Current Therapeutic Research-clinical and Experimental最新文献

{"title":"Tarlatamab and the Future of Immunotherapy: A New Approach to Small Cell Lung Cancer","authors":"Raza Ur Rehman MBBS, Ahmad Furqan Anjum MBBS, Rida Fatima MBBS","doi":"10.1016/j.curtheres.2024.100773","DOIUrl":"10.1016/j.curtheres.2024.100773","url":null,"abstract":"","PeriodicalId":10920,"journal":{"name":"Current Therapeutic Research-clinical and Experimental","volume":"102 ","pages":"Article 100773"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11772990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058343","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":"A Randomized, Prospective and Crossover Study, Comparing the Eradication Rate After 10 Days of Concomitant Therapy to Bismuth Quadruple Therapy Among a Sample of the Lebanese Population","authors":"Jad Chidiac MD ,&nbsp;Reine-Marie Kahwaji MD ,&nbsp;Souheil Hallit PharmD, MSc, MPH, PhD ,&nbsp;Yara Yazbeck MD ,&nbsp;Bassem Akiki MD ,&nbsp;Charbel Yazbeck MD","doi":"10.1016/j.curtheres.2025.100791","DOIUrl":"10.1016/j.curtheres.2025.100791","url":null,"abstract":"<div><h3>Background</h3><div>Concomitant therapy and bismuth quadruple therapy are both recommended as first-line treatment regimens for the empiric treatment of <em>Helicobacter pylori</em> infection, especially after the increased resistance to clarithromycin.</div></div><div><h3>Objective</h3><div>Our goal was to compare both treatment regimens among a sample of the Lebanese population to eventually conclude whether one of these therapies has a higher efficacy than the other one as a first- and second-line treatment regimens.</div></div><div><h3>Methods</h3><div>It is a randomized, prospective, and crossover study, started from March 2016 to December 2018. Participants were randomly chosen patients diagnosed with active <em>H pylori</em> through histology. Two groups were then formed randomly and equally: patients in the first group received 10 days of concomitant therapy, whereas patients in the second group received 10 days of bismuth quadruple therapy. Eradication was evaluated by the ¹⁴C urea breath test done 6 weeks after the end of antibiotic use. A negative breath test indicated a successful eradication. All patients with a positive breath test were then given the other treatment regimen for another 10 days and then re-evaluated for eradication in the same manner.</div></div><div><h3>Results</h3><div>Both regimens demonstrated similar efficacy as first-line therapies for <em>H pylori</em> eradication. Among 175 patients receiving concomitant therapy, 160 (91.4%) achieved eradication, whereas in the 174 patients treated with bismuth quadruple therapy, 164 (94.2%) were successfully eradicated (<em>P</em> = 0.306). Among patients requiring second-line treatment, 14 of 15 (93.3%) who failed concomitant therapy were successfully treated with bismuth quadruple therapy, whereas all 10 patients (100%) who failed bismuth therapy achieved eradication with concomitant therapy (<em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Bismuth quadruple therapy and concomitant therapy are both equally effective first-line treatment regimens for the eradication of <em>H pylori</em>. They are also effective if used as second-line treatment regimens for this purpose. Lebanese Clinical Trials Registry identifier: LBCTR2024095653.</div></div>","PeriodicalId":10920,"journal":{"name":"Current Therapeutic Research-clinical and Experimental","volume":"102 ","pages":"Article 100791"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144124624","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":"Determination of the Accuracy of Thyromental Height Test for Predicting Difficult Laryngoscopy in Obstetric Patients Who Are Candidates for Cesarean Section: An Observational Study","authors":"Saghar Samimi Sadeh MD ,&nbsp;Babak Moayer MD ,&nbsp;Masoomeh Natajmajd MD ,&nbsp;Parisa Kianpour PharmD ,&nbsp;Kousha Farhadi MD ,&nbsp;Mahgol Etezadi PharmD ,&nbsp;Mojgan Rahimi MD ,&nbsp;Farhad Etezadi MD","doi":"10.1016/j.curtheres.2025.100784","DOIUrl":"10.1016/j.curtheres.2025.100784","url":null,"abstract":"<div><h3>Background</h3><div>Pregnant women frequently have face and upper airway edema, which makes managing the airways during anesthesia difficult and increases the risk of mask breathing complications and intubation failure. This necessitates an investigation into the sensitivity of various airway tests in predicting difficult intubation.