Drugs in Context最新文献

{"title":"Autoimmune findings in patients with silicosis in Spain.","authors":"Coral González Fernández, Jose Antonio Ros Lucas, Maria Molina Molina, Juan Rigual Bobillo, Rogelio Alejandro García Montenegro, Raquel Fernández González, Ana Jaureguiza Oriol, Jose Abal Arca","doi":"10.7573/dic.2023-11-1","DOIUrl":"10.7573/dic.2023-11-1","url":null,"abstract":"<p><strong>Background: </strong>Occupational exposure to silica is related to autoimmune diseases and features of autoimmunity, mainly autoantibodies. The study objectives were to estimate the prevalence of silicosis with associated autoimmune findings or diagnosed autoimmune diseases in Spain, and to assess the clinical and functional characteristics of affected patients.</p><p><strong>Methods: </strong>This is a multicentre prospective study in patients diagnosed with silicosis. Autoantibodies analysed were antinuclear antibodies, isotypes IgA, IgM and IgG, rheumatoid factor, anticyclic citrullinated peptide, anti-Scl70, anti-Ro, and anti-LA. Pulmonary function tests were performed.</p><p><strong>Results: </strong>Autoimmunity was assessed in 105 patients. Autoimmune findings were recorded in 29 (27%) patients, including antinuclear antibodies (<i>n</i>=21), anti-Ro (<i>n</i>=7), rheumatoid factor (<i>n</i>=5) and anti-Scl70 (<i>n</i>=3). Autoimmune disease was diagnosed in 16 (15%) patients, mainly rheumatoid arthritis (<i>n</i>=7) and systemic lupus erythematosus (<i>n</i>=4). Patients with silicosis and autoimmune findings had a lower mean time of exposure to silica and showed a trend toward lower values in pulmonary function tests.</p><p><strong>Conclusions: </strong>Autoimmune findings and diagnosis of autoimmune diseases were frequent in patients with silicosis in Spain.</p>","PeriodicalId":11362,"journal":{"name":"Drugs in Context","volume":"13 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10911535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140027702","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 activity of treatments after progression from palbociclib plus endocrine therapy in patients with HR⁺/HER2^- metastatic breast cancer: a prospective, monocentric study.","authors":"Raffaella Palumbo, Erica Quaquarini, Giuseppe Saltalamacchia, Alberto Malovini, Pietro Lapidari, Barbara Tagliaferri, Ludovica Mollica, Cristina Maria Teragni, Chiara Barletta, Laura Deborah Locati, Federico Sottotetti","doi":"10.7573/dic.2023-7-5","DOIUrl":"10.7573/dic.2023-7-5","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer is the most frequent tumour worldwide, and the HR⁺/HER2^- subtype is the most common. For this tumour type, endocrine therapy (ET) is the mainstay of treatment. The association of ET and CDK4/6 inhibitors (CDK4/6i) represents the gold standard for first-line or second-line therapies. However, the optimal therapeutic strategy after CDK4/6i progression is still a matter of debate, with several randomized clinical trials still ongoing.</p><p><strong>Patients and methods: </strong>This is an observational, prospective, real-world study including women with HR⁺/HER2^- metastatic breast cancer progressing to palbociclib plus ET. Patients received either ET or chemotherapy (CT). The primary objective was the evaluation of efficacy of the different therapeutic strategies after palbociclib in terms of median progression-free survival 2. Secondary objectives were the activity of therapeutic strategies measured with the clinical benefit rate, evaluation of the parameters used for the treatment choice, and progression-free survival 1 related to palbociclib plus ET treatment.</p><p><strong>Results: </strong>Overall, 48 patients (median age 53, range 33-78 years) were included. The median progression-free survival 2 was of 5 months in the overall cohort (95% CI 4-48 months) with a statistically significant difference between the two therapeutic strategies adopted (ET <i>versus</i> CT, 10 months <i>versus</i> 5 months, respectively). Regarding secondary objectives, the clinical benefit rate was 55.2% in the CT cohort and 50% in ET. Moreover, women treated with CT had a greater number of visceral metastases and a shorter median progression-free survival 1 than patients who received ET.</p><p><strong>Conclusions: </strong>ET and CT represent two possible therapeutic alternatives for patients progressing on CDK4/6i plus ET. The choice is based on clinical parameters, with a potential preference for ET.