Paolo Lido, Luca Di Lullo, Marco Infante, Camillo Ricordi, Stefano Rezk, Daniele Romanello, Gabriele D'Urso, Maria Josè Ceravolo, David Della-Morte, Manfredi Tesauro, Annalisa Noce
{"title":"Choosing the right calcium channel blocker for patients with hypertension and proteinuric chronic kidney disease.","authors":"Paolo Lido, Luca Di Lullo, Marco Infante, Camillo Ricordi, Stefano Rezk, Daniele Romanello, Gabriele D'Urso, Maria Josè Ceravolo, David Della-Morte, Manfredi Tesauro, Annalisa Noce","doi":"10.1080/03007995.2025.2544594","DOIUrl":"10.1080/03007995.2025.2544594","url":null,"abstract":"<p><p>Arterial hypertension and diabetes mellitus represent major modifiable risk factors for the occurrence of cardiovascular disease, development of chronic kidney disease (CKD) and progression of CKD to end-stage renal disease (ESRD). In view of the rising burden of hypertension, diabetes mellitus and CKD on a global scale, there is currently a great need for drugs that can effectively prevent the onset and reverse or slow down the progression of CKD in diverse patient populations. Over the last decades, a growing body of evidence has demonstrated that calcium channel blockers (CCBs) can exert cardioprotective and nephroprotective actions. In the present narrative review, we aimed to specifically describe the cardiorenal protective effects of dihydropyridine CCBs (particularly lercanidipine and manidipine, based on the available evidence) and non-dihydropyridine CCBs (verapamil and diltiazem). With regard to this research topic, we also reviewed the 2023 European Society of Hypertension (ESH) Guidelines for the management of arterial hypertension [endorsed by the International Society of Hypertension (ISH) and the European Renal Association (ERA)] and the 2023 European Society of Cardiology (ESC) Guidelines for the management of cardiomyopathies. Finally, we proposed practical criteria for prescribing the most appropriate CCB (among dihydropyridine CCBs and non-dihydropyridine CCBs) for patients with hypertension and proteinuric CKD (with or without diabetes) in different clinical settings.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1333-1351"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144788480","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}
Yiqiao Zhang, Zhenxiang Zhao, Sonia Kim, Anthony N Fabricatore, Prashanth Iyer
{"title":"The epidemiology, clinical characteristics, and burden of heart failure with or without obesity in US patients.","authors":"Yiqiao Zhang, Zhenxiang Zhao, Sonia Kim, Anthony N Fabricatore, Prashanth Iyer","doi":"10.1080/03007995.2025.2535464","DOIUrl":"10.1080/03007995.2025.2535464","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the prevalence of heart failure (HF), including HF with preserved ejection fraction (HFpEF) and HF with reduced ejection fraction (HFrEF), among patients with obesity, and the prevalence of obesity in patients with these HF subgroups between 2019 and 2023. Additionally, it sought to describe the clinical burden, comorbidities, and medication used across five distinct patient subgroups.</p><p><strong>Methods: </strong>A non-interventional retrospective study using Komodo Healthcare Map data was conducted. Patients were categorized into five subgroups: HFpEF with obesity, HFpEF without obesity, HFrEF with obesity, HFrEF without obesity, and obesity without HF. Annual and overall prevalence rates were calculated, and clinical characteristics, comorbidities, and concomitant medication use were analyzed across subgroups.</p><p><strong>Results: </strong>A total of 44,574,028 patients were included in the study. HF prevalence in obesity was 852.84 per 10,000. Obesity prevalence among HF patients was 6872.29 per 10,000, with a particularly high rate among those with HFpEF. Patients with obesity and HF were younger and had elevated rates of hypertension, dyslipidemia, type 2 diabetes, obstructive sleep apnea, and chronic kidney disease. Compared to HF patients without obesity, those with obesity had significantly greater use of antihypertensives, lipid-lowering agents, and antidiabetics. Adjusted analyses showed significantly higher odds of multiple comorbidities and medication use in patients with obesity and HF compared to non-obese or non-HF subgroups.</p><p><strong>Conclusion: </strong>Obesity is common in HF, especially HFpEF, and associated with greater clinical and medication burdens, underscoring the need for targeted strategies to manage both conditions and reduce associated complications.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1149-1163"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658642","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}
Sami Bahçebaşı, Banu Açmaz, Erdem Aydın, İfakat İrem Biçer, Şeyma Yıldız
