Expert Opinion on Pharmacotherapy最新文献

The effectiveness and safety of administering antiplatelet medications following reperfusion therapy in patients with ischemic stroke. 缺血性卒中患者再灌注治疗后给予抗血小板药物的有效性和安全性。

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-06-19 DOI: 10.1080/14656566.2025.2521371

Xiaoning Ju, Ningfen Wang, Yubin Wu, Guoqing Wang

{"title":"The effectiveness and safety of administering antiplatelet medications following reperfusion therapy in patients with ischemic stroke.","authors":"Xiaoning Ju, Ningfen Wang, Yubin Wu, Guoqing Wang","doi":"10.1080/14656566.2025.2521371","DOIUrl":"10.1080/14656566.2025.2521371","url":null,"abstract":"Background: Ischemic stroke is a major cause of morbidity and mortality worldwide. Although reperfusion therapy enhances patient outcomes, the ideal antiplatelet regimen post-treatment remains unclear. This study investigates the efficacy and safety of dual antiplatelet therapy (DAPT) versus triple antiplatelet therapy (TAT) in ischemic stroke patients after reperfusion.Research design and methods: A retrospective observational analysis was conducted on 730 patients treated at a single institution from January 2018 to December 2023. Patients were divided into two groups: DAPT (aspirin and clopidogrel) or TAT (aspirin, clopidogrel, and tirofiban). Outcomes included neurological improvement via NIHSS scores, functional recovery using mRS, and bleeding complications.Results: TAT demonstrated significantly better neurological recovery, with more patients achieving NIHSS ≤ 3 (p < 0.001). All TAT patients had mRS ≤ 2 at 30 days. However, TAT was associated with higher bleeding rates (37.4% vs. 18.8%, p < 0.05). Intravenous thrombolysis increased bleeding risk (OR = 3.95, 95% CI: 1.26-12.44, p = 0.02).Conclusion: TAT may enhance neurological recovery but increases bleeding risk. Patient selection and monitoring are crucial, and long-term studies are needed to fully evaluate its risk-benefit profile.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"1-10"},"PeriodicalIF":2.5,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Selecting optimal therapy for large granular lymphocytic (LGL) leukemia: current state and future prospects based on molecularly-defined characterization. 大颗粒淋巴细胞（LGL）白血病的最佳治疗选择：基于分子定义特征的现状和未来前景

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-06-18 DOI: 10.1080/14656566.2025.2522811

Victor M Samperio, Ifeoma Ike, Constantin A Dasanu

引用次数: 0

New strategies for the management of biofilms formed by Gram-negative bacteria. 革兰氏阴性菌形成的生物膜管理的新策略。

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-06-17 DOI: 10.1080/14656566.2025.2519692

Cristina Ortega-Portas, Jaime Esteban

{"title":"New strategies for the management of biofilms formed by Gram-negative bacteria.","authors":"Cristina Ortega-Portas, Jaime Esteban","doi":"10.1080/14656566.2025.2519692","DOIUrl":"10.1080/14656566.2025.2519692","url":null,"abstract":"Introduction: The global rise of multidrug-resistant (MDR) Gram-negative bacteria (GNB) has intensified the threat of chronic and hard-to-treat infections, many of which are associated with biofilm formation. These biofilms confer enhanced resistance to antimicrobials and immune responses, posing a major clinical challenge.Areas covered: This review summarizes the biological mechanisms of biofilm formation in GNB and explores both traditional and novel strategies for their prevention and eradication. The literature search covered peer-reviewed articles from major databases, focusing on therapeutic approaches such as quorum sensing inhibitors, EPS matrix disruptors, phage therapy, nanotechnology, and synergistic drug combinations. The novelty of this review lies in its effort to understand biofilm biology to identify key intervention points and organize therapeutic strategies according to their biological, chemical or physical nature. Emphasis is also placed on combined approaches that simultaneously target multiple components of the biofilm structure.Expert opinion: Despite significant in vitro progress, most antibiofilm strategies remain experimental. Translating these findings into clinical applications requires standardization, in vivo validation, and regulatory alignment. A multidisciplinary approach integrating different agents and targeted drug delivery systems holds promise for improving patient outcomes.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"1-13"},"PeriodicalIF":2.5,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Advancing care in primary biliary cholangitis: emerging insights and novel therapies. 推进原发性胆管炎的护理：新见解和新疗法。

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-06-16 DOI: 10.1080/14656566.2025.2516622