</div></div><div><h3>Objective</h3><div>To assess the accuracy of the thyromental height test (TMHT) in predicting difficult laryngoscopy in obstetric patients undergoing cesarean section and to compare its effectiveness with other airway assessment methods.</div></div><div><h3>Methods</h3><div>We included a cohort of obstetric patients, approved by the Ethics Committee of Tehran University of Medical Sciences, scheduled for elective cesarean sections. During laryngoscopy, preoperative evaluations of the airway were done. The primary aim was to determine the relationship between TMHT (the distance between mentum and the thyroid cartilage) and the Cormack-Lehane (which categories laryngoscopy view from fully observable vocal cords to nonvisible epiglottis) classification, which indicates the level of difficulty in laryngoscopy.</div></div><div><h3>Results</h3><div>After eligibility assessment, 156 patients entered the study, of which 16 had Cormack-Lehane grades III and IV and were considered difficult laryngoscopy. The TMHT demonstrated a higher Matthews correlation coefficient (0.695), sensitivity (0.75), and specificity (0.96) compared with other tests, suggesting that TMHT has the potential to serve as a dependable predictor of challenging laryngoscopy.</div></div><div><h3>Conclusions</h3><div>The use of TMHT can improve patient outcomes and the preoperative evaluation process, making it a valuable tool for anesthesiologists managing obstetric patients. The TMHT could be considered a complementary tool to existing airway assessment methods, particularly in obstetric patients, due to its high predictive accuracy and ease of use.</div><div>This study is registered at Iranian Registry of Clinical Trial (IRCT) under identifier code of IR.TUMS.SINAHOSPITAL.REC.1399.061.</div></div>","PeriodicalId":10920,"journal":{"name":"Current Therapeutic Research-clinical and Experimental","volume":"102 ","pages":"Article 100784"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143821267","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":"Ethnomedicine Knowledge Among Iranian Patients With Gastrointestinal And Liver Disorders: A Cross-Sectional Study","authors":"Fatemeh Sadat Hasheminasab MD,Ph.D ,&nbsp;Yasaman Zamanian MD ,&nbsp;Saiedeh Haji-Maghsoudi Ph.D ,&nbsp;Alireza Bakhshipour MD ,&nbsp;Maryam Azimi MD,Ph.D","doi":"10.1016/j.curtheres.2024.100774","DOIUrl":"10.1016/j.curtheres.2024.100774","url":null,"abstract":"<div><h3>Introduction</h3><div>The role of complementary and alternative medicine (CAM) in healthcare is substantial and frequently overlooked, with widespread use in both developed and developing countries. This study aimed to explore the ethnomedicinal knowledge including prevalence, socio-demographic, and health related characteristics related to gastroenterology and hepatology disorders in Kerman province.</div></div><div><h3>Materials and methods</h3><div>This study included 400 eligible patients attending gastroenterology and hepatology outpatient clinic. Data collection was conducted using various assessment tools, that is, a self-administered demographic and ethnomedicine questionnaire, and quality of life questionnaire.</div></div><div><h3>Results</h3><div>The findings of the present study revealed that 40.3% of the patients surveyed commonly used CAM. Among the participants, 63.4% did not alter their medication intake while using CAM, and 85.7% were satisfied with its effectiveness. The majority of consumers relied on friends and family, making up 41.6% of the sources of information on CAM, with only 14.9% disclosing their CAM usage to physicians. Furthermore, CAM users have a significantly higher level of education, with the physical functioning being a key aspect of QOL.