (IvBMD). Inflammation and insulin resistance (IR) were assessed by albumin-to-globulin ratio (AGR <1.50) and the TG/HDL ratio (>2.50 in women and >2.80 in men), respectively.</p><p><strong>Results: </strong>We analysed 294 COVID-19 cases and 528 controls. AOMI+ individuals had a higher prevalence of COVID-19 (41.5% vs. 33.2%; <i>p</i> = 0.031), an adverse lipid pattern (\"A\" profile: high ApoB, LDL and TC) and pronounced bone changes (higher P1NP and CTX, lower BMD-TH, TBS, and IvBMD). AOMI - individuals were more likely to have metabolic syndrome, displayed a different lipid profile (\"B\" profile: elevated TG, AIP, and TG/HDL ratio), fewer bone alterations, and lower COVID-19 prevalence. TG/HDL ratio was 1.66 ± 1 in \"A\" profile, while it was 2.85 ± 1.4 in \"B\" profile individuals (<i>p</i> = 0.0001). Age acted as an effect modifier, and lowest tercile significantly increased COVID-19 risk associated with AOMI+ [Mantel-Haenszel OR = 1.42 (95%CI: 1.08-1.9); <i>p</i> = 0.022]. KMA identified AOMI+ men and individuals of both sexes in lowest age tercile, as groups with shorter TTI: These younger individuals had high CTX (women), low TBS (men), and high ApoB (both). In multivariable analyses, plasma CTX levels negatively correlated with TTI (adjusted β= -0.325; <i>p</i> = 0.0001). AOMI+ status was associated with increased COVID-19 risk after controlling for confounders, including IR (adjusted OR = 1.51; 95%CI: 1.04-2.10; <i>p</i> = 0.027), although this association weakened when adjusting for AGR (95%CI: 0.99-2.28; <i>p</i> = 0.055). ANCOVA-estimated adjusted TBS means were lower in COVID-19 cases compared to controls (1.259 vs. 1.294; <i>p</i> = 0.013).</p><p><strong>Conclusions: </strong>Impaired bone metabolism was found to be associated with increased COVID-19 risk, in a relationship potentially mediated by underlying inflammation. Elevated osteoclastic activity and a defined lipid profile with high ApoB, TC, LDL levels, played a crucial role in the results. Bone quality parameters more accurately captured COVID-19-related bone changes than BMD.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"473-485"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647606","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 public involvement and engagement in real world data and evidence research across the medicines development cycle: a rapid review of peer-reviewed literature and NICE technology appraisals.","authors":"Sally-Anne Dews, Arisa Oluwatomi, Alex Inskip, Opeyemi Agbeleye, Sarah Markham, Peter Latchford, Natalie Bohm, Polly Westergaard, Rebecca Butfield, Alexia Campbell-Burton, Nick Meader, Akvile Stoniute","doi":"10.1080/03007995.2025.2482668","DOIUrl":"10.1080/03007995.2025.2482668","url":null,"abstract":"<p><strong>Objectives: </strong>The objective of this rapid review is to understand the reporting, role and quality of patient and public involvement and engagement (PPIE) in real world data and evidence (RWDE) research across the medicines development cycle.</p><p><strong>Methods: </strong>We comprehensively searched, with no date restrictions, Medline and Embase databases for peer-reviewed literature and conference abstracts (Embase only) reporting PPIE in RWD studies. We also assessed PPIE in a sample of 100 NICE technology appraisals (TAs) comprising both single technology appraisals (STAs) and highly specialized technologies (HSTs). We used standard methods for screening and data extraction. In addition, we used the Patient Focused Medicines Development (PFMD)'s Patient Engagement Quality Guidance (PEQG) as a framework to assess the quality of PPIE. We planned to conduct narrative synthesis of included studies, however there were insufficient studies and data reported.</p><p><strong>Results: </strong>We included three RWD studies that reported PPIE from the peer-reviewed literature and two NICE HSTs. One of the HSTs included data from one of the peer-reviewed journal articles. Reporting of PPIE in included studies was limited. No studies reported a PPIE framework and it was unclear how integrated and meaningful PPIE was. Four out of seven of PFMD's quality criteria for PPIE were poorly reported by included studies. This suggests reporting and/or conduct of PPIE requires improvement in RWD studies.</p><p><strong>Conclusions: </strong>Our review found that PPIE was rarely reported in RWDE research and uncovers a need for consistent reporting. For most publications there was insufficient information to judge the extent to which patients and carers, were considered meaningful partners. However, our review provided preliminary evidence that PPIE can influence protocol development, recruitment, and retention methods in RWD studies. More inclusive approaches to PPIE would help interpretation of RWE regarding relevance and importance to patients and carers.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"521-533"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691474","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":"Real-world prevalence of potential drug-drug interactions associated with oral advanced therapies indicated for ulcerative colitis.","authors":"Maryia Zhdanava, Sabree Burbage, Todor I Totev, Sumesh Kachroo, Lilian Diaz, Bridget Godwin, Patrick Lefebvre, Dominic Pilon","doi":"10.1080/03007995.2025.2465649","DOIUrl":"10.1080/03007995.2025.2465649","url":null,"abstract":"<p><strong>Objective: </strong>To describe potential drug-drug interactions (DDIs) with oral advanced therapies among patients with ulcerative colitis (UC) and characterize clinical assessments before ozanimod initiation.