</p>","PeriodicalId":11362,"journal":{"name":"Drugs in Context","volume":"13 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10852029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139706375","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":"Chronic liver disease and management with silymarin: an introductory review of a clinical case collection.","authors":"Francesco Angelico","doi":"10.7573/dic.2023-7-4","DOIUrl":"10.7573/dic.2023-7-4","url":null,"abstract":"<p><p>Chronic liver disease (CLD) is a significant global health concern and generally leads to fibrosis, cirrhosis and hepatocellular carcinoma. Various factors, such as metabolic abnormalities, viral infections, alcoholism, genetics and autoimmune responses, contribute to liver damage. CLD is characterized by different phenotypes, including non-alcoholic fatty liver disease, metabolic-associated fatty liver disease, drug-induced liver injury and alcoholic liver disease. These conditions have seen an increase in comorbidities and hospitalizations over the past decade, imposing a substantial burden on patients and healthcare systems. Understanding the underlying mechanisms of liver injury is crucial for effective management and reducing the clinical and economic burden of CLD. Although several attempts have been evaluated to find a drug therapy option for the management of non-alcoholic fatty liver disease and metabolic-associated fatty liver disease, there is no effective drug approved to date. However, different studies have demonstrated that silymarin, the milk thistle extract, could exert hepatoprotective, antioxidant, anti-inflammatory and antifibrotic properties and should therefore be considered an efficacious, tolerable and promising herbal product for the management of liver activity in CLDs. This review discusses the clinical features, diagnosis and available treatments for major liver diseases, acting as an introduction to a clinical case collection based on the management and treatment of major liver diseases with silymarin. This article is part of the <i>Current clinical use of silymarin in the treatment of toxic liver diseases: a case series</i> Special Issue: https://www.drugsincontext.com/special_issues/current-clinical-use-of-silymarin-in-the-treatment-of-toxic-liver-diseases-a-case-series.</p>","PeriodicalId":11362,"journal":{"name":"Drugs in Context","volume":"13 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10852028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139706374","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":"Corrigendum: Vulnerable period in heart failure: a window of opportunity for the optimization of treatment - a statement by Mexican experts.","authors":"","doi":"10.7573/dic.2024-2-5","DOIUrl":"https://doi.org/10.7573/dic.2024-2-5","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.7573/dic.2023-8-1.].</p>","PeriodicalId":11362,"journal":{"name":"Drugs in Context","volume":"13 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11006242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140862436","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 magnitude and predictors of self-medication amongst street dwellers in Ethiopia: a multicentre study.","authors":"Tirsit Ketsela Zeleke, Bekalu Dessie Alamirew, Zegaye Agmassie Bazezew, Muluken Adela Alemu, Abdisa Gemedi Jara, Rahel Belete Abebe","doi":"10.7573/dic.2023-7-2","DOIUrl":"10.7573/dic.2023-7-2","url":null,"abstract":"<p><strong>Background: </strong>Low levels of living standards amongst street dwellers worldwide limit their access to conventional healthcare services, resulting in self-medication use for the treatment of an illness. Nevertheless, self-medication use has risks, including adverse drug reactions, increased polypharmacy, drug resistance, drug dependence, drug interactions and incorrect diagnosis. Ethiopia has a large street-dwelling community; however, there are no studies conducted in Ethiopia assessing self-medication use amongst street dwellers. This study provides insight into self-medication use and predictors amongst street dwellers in Ethiopia.</p><p><strong>Methods: </strong>A community-based, multicentre cross- sectional study was conducted amongst street dwellers from 1 September 2022 to 1 February 2023 at community drug-retail outlets in the three major cities in the Amhara region of Ethiopia. The data were obtained using an interviewer-administered questionnaire. Frequencies and percentages of descriptive statistics were calculated. Bivariable and multivariable logistic regression analyses were employed to indicate predictors of self-medication use. To determine statistical significance, a 95% confidence interval with a <i>p</i> value below 0.05 was utilized.