</div></div><div><h3>Conclusion</h3><div>Although the results of this study may not be broadly generalizable, specific points in the findings are still significant. The utilization of CAM treating for gastrointestinal and liver issues is becoming more prevalent among patients in the area. It is essential to educate patients about the real effects of CAM in disease prevention and treatment, particularly considering patient concerns about side effects, and untrustworthy information sources.</div></div>","PeriodicalId":10920,"journal":{"name":"Current Therapeutic Research-clinical and Experimental","volume":"102 ","pages":"Article 100774"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143142208","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":"Real-World Utilization Patterns, Safety, and Efficacy of Tafamidis in Patients With Hereditary Transthyretin Amyloidosis in Japan","authors":"Hiroaki Konishi PharmD ,&nbsp;Hajime Abe MD, PhD ,&nbsp;Noriko Matsumoto ,&nbsp;Yutaka Endo ,&nbsp;Yoshiki Sekijima MD, PhD ,&nbsp;Mitsuharu Ueda MD, PhD ,&nbsp;Yukio Ando MD, PhD","doi":"10.1016/j.curtheres.2025.100793","DOIUrl":"10.1016/j.curtheres.2025.100793","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;div&gt;Patients with hereditary transthyretin (ATTRv) amyloidosis experience progressive degeneration of the somatic and peripheral nervous system that can impair ambulation, autonomy, and quality of life (QOL). Tafamidis meglumine (tafamidis) is the first pharmacotherapy approved to slow the progression of peripheral neurological impairment in ATTRv amyloidosis and was well tolerated and efficacious in clinical trials; however, longer-term safety in Japanese patients with ATTRv amyloidosis has not been fully elucidated. Consequently, the present study was conducted to understand the safety and efficacy of long-term use (up to 156 weeks) of tafamidis meglumine under postmarketing conditions in Japan.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This single-arm observational study (conducted from November 2013 to May 2021) included all patients prescribed tafamidis (20 mg/day) for the treatment of ATTRv amyloidosis in routine clinical practice. The observation period was 156 weeks (3 years) following tafamidis initiation (78 weeks [1.5 years] for patients who initiated treatment after May 2018). The outcomes of interest were clinical characteristics of patients, tafamidis utilization patterns, adverse drug reactions (ADRs), serious ADRs (safety analysis set), and efficacy (Neuropathy Impairment Score–Lower Limbs [NIS-LL] score, total QOL [TQOL] score, modified body mass index [mBMI], and ambulatory status; efficacy analysis set).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;A total of 400 and 397 patients were included in the safety and efficacy analysis sets, respectively. The mean ± standard deviation (SD) age was 61.5 ± 15.0 years, 65.5% were male, 57.3% were aged ≥50 years at disease onset, 71.0% were from nonendemic areas, and 10.3% had Karnofsky Performance Status 40 to 10. A total of 212 (53.0%) patients were treated with tafamidis for &gt;156 weeks (mean ± SD treatment duration: 120.8 ± 56.4 weeks) and 145 (36.3%) patients discontinued the study, with the reasons for discontinuation (duplicate) being adverse events (&lt;em&gt;n&lt;/em&gt; = 46), hospital transfer (&lt;em&gt;n&lt;/em&gt; = 33), loss to follow-up (&lt;em&gt;n&lt;/em&gt; = 15), insufficient clinical response (&lt;em&gt;n&lt;/em&gt; = 9), and others (&lt;em&gt;n&lt;/em&gt; = 62). ADRs and serious ADRs were reported in 58 (14.5%) and 12 (3.0%) patients, respectively. In the efficacy analysis set, NIS-LL score, TQOL score, mBMI, and ambulatory status after 156 weeks of treatment were comparable to those reported prior to tafamidis initiation.