</p><p><strong>Methods: </strong>Adults with UC were selected from the Merative MarketScan Commercial Database (01 January 2018-31 January 2023); the index date was the most recent UC diagnosis. Patients had no other immune conditions in the 12-month baseline period before the index date. Those with moderate-to-severe UC were analyzed separately. Potential baseline DDIs were identified as claims for medications that may cause a moderate/severe DDI with Janus kinase (JAK) inhibitors (tofacitinib/upadacitinib) or ozanimod according to the Merative Micromedex Complete Drug Interactions Tool. Clinical assessments before ozanimod initiation were characterized.</p><p><strong>Results: </strong>Of 58,870 patients with UC, 24,654 (41.9%) had moderate-to-severe UC. All potential DDIs with ozanimod were severe, while JAK inhibitors had moderate and severe potential DDIs. Among patients with UC, mean (standard deviation) number of severe DDIs was 2.0 (2.4) for ozanimod and 0.2 (0.5) for JAK inhibitors; in moderate-to-severe UC, it was 2.3 (2.6) for ozanimod and 0.4 (0.6) for JAK inhibitors. The most common potential DDIs for ozanimod in UC and moderate-to-severe UC were ondansetron (18.6% and 22.7%), azithromycin (11.9% and 12.8%), as well as hydrocodone, fentanyl, albuterol, ciprofloxacin, and metronidazole (9.0%-11.0% each). For JAK inhibitors, these were COVID-19 vaccines (30.7% and 31.4%), infliximab (8.5% and 20.2%), fluconazole (6.1% and 6.8%), and azathioprine (5.5% and 13.0%). Among patients initiating ozanimod, the first claim for a required clinical assessment was on average, 8 months before initiation.</p><p><strong>Conclusion: </strong>Comorbidities and polypharmacy among patients with UC pose a high risk of DDIs for oral advanced therapies and required pre-treatment clinical assessments can be complicated. This justifies a thorough review of patient profiles for prescribers considering novel treatment options.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"329-338"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406119","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":"Improving the management of Polycythemia Vera patients eligible for cytoreduction: report of a multidisciplinary advisory board.","authors":"Francesco Ramundo, Elena Rossi, Ketty Peris, Alfredo Pontecorvi, Gabriele Sani, Silvia Betti, Marco Marietta, Valerio De Stefano","doi":"10.1080/03007995.2025.2458531","DOIUrl":"10.1080/03007995.2025.2458531","url":null,"abstract":"<p><strong>Introduction: </strong>The management of patients with Polycythemia Vera (PV) traditionally includes low-dose aspirin, phlebotomy, and cytoreductive therapy for high-risk individuals. Recent evidence suggests that cytoreductive treatment may be warranted for patients with additional risk factors beyond the traditional criteria of a history of thrombosis and age over 60 years. Introducing new therapeutic agents, including ropeginterferon alfa-2b and ruxolitinib, enables a more personalized treatment approach tailored to individual patient characteristics.</p><p><strong>Case report: </strong>This report presents three complex clinical scenarios involving patients with PV who required cytoreductive therapy, which were discussed by a multidisciplinary advisory board. Each case is accompanied by a concise literature review and recommendations from non-hematologist specialists on managing adverse events associated with cytoreductive treatment. A multidisciplinary expert panel has identified three conceptual pathways to guide clinicians in selecting cytoreductive therapies and managing their associated complications.</p><p><strong>Conclusion: </strong>The advent of new criteria for starting cytoreduction and the approval of novel drugs for PV has increased the complexity of selecting appropriate cytoreductive therapies. A multidisciplinary approach is increasingly essential to ensure personalized care that maximizes tolerability and minimizes adverse events, particularly given the often chronic nature of the treatment.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"239-245"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063887","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":"Methodological challenges and clinical perspectives in evaluating new treatments for ultra rare cancers.","authors":"Stefania Bellino, Anna La Salvia","doi":"10.1080/03007995.2025.2470735","DOIUrl":"10.1080/03007995.2025.2470735","url":null,"abstract":"<p><p>Patients with ultra rare cancers have a high unmet medical need for the development of safe and effective treatments. To advance cancer drug development is often considered economically unattractive, and usually infeasible with the use of traditional paradigms. Compounding the challenges, evolving scientific understanding of the molecular biology of cancers has resulted in further subdivision of rare cancers into small molecularly defined subsets that may be eligible for targeted therapies. Indeed, research in oncology has undergone an evolution due to advances in biomarker discovery and drug target innovation moving towards a more personalized medicine and effective approach to cancer treatment. These therapies have shown remarkable efficacy with better disease management and brought a higher quality of life for cancer patients. Given the rarity of the diseases, standard randomized controlled trials may not be feasible, and innovative study designs and statistical methods should be applied to evaluate new treatments. To this aim, regulatory agencies have developed guidelines to introduce flexibility in planning of clinical trials, including new adaptive designs, use of real-world data, and surrogate endpoints. This commentary aims at reporting challenges on the evaluation of new treatments for ultra rare cancers with a focus on innovative trial designs, statistical methods, and managing of patients as these cancers are often poorly understood, have limited clinical data, and may require specialized treatment approaches.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"369-373"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467103","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}