</p><p><strong>Results: </strong>The prevalence of self-medication use was 67.4%. Time and financial savings were reported as the reasons for most self-medication use. The most commonly reported illnesses for which people sought self-medication were gastrointestinal diseases. Low monthly income (adjusted OR 3.72, 95% CI 2.34-5.91) and residing near sewage areas (adjusted OR 3.37, 95% CI 2.03-5.58) were significantly associated with self-medication use.</p><p><strong>Conclusion: </strong>Street dwellers had a high rate of self- medication use. Residing near sewage areas and having a low level of income were factors in self-medication use. Gastrointestinal diseases, respiratory ailments and dermatological conditions were the most frequently reported complaints, whereas antimicrobials and anthelmintics were the most commonly used medications. We recommend that healthcare services enhance outreach programmes to the most vulnerable people, such as street dwellers, especially those with lower monthly incomes and who live near sewage areas, to reduce self-medication rates.</p>","PeriodicalId":11362,"journal":{"name":"Drugs in Context","volume":"13 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10803126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139541861","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":"Diuretic resistance and the role of albumin in congestive heart failure.","authors":"Carol Fernandez Hazim, Gustavo Duarte, Ana P Urena, Swati Jain, Rishabh Mishra, Timothy J Vittorio, Miguel Rodriguez-Guerra","doi":"10.7573/dic.2023-6-5","DOIUrl":"10.7573/dic.2023-6-5","url":null,"abstract":"<p><p>Diuresis with loop diuretics is the mainstay treatment for volume optimization in patients with congestive heart failure, in which perfusion and volume expansion play a crucial role. There are robust guidelines with extensive evidence for the management of heart failure; however, clear guidance is needed for patients who do not respond to standard diuretic treatment. Diuretic resistance (DR) can be defined as an insufficient quantity of natriuresis with proper diuretic therapy. A combination of diuretic regimens is used to overcome DR and, more recently, SGLT2 inhibitors have been shown to improve diuresis. Despite DR being relatively common, it is challenging to treat and there remains a notable lack of substantial data guiding its management. Moreover, DR has been linked with poor prognosis. This review aims to expose the multiple approaches for treatment of patients with DR and the importance of intravascular volume expansion in the response to therapy.</p>","PeriodicalId":11362,"journal":{"name":"Drugs in Context","volume":"12 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10768781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139377364","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 itopride SR for upper gastrointestinal symptoms in patients with diabetic gastroparesis: real-world evidence from Pakistan","authors":"Adil Ramzan, Ghulam Fareed Memon, Asif Ali, Muhammad Masood, Tariq Meher, Adnan Ghafoor, Naveed Ahmed Shehzad, Safian Ahmed, Zunaira Nawaz, Muhammad Rehan, Tariq Saeed, Waqar Taj, Sakhawat Abbass, Ramiz Khan, Hamza Ehsan, Abubakkar Alam, Bilal Manzoor, Muhammad Nawaz Khan, Khalid Mahmood Yahya, Farhan Mukhtiar, Muhammad Asif Javed, Muhammad Usman Sheikh, Danish Janjua, Sumerah Jabeen, Junaid Zafar, Riaz Hussain Khokar, Madeeha Nazar, N. Maheshwary, Muhammad Athar Khan","doi":"10.7573/dic.2023-6-4","DOIUrl":"https://doi.org/10.7573/dic.2023-6-4","url":null,"abstract":"Background: Gastroparesis is a serious condition that can be caused by diabetes, surgery or infection, or can be idiopathic. When there is no mechanical obstruction, gastroparesis is characterized by delayed stomach emptying. Itopride, a prokinetic drug, inhibits acetylcholinesterase activity in addition to antagonizing dopamine D2 receptors. Methods: This prospective, multicentre study is based on real-world data from 988 patients with a diagnosis of diabetic gastroparesis for index (PAGI-SYM2) evaluation at baseline and week 4 of treatment for upper gastrointestinal disorder symptoms. Results: Upper gastrointestinal symptom severity scores improved significantly after 4 weeks of treat-ment ( p <0.001), with significant improvement across all categories of gastroparesis (very mild (37–58.6%), mild degree (24.6–31.6%), moderate (29.3–7.3%) and severe (8.8–2.6%).","PeriodicalId":11362,"journal":{"name":"Drugs in Context","volume":" 916","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138960285","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":"Fentanyl