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Implications&lt;/h3&gt;&lt;div&gt;The findings of this study indicate that late-onset cases of ATTRv amyloidosis and those that originate from nonendemic areas may be more prevalent in Japan than historically believed. The safety profile of tafamidis was largely consistent with that obtained from previous research, and no new safety concerns were identified. The efficacy of tafamidis was also demonstrated in the real-world clinical setting.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Clinical trial registration","PeriodicalId":10920,"journal":{"name":"Current Therapeutic Research-clinical and Experimental","volume":"102 ","pages":"Article 100793"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144116671","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":"Exploring the Use of Mobile Health Applications in Palestinian Community Pharmacy Practice","authors":"Ahmed Nouri PharmD, MSc","doi":"10.1016/j.curtheres.2025.100782","DOIUrl":"10.1016/j.curtheres.2025.100782","url":null,"abstract":"<div><h3>Background</h3><div>Mobile health applications have become essential tools in modern healthcare, enabling professionals to access real-time drug information, clinical guidelines, and patient management resources. While globally embraced, the adoption of these apps in resource-limited settings like Palestine remains under-researched, particularly among community pharmacists, who are pivotal to the healthcare system.</div></div><div><h3>Aims</h3><div>This study explores the perceptions, awareness, and challenges faced by Palestinian community pharmacists regarding mobile health applications. It aims to assess the feasibility of integrating these tools into their practice to improve pharmaceutical care and patient outcomes.</div></div><div><h3>Methods</h3><div>A cross-sectional online survey was conducted in 2023 among community pharmacists in Palestine. A self-administered electronic questionnaire was distributed via social media, targeting registered pharmacists. Data were collected using a structured, validated questionnaire addressing demographics, app usage patterns, perceived benefits, and barriers. Descriptive and inferential analyses were performed using SPSS® software, with P-values ≤0.05 considered statistically significant.</div></div><div><h3>Results</h3><div>The study included 400 community pharmacists, predominantly female (65.8%). Pharmacists frequently used information resources for verifying drug interactions (89%) and dosages (98%), citing quick access to reliable information as a major advantage. Barriers included time constraints (92.3%) and concerns about patient trust (77.8%). No significant associations were found between demographics (e.g., gender, years of experience) and perceptions of app usefulness or trust. A strong positive correlation (<em>P</em> &lt; 0.001) was observed between community pharmacists’ support for mobile health applications and their perception of the applications’ reliability. This indicates that pharmacists who perceive mobile apps as reliable are more likely to support their use in practice.</div></div><div><h3>Conclusion</h3><div>Limited app use among Palestinian community pharmacists impacts medication safety, patient trust, and care quality. Adopting mobile tools can improve efficiency, reduce errors, and align pharmacy practice with modern standards, highlighting the need for future research.</div></div>","PeriodicalId":10920,"journal":{"name":"Current Therapeutic Research-clinical and Experimental","volume":"102 ","pages":"Article 100782"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684679","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":"The Effects of Fasinumab on Peripheral Nerve Function and Ganglion Anatomy: Results From a Randomized, Double-Blind, Placebo-Controlled Study in Patients With Pain Due to Osteoarthritis of the Knee or Hip, and a Series of Nonclinical Studies","authors":"Simon Eng MD ,&nbsp;Michael Fetell MD ,&nbsp;Haitao Gao PhD ,&nbsp;Jingning Mei PhD ,&nbsp;Jesus Trejos MSc, PhD ,&nbsp;Luz Cortes-Burgos MSc ,&nbsp;Tina Ho PharmD ,&nbsp;Garen Manvelian MD ,&nbsp;Yamini Patel PhD ,&nbsp;Ngan Trinh MBA ,&nbsp;Kenneth C. Turner PhD ,&nbsp;Hazem E. Hassan PhD, RPh, FCP ,&nbsp;Stephen DiMartino MD, PhD ,&nbsp;Pamela Krueger BSc ,&nbsp;Gregory P. Geba MD, DrPH ,&nbsp;Ned Braunstein MD ,&nbsp;Lynn E. Macdonald PhD ,&nbsp;Randy Soltys PhD ,&nbsp;Susan D. Croll PhD ,&nbsp;Paula Dakin MBChB","doi":"10.1016/j.curtheres.2025.100813","DOIUrl":"10.1016/j.curtheres.2025.100813","url":null,"abstract":"<div><h3>Purpose</h3><div>Osteoarthritis (OA) is a chronic disease where breakdown and loss of cartilage leads to pain, primarily in the joints. Nerve growth factor inhibitors (eg, fasinumab) can reduce pain, but have been associated with nervous system adverse events (AEs). Here we describe the results of a Phase 2, randomized, double-blind, placebo-controlled study and a series of nonclinical analyses investigating the effects of fasinumab on peripheral nerve function and ganglion anatomy.</div></div><div><h3>Methods</h3><div>In the Phase 2 study, 180 adults with knee or hip OA and moderate-to-severe pain inadequately controlled with analgesics, who could not tolerate/were unwilling to take opioids, received subcutaneous fasinumab 1 mg every 4 weeks or placebo for 12 weeks. The primary endpoint was change from baseline to Week 16 in conduction velocity and amplitude for the peroneal, sural, and ulnar nerves. Secondary endpoints included peripheral sensory events. The nonclinical analyses involved adult and developing Sprague-Dawley rats and developing cynomolgus monkeys; endpoints included baseline and isoproterenol‑induced hemodynamic parameters, dorsal root ganglia (DRG) and superior cervical ganglia (SCG) volumes, neuron volumes and counts, and volumes and counts of specific neural subsets.</div></div><div><h3>Findings</h3><div>In the Phase 2 study, nerve conduction velocities and action potential amplitudes between baseline and Week 16 were generally within normal ranges. There were no compelling differences in nerve conduction tests between fasinumab- and placebo-treated patients. Incidences of AEs, including peripheral sensory AEs, were similar between fasinumab and placebo. In the nonclinical analyses, neither hemodynamic parameters nor DRG and SCG stereological parameters were statistically significantly different between fasinumab-treated and isotype control antibody–treated rats.</div></div><div><h3>Implications</h3><div>No clinically meaningful differences were observed between fasinumab- and placebo-treated patients for nerve conduction velocities and action potential amplitudes. In the nonclinical studies, no significant changes could be detected in adult rat ganglion anatomical parameters or hemodynamic parameters at a variety of fasinumab doses. Results from these studies demonstrated that fasinumab did not affect the tested nervous system parameters in adult humans or rats.</div><div>Trial registration number: NCT02447276; <span><span>https://clinicaltrials.gov/study/NCT02447276</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":10920,"journal":{"name":"Current Therapeutic Research-clinical and Experimental","volume":"103 ","pages":"Article 100813"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145516942","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":"Efficacy of Cevimeline on Xerostomia in Sjögren's Syndrome Patients: A Systematic Review and Meta-Analysis of Randomized Clinical Trials","authors":"Mehdi Karimi MD ,&nbsp;Fatemeh Ahmadi Hajikolaei MD ,&nbsp;Fahime Hoseinpour MD ,&nbsp;Seyed-Ali Hashemi MD ,&nbsp;Anita Fatehi MD ,&nbsp;Seyed-Abbas Pakmehr MD ,&nbsp;Niloofar Deravi MD ,&nbsp;Mahdyieh Naziri MSc ,&nbsp;Mohaddeseh Belbasi MD ,&nbsp;Sahar Khoshravesh MD ,&nbsp;Seyed Hossein Vaezzadeh MD","doi":"10.1016/j.curtheres.2024.100770","DOIUrl":"10.1016/j.curtheres.2024.100770","url":null,"abstract":"<div><h3>Background</h3><div>Xerostomia, or dry mouth, is a common and debilitating symptom in patients with Sjögren's syndrome, affecting their quality of life. Although Cevimeline, a muscarinic agonist, has been investigated as a potential treatment, its efficacy and optimal dosage remain uncertain. This study aims to assess the effectiveness of Cevimeline in relieving xerostomia in patients with Sjögren's syndrome by a meta-analysis of randomized clinical trials (RCT).