{"title":"Sex-specific clinical and inflammatory predictors of insulin resistance in individuals living with obesity: a retrospective analysis of 1,457 adults.","authors":"Sami Bahçebaşı, Banu Açmaz, Erdem Aydın, İfakat İrem Biçer, Şeyma Yıldız","doi":"10.1080/03007995.2025.2545489","DOIUrl":"10.1080/03007995.2025.2545489","url":null,"abstract":"<p><strong>Background: </strong>Insulin resistance (IR) is a key metabolic abnormality associated with obesity and can precede type 2 diabetes. Although HOMA-IR is commonly used, simpler clinical markers are needed to identify IR, especially in resource-limited settings. This study aimed to evaluate the predictive value of anthropometric, biochemical, and hematological inflammation markers for insulin resistance in people living with obesity.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 1,457 adults, categorized into five groups based on BMI, HOMA-IR, and HbA1c levels: healthy controls, people living with obesity without insulin resistance, people living with obesity with insulin resistance, people living with obesity with prediabetes, and people living with obesity with diabetes.</p><p><p>To eliminate the confounding effect of BMI, subgroup analyses were performed based on obesity class (stage 1: BMI 30-35, stage 2: 35-40, stage 3: ≥40).</p><p><strong>Results: </strong>BMI, waist circumference/height ratio (WC/Ht), and fasting glucose levels were significantly higher in the people living with obesity with insulin resistance group compared to the non-IR group (<i>p</i> < 0.001). In women, additional markers-including waist circumference, triglycerides, HDL, TG/HDL ratio, ALT, CRP, WBC, systemic inflammatory response index (SIRI), and monocyte/HDL ratio (MHR)-showed significant predictive value for IR. In men, no significant differences were observed in these inflammatory or lipid-related markers across obesity subgroups.</p><p><strong>Conclusion: </strong>BMI, WC/Ht ratio, and glucose levels are useful predictors of insulin resistance in both sexes. In women living with obesity, specific biochemical and inflammatory markers such as TG/HDL, and WBC enhance predictive accuracy.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1197-1206"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144788481","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}
Wiaam Al Hasani, Christopher N Floyd, Cheryl Walsh, Shu C Michael Yau, Soundrie T Padayachee, Zofia McMahon, Radha Ramachandran, Martin A Crook, Anthony S Wierzbicki
{"title":"Diagnostic accuracy of cardiovascular and imaging biomarkers to identify index patients with familial hypercholesterolaemia.","authors":"Wiaam Al Hasani, Christopher N Floyd, Cheryl Walsh, Shu C Michael Yau, Soundrie T Padayachee, Zofia McMahon, Radha Ramachandran, Martin A Crook, Anthony S Wierzbicki","doi":"10.1080/03007995.2025.2536607","DOIUrl":"10.1080/03007995.2025.2536607","url":null,"abstract":"<p><strong>Objective: </strong>To determine the utility of secondary stratification measures in ascertainment of index cases for monogenic familial hypercholesterolaemia (FH).</p><p><strong>Methods: </strong>Referrals from primary care were screened by methods for the potential diagnosis of FH, including Simon Broome (SB) or Dutch Lipid Clinic Network score (DLCN) criteria, initial LDL-C, lipoprotein (a) (Lp(a)) > 125 nM, troponin-T (hsTnT), imaging using carotid intima-media thickness and plaque assessment and a single nucleotide polymorphism (SNP) polygenic hypercholesterolaemia panel (12 loci).</p><p><strong>Results: </strong>The population comprised 793 patients aged 55 ± 17 years, of whom 3% had tendon xanthomata, 7% coronary artery disease, and with pre-treatment LDL-C 5.84 ± 1.47 mmol/L. Genotyping was performed in 793 patients and 36% had monogenic FH. Dutch lipid score assessment was associated with a positive likelihood ratio (PLR) for FH 3.91 with a net reclassification index (NRI) of 8% while addition of negative modification for triglycerides (Welsh lipid score) had a PLR 6.88 (NRI 30%). In the whole cohort, the SNP12 score had a negative LR (NLR) of 1.32 (NRI -16%) above the 75<sup>th</sup> centile while Lp(a) > 125nmol/L had a NLR of 1.18 (NRI -29%) and raised hsTnT a PLR of 1.08 (NRI -16%). In a non-pre-stratified primary care cohort (<i>n</i> = 236), imaging had a PLR 1.70 (NRI 14%) for identifying patients with FH.</p><p><strong>Conclusions: </strong>A clinical algorithm based on Welsh Lipid score criteria modifying DLCN score for triglycerides allied with stratification for the presence of tendon xanthomata, highly elevated LDL-C (>7 mmol/L) or positive imaging provides an efficient system to raise the yield of diagnosis of FH with a low chance of missing cases.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1173-1183"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667376","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}
Michael Pollack, Joseph Tkacz, Jill Schinkel, Barnabie Agatep, Edward Portillo, Hayley D Germack, Michael G Crooks, Charlie Strange, Jonathan Marshall, Hana Mullerova