in cancer pain management: avoiding hasty judgments and discerning its potential benefits","authors":"Arturo Cuomo","doi":"10.7573/dic.2023-10-2","DOIUrl":"https://doi.org/10.7573/dic.2023-10-2","url":null,"abstract":"Cancer pain is an important challenge in treatment and requires a rapid onset of action for its control. In particular, breakthrough cancer pain (BTcP) should be adequately controlled with a stable dose of a short-acting oral opioid. Fentanyl is a synthetic, highly selective opioid with many advantageous chemical properties, including high lipophilicity and distinct pharmacokinetic properties. It is recommended for pain management in a variety of settings, including acute pain, chronic pain and BTcP. To date, its variously designed formulations allow non-invasive administration; amongst others, sublingual fentanyl has proven useful in the management of BTcP and in improving the quality of life of patients with cancer. This review provides an update on the management of BTcP with fentanyl, with consideration of safety, as it remains an important tool in the treatment of cancer pain.","PeriodicalId":11362,"journal":{"name":"Drugs in Context","volume":"8 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139003110","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":"Sleep-related breathing disorder (central sleep apnoea) improved coincidentally by medical therapy with fumarates (dimethyl fumarate).","authors":"Abdulmajeed M Albadi, Mana M Alshahrani, Riyad O Allehebi","doi":"10.7573/dic.2023-6-3","DOIUrl":"10.7573/dic.2023-6-3","url":null,"abstract":"<p><p>Central sleep apnoea (CSA) is a sleep disorder characterized by the repeated cessation or reduction of both airflow and ventilatory effort when sleeping. Individuals with central breathing disorders have difficulty in receiving appropriate medical treatment. In this article, we describe a case study of a 31-year-old woman known to have multiple sclerosis and concomitant severe CSA. She received the medication dimethyl fumarate for the treatment of multiple sclerosis, and her CSA significantly improved to mild CSA after the treatment.</p>","PeriodicalId":11362,"journal":{"name":"Drugs in Context","volume":"12 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10688778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138476941","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":"Optimization of GDMT for patients with heart failure and reduced ejection fraction: can physiological and biological barriers explain the gaps in adherence to heart failure guidelines?","authors":"Marilyne Jarjour, Anique Ducharme","doi":"10.7573/dic.2023-5-6","DOIUrl":"https://doi.org/10.7573/dic.2023-5-6","url":null,"abstract":"<p><p>Heart failure is a growing epidemic with high mortality rates and recurrent hospital admissions that creates a burden on affected individuals, their caregivers and the whole healthcare system. Throughout the years, many randomized trials have established the effectiveness of several pharmacological therapies and electrophysiological devices to reduce hospitalizations and improve quality of life and survival, mostly for patients with heart failure with reduced ejection fraction (HFrEF). These studies led to the publication of national societies' recommendations to guide clinicians in the management of HFrEF. Yet, many reports have shown significant care gaps in adherence to these recommendations in clinical practice, highlighting suboptimal use and/or dosing of evidence-based therapies. Adherence to guidelines has been shown to be associated with the best prognosis in HFrEF, with patients presenting with intolerances or contraindications having the highest risk of events; however, it remains unclear whether this association is causal or merely a marker of more advanced disease. Furthermore, individual characteristics may limit the possibility of reaching the targeted dosage of specific agents. Herein, we provide a comprehensive overview of clinicians' adherence to heart failure guidelines in a specialized real-life setting, particularly regarding use and optimization of guideline-derived medical therapies, as well as the implementation of more recent agents such as sacubitril/valsartan and SGLT2 inhibitors. We seek potential explanations for suboptimal treatment and its impact on patient outcomes.</p>","PeriodicalId":11362,"journal":{"name":"Drugs in Context","volume":"12 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10664772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138458600","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}