</div></div><div><h3>Method</h3><div>A comprehensive search was conducted across PubMed, Scopus, Cochrane, and Web of Science databases, utilizing Medical Subject Headings terms and keywords related to “cevimeline,” “xerostomia,” and “Sjögren's syndrome” from inception until January 3, 2024. Studies were selected based on predefined inclusion criteria, focusing on clinical trials involving human subjects treated with cevimeline for xerostomia in Sjögren's syndrome. Data extraction was performed systematically, and statistical analysis was conducted using STATA software.</div></div><div><h3>Result</h3><div>This meta-analysis included three RCTs with a total of 302 patients with Sjögren's syndrome (Cevimeline = 187; Placebo = 115). The analysis demonstrated that Cevimeline significantly reduces xerostomia (regarded as salivary flow, mouth dryness) in patients with Sjögren's syndrome with a pooled odds ratio –5.79 (95% CI [–10.55, –1.03]; <em>I</em><strong>²</strong> = 39.6%).</div></div><div><h3>Conclusions</h3><div>In summary, cevimeline significantly increases salivary flow secretion rates in patients with Sjögren's syndrome. With a favorable safety profile at recommended dosages, cevimeline represents a viable therapeutic option for managing xerostomia, particularly in patients with mild to moderate salivary gland destruction.</div></div>","PeriodicalId":10920,"journal":{"name":"Current Therapeutic Research-clinical and Experimental","volume":"102 ","pages":"Article 100770"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11764655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045872","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":"Efficacy and Safety of Nebulized Sodium Bicarbonate in Adults with COVID-19 (SODIC): A Randomized, Single-Center, Double-Blinded, Controlled Trial","authors":"Mohammad Khairy El-Badrawy MD ,&nbsp;Rehab Ahmad Elmorsey MD ,&nbsp;Mahmoud Mostafa Elhosiny MD ,&nbsp;Mohammed Shehta MD ,&nbsp;Tamer Ali El-Hadidy MD ,&nbsp;Ibrahim El-Said Abdelwahab MD ,&nbsp;Adel El-Badrawy MD ,&nbsp;Ahmed A. Shokeir MD","doi":"10.1016/j.curtheres.2025.100801","DOIUrl":"10.1016/j.curtheres.2025.100801","url":null,"abstract":"<div><h3>Background</h3><div>Entry of severe acute respiratory syndrome coronavirus 2 into a host cell is pH-dependent. Hence, intracellular alkalinization by nebulized sodium bicarbonate could elevate endosomal pH and then block viral entry into the host cells.</div></div><div><h3>Objective</h3><div>To study the efficacy of nebulized sodium bicarbonate as an adjuvant treatment for coronavirus disease 2019 (COVID-19).</div></div><div><h3>Methods</h3><div>A prospective, randomized, double-blinded trial was conducted in Mansoura University Hospital, Egypt. Eligible patients were &gt;18 years old with all COVID-19 severities. Patients were electronically randomly assigned (1:1) to receive standard treatment only (control group) (274 patients) or standard treatment plus nebulized sodium bicarbonate (272 patients). The primary end points were time to clinical improvement, defined as number of days from diagnosis until reporting of a better feeling by the patients; length of hospital stay for admitted patients; and mortality. This study was registered at ClinicalTrials.gov (NCT05035524) on September 2, 2021, and has been completed.