{"title":"Prompt initiation of single-inhaler budesonide/glycopyrrolate/formoterol fumarate (BGF) following a COPD exacerbation reduces exacerbations and cardiopulmonary risk in patients with COPD: insights from the MITOS EROS+CP study in the United States.","authors":"Michael Pollack, Joseph Tkacz, Jill Schinkel, Barnabie Agatep, Edward Portillo, Hayley D Germack, Michael G Crooks, Charlie Strange, Jonathan Marshall, Hana Mullerova","doi":"10.1080/03007995.2025.2545493","DOIUrl":"10.1080/03007995.2025.2545493","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the association between the timing of single-inhaler triple therapy Budesonide/Glycopyrrolate/Formoterol Fumarate (BGF) initiation following a COPD exacerbation and subsequent COPD exacerbations and non-fatal cardiopulmonary events.</p><p><strong>Methods: </strong>This was a retrospective analysis of the Inovalon MORE<sup>2</sup> Registry and Medicare Fee-for-Service claims databases spanning July 1, 2019 to May 31, 2023. Eligible patients with COPD were aged ≥40 years, and initiated BGF treatment within 1-year of a qualifying COPD exacerbation (index event) with 12 months of baseline enrollment. Secondary study populations included patients escalating from dual therapy and patients with comorbid asthma. Negative binomial regressions were used to evaluate the adjusted risks for subsequent annualized exacerbations and cardiopulmonary events based on the timing of BGF initiation: prompt (≤30 days), delayed (31-180 days), and very delayed (181-365 days).</p><p><strong>Results: </strong>Among 25,603 patients included, 14.8% were prompt, 37.7% delayed, and 47.5% very delayed initiators. Mean age was 60.3 years and 64.3% were female. Among the 10,630 cardiopulmonary events observed, 63% were cardiovascular-related. During follow-up, prompt initiators had 25.7% (adjIR<sub>D</sub>: 0.74 [0.72-0.77]) and 30.6% (adjIR<sub>VD</sub>: 0.69 [0.67-0.72]) lower risk of subsequent annualized exacerbations compared to delayed and very delayed initiators, respectively. Additionally, prompt initiators had 16.3% (adjIR<sub>D</sub>: 0.84 [0.77-0.91]) and 17.5% (adjIR<sub>VD</sub>: 0.83 [0.77-0.89]) lower risk of cardiopulmonary events, respectively. Similar results were observed for patients escalating from dual therapy and those with asthma.</p><p><strong>Conclusions: </strong>Prompt initiation of BGF following a COPD exacerbation, including among patients previously managed with dual therapy, was associated with lower annualized rates of cardiopulmonary and exacerbation events.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1373-1384"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816035","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":"Serum uric acid to HDL-cholesterol ratio: a novel indicator for metabolic syndrome risk in children.","authors":"Meyri Arzu Yoldaş, Semih Bolu","doi":"10.1080/03007995.2025.2546949","DOIUrl":"10.1080/03007995.2025.2546949","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this cross-sectional study was to examine the association between the serum uric acid to high-density lipoprotein cholesterol ratio (UHR) and metabolic syndrome (MetS) in pediatric populations, as well as its potential role in predicting the diagnosis of MetS in children and adolescents.</p><p><strong>Methods: </strong>This is a cross-sectional study included 323 overweight and obese children and adolescents (116 males, 207 females) aged 8 to 17 years who were referred to the Pediatric Endocrinology Clinic. Participants were grouped based on the presence or absence of MetS. Demographic data, anthropometric measurements, blood pressure readings, and blood biochemical parameters, including serum uric acid and UHR, were recorded and analyzed.</p><p><strong>Results: </strong>Significantly higher levels of fasting blood glucose, triglycerides, systolic and diastolic blood pressure, hypertension, serum uric acid (SUA), and UHR were observed in participants with MetS compared to those without MetS. In contrast, high-density lipoprotein cholesterol(HDL-C) levels were significantly lower in children with MetS. Furthermore, each one-unit increase in the UHR was associated with a 6.19-fold higher likelihood of MetS diagnosis. It also showed high diagnostic accuracy for metabolic syndrome (AUC = 0.883).</p><p><strong>Conclusions: </strong>These findings suggest that the UHR is a simple, reliable, and innovative marker for early detection and risk stratification of MetS in children. It may serve as an effective screening tool for identifying at-risk children, thereby facilitating early intervention and management of MetS.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1239-1247"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144834440","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}
Christoph Wanner, Nathalia Duarte, Vikram Thanam, Egon Pfarr
{"title":"Safety of empagliflozin treatment in four clinical studies: a plain language summary.","authors":"Christoph Wanner, Nathalia Duarte, Vikram Thanam, Egon Pfarr","doi":"10.1080/03007995.2025.2547905","DOIUrl":"10.1080/03007995.2025.2547905","url":null,"abstract":"","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":"41 7","pages":"1207-1217"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945579","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}
Fatima I Auwal, Elizabeth J Clark, Caroline S Copeland, Graham R McClelland
{"title":"From insight to impact: a qualitative study on pharmaceutical industry professionals' perceptions of the value of patient engagement.","authors":"Fatima I Auwal, Elizabeth J Clark, Caroline S Copeland, Graham R McClelland","doi":"10.1080/03007995.2025.2537888","DOIUrl":"10.1080/03007995.2025.2537888","url":null,"abstract":"<p><strong>Introduction: </strong>Patient engagement (PE) is increasingly recognised as a critical component of clinical research and pharmaceutical development. However, its implementation remains inconsistent, and evidence of its impact limited.</p><p><strong>Objectives: </strong>This study explored pharmaceutical professionals' perspectives on the value, challenges, and facilitators of PE in medicine development.</p><p><strong>Methods: </strong>Twenty-eight industry professionals from Europe and North America were interviewed online (November 2023-May 2024). Data were analysed using inductive reflexive thematic analysis.</p><p><strong>Results: </strong>The result showed that while PE is acknowledged for its potential in enhancing trial design, patient recruitment and retention, enhancing data quality, regulatory success and market access - the evidence demonstrating its impact in these areas are still limited. Key challenges highlighted were the lack of standardised ways for assessing PE's value, limited access to patient organisations in some regions, and disparities in regulatory requirements that complicate global adoption. Additionally, practical barriers - such as time, resource constraints, and cultural differences, hinder the implementation of consistent and meaningful engagement practices. The study also identified a number of potential enablers for creating systematic and consistent PE: the use of digital tools, cost-effective engagement methods, culturally sensitive communication approaches, partnerships with patient advocacy groups and the establishment of PE as a recognised scientific discipline.</p><p><strong>Conclusion: </strong>This research emphasised the need for robust methodologies and standardized PE practices to demonstrate return on engagement and its contribution to successful development of innovative medicines.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1261-1275"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697839","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}
Nemencio Nicodemus, Virgilio Novero, Wiryawan Permadi, Ketut Suastika, Alexander Tan Tong Boon, Chaicharn Deerochanawong, Kerstin Brand, Maria Christina Hanindita, Alina Markova
{"title":"Metformin in the treatment of hyperglycemia during pregnancy and periconception: guideline-informed expert recommendations from seven countries/states in the Asia-Pacific region.","authors":"Nemencio Nicodemus, Virgilio Novero, Wiryawan Permadi, Ketut Suastika, Alexander Tan Tong Boon, Chaicharn Deerochanawong, Kerstin Brand, Maria Christina Hanindita, Alina Markova","doi":"10.1080/03007995.2025.2496430","DOIUrl":"10.1080/03007995.2025.2496430","url":null,"abstract":"<p><p>Hyperglycemia in pregnancy (HIP) poses significant risks to maternal and fetal health yet remains underreported, particularly in the Asia-Pacific region. This public health challenge includes gestational diabetes mellitus, pre-existing diabetes, and diabetes diagnosed during pregnancy, with regional prevalence rates as high as 28%. Left untreated, HIP can lead to adverse maternal outcomes such as preeclampsia and excessive gestational weight gain, as well as neonatal complications, including macrosomia and neonatal hypoglycemia. International and regional guidelines emphasize early detection and tailored interventions when addressing unmet medical needs in HIP management. Screening protocols vary, with a one-step oral glucose tolerance test increasingly favored for its diagnostic accuracy. Metformin, recognized for its favorable safety profile, efficacy, and cost-effectiveness, has emerged as a preferred first-line treatment alongside lifestyle modifications. Recent updates to metformin's regulatory labeling highlight its safe use during pregnancy, with evidence demonstrating benefits such as reduced maternal weight gain and neonatal complications. This expert recommendation from the Asia-Pacific region focus on the use of metformin during pregnancy and the periconceptional period. Recommendations advocate for routine screening, optimal glycemic control, and structured postpartum care to mitigate HIP's long-term health impacts. Integrating metformin into management strategies enhances patient satisfaction, accessibility, and overall outcomes, offering a practical solution to improve maternal and neonatal health in diverse healthcare settings.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1185-1196"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144741469","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}