</div></div><div><h3>Results</h3><div>Between September 2, 2021, and April 30, 2022, 546 patients (215 men and 331 women) were enrolled and randomly allocated for treatment. Mean (SD) age was 50.7 (16.8) years. Study showed a significantly shorter time to clinical improvement and length of hospital stay in the study group (<em>P</em> &lt; 0.001), and the number of deaths was significantly low only in the severe grade of the study group (11 cases in the study group vs 22 cases in the control group, <em>P</em> = 0.014). C-reactive protein and D-dimer levels measured at 1 week were significantly lower in the severe cases of the study group (<em>P</em> = 0.001). The overall median computed tomography score was significantly better in the study group at all points of follow-up (<em>P</em> &lt; 0.05). All patients reported mild irritative cough initially with sodium bicarbonate inhalation. No serious treatment adverse events were observed.</div></div><div><h3>Conclusions</h3><div>Nebulized sodium bicarbonate (8.4%) could be a possible adjuvant therapy for patients with moderate and severe COVID‑19. ClinicalTrials.gov identifier: NCT05035524.</div></div>","PeriodicalId":10920,"journal":{"name":"Current Therapeutic Research-clinical and Experimental","volume":"103 ","pages":"Article 100801"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144470634","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":"Pharmacodynamics, Safety, and Tolerability of Pyridostigmine Bromide in Heart Failure","authors":"Randal Goldberg MD ,&nbsp;Lucy Norcliffe-Kaufmann PhD ,&nbsp;Horacio Kaufmann MD ,&nbsp;Ikoa Jeschke-Lopez MD ,&nbsp;Yu Guo MS ,&nbsp;Judy Zhong PhD ,&nbsp;Kenneth I. Berger MD ,&nbsp;Roberta M. Goldring MD ,&nbsp;David S. Goldstein MD, PhD ,&nbsp;Carey Pope PhD ,&nbsp;Lara Maxwell DVM, PhD ,&nbsp;Manushree Bharadwaj PhD ,&nbsp;Alex Reyentovich MD ,&nbsp;Stuart D. Katz MD, MS","doi":"10.1016/j.curtheres.2025.100814","DOIUrl":"10.1016/j.curtheres.2025.100814","url":null,"abstract":"<div><h3>Background</h3><div>Pyridostigmine bromide is a short-acting carbamate acetylcholinesterase inhibitor that has been shown to acutely augment parasympathetic signaling in cardiovascular disease populations.</div></div><div><h3>Objective</h3><div>This study was undertaken to characterize pharmacodynamics, safety, and tolerability of pyridostigmine during repeated dosing in patients with heart failure.</div></div><div><h3>Methods</h3><div>A prospective ascending-dose, forced titration, double-blind Phase II randomized clinical trial was conducted to compare the effects of pyridostigmine bromide (15, 30, and 60 mg TID over 8 weeks) versus matching placebo on red blood cell (RBC) acetylcholinesterase activity, cholinergic side effects, and physiologic measures of parasympathetic heart rate modulation and sympathovagal balance in ambulatory patients with chronic systolic heart failure.</div></div><div><h3>Results</h3><div>Fifty subjects were screened, and 33 eligible subjects were randomly assigned (mean age, 55 years; mean left ventricular ejection fraction, 23%). Pyridostigmine bromide significantly decreased RBC acetylcholinesterase activity (<em>P</em> &lt; 0.02 vs placebo) and increased the frequency of participant-reported cholinergic excess symptoms (<em>P</em> &lt; 0.001 vs placebo). Physiologic measures of parasympathetic heart rate modulation and sympathovagal balance did not differ between treatment groups. In the pyridostigmine bromide group, RBC acetylcholinesterase activity was not significantly associated with postexercise parasympathetic heart modulation.</div></div><div><h3>Conclusions</h3><div>Pyridostigmine bromide administered over 8 weeks was associated with a significant reduction of RBC acetylcholinesterase activity and relatively mild symptoms of cholinergic excess, but changes in parasympathetic signaling in the sinoatrial node previously reported after acute administration were not observed. Further investigations are needed to delineate pharmacodynamic and pathobiological factors contributing to these findings. ClinicalTrials.gov identifier: NCT01415921.</div></div>","PeriodicalId":10920,"journal":{"name":"Current Therapeutic Research-clinical and Experimental","volume":"103 ","pages":"Article 100814"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145568203","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}