Marius Vögelin, Andreas E Kremer

{"title":"Advancing care in primary biliary cholangitis: emerging insights and novel therapies.","authors":"Marius Vögelin, Andreas E Kremer","doi":"10.1080/14656566.2025.2516622","DOIUrl":"10.1080/14656566.2025.2516622","url":null,"abstract":"Introduction: Primary biliary cholangitis (PBC) is a chronic, cholestatic liver disease, is associated with fatigue and pruritus and can progress to cirrhosis if left untreated. Ursodeoxycholic acid (UDCA) has been the mainstay of therapy for over 40 years. However, 30-40% of PBC patients do not adequately respond to UDCA or have risk factors for disease progression and require second-line treatment.Areas covered: Recent international cohort analyses have provided new insights that enable early identification of high-risk PBC patients and suggest that stricter treatment goals may lower mortality and reduce the need for liver transplantation. Alongside established second-line agents, several promising substances have progressed to phase 2 and 3 trials. Notably, seladelpar and elafibranor, two selective agonists of peroxisome proliferator-activated receptors, achieved high rates of biochemical response and good tolerability, leading to their recent approval for second-line treatment of PBC. Moreover, dedicated clinical trials addressed fatigue and pruritus, the two main symptoms of PBC.Expert opinion: Personalized treatment approaches for PBC are both feasible and essential to improve biochemical response, extend transplant-free survival and alleviate symptom burden. Well-tolerated novel therapies are poised to reshape the treatment landscape in the near future.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"1-14"},"PeriodicalIF":2.5,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Eosinophilic esophagitis in children: new kids on the block. 儿童嗜酸性粒细胞性食管炎：新来的孩子。

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-06-16 DOI: 10.1080/14656566.2025.2517801

Cosimo Ruggiero, Giovanna Alfano, Lucy Jackman, Giusy Russo, Danila Volpe, Edward Gaynor, Leanne Goh, Salvatore Oliva, Osvaldo Borrelli

{"title":"Eosinophilic esophagitis in children: new kids on the block.","authors":"Cosimo Ruggiero, Giovanna Alfano, Lucy Jackman, Giusy Russo, Danila Volpe, Edward Gaynor, Leanne Goh, Salvatore Oliva, Osvaldo Borrelli","doi":"10.1080/14656566.2025.2517801","DOIUrl":"10.1080/14656566.2025.2517801","url":null,"abstract":"Introduction: Eosinophilic esophagitis (EoE) is an immune-mediated disease characterized by esophageal dysfunction and eosinophil rich inflammatory infiltrate. Its incidence is rising globally due to increased awareness, improved diagnostics, and environmental and genetic factors. EoE is driven by a Th2-mediated immune response to food and environmental allergens, leading to chronic inflammation, epithelial barrier dysfunction and progressive esophageal remodeling.Areas covered: This review explores pediatric EoE, focusing on epidemiology, pathogenesis, clinical presentation, diagnosis, and both standard and new treatment strategies. Symptoms vary by age, from feeding difficulties in infants to dysphagia and food impaction in older children. Diagnosis relies on clinical symptoms, endoscopic findings and histologic assessment. Standard treatments include dietary elimination, proton pump inhibitors and topical corticosteroids, while biologic therapies such as dupilumab offer targeted alternatives for refractory cases.Expert opinion: Future research focuses on optimizing treatment sequencing (step-up and step-down approach), exploring non-eosinophil-mediated inflammation, and enhancing noninvasive test to predict disease severity and phenotypes for better long-term management.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"1-16"},"PeriodicalIF":2.5,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Tackling multidrug-resistant gram-negative infections in Children globally: current therapeutic options and perspectives. 应对全球儿童多重耐药革兰氏阴性感染：目前的治疗选择和前景。

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-06-15 DOI: 10.1080/14656566.2025.2519690

Lorenzo Chiusaroli, Costanza Tripiciano, Cecilia Liberati, Marica De Pieri, Giulia Brigadoi, Daniele Donà

{"title":"Tackling multidrug-resistant gram-negative infections in Children globally: current therapeutic options and perspectives.","authors":"Lorenzo Chiusaroli, Costanza Tripiciano, Cecilia Liberati, Marica De Pieri, Giulia Brigadoi, Daniele Donà","doi":"10.1080/14656566.2025.2519690","DOIUrl":"https://doi.org/10.1080/14656566.2025.2519690","url":null,"abstract":"Introduction: Over the past two decades, the global burden of multidrug-resistant organisms has grown steadily, representing a major concern in pediatric healthcare. Among these, hospital-acquired infections caused by multidrug-resistant Gram-negative bacteria (MDR-GNB) are particularly challenging to manage in children, due to limited therapeutic options and the scarcity of pharmacokinetic data in the pediatric population. Although several new antibiotics - especially β-lactams combined with β-lactamase inhibitors - have become available, uncertainties remain regarding their optimal use in pediatric populations.Areas covered: This review explores potential treatment strategies for MDR-GNB infections in children, with a focus on pathogens listed in the WHO priority list. It examines the pharmacological properties of both traditional and newly approved antibiotics, assessing their role and applicability in pediatric clinical practice.Expert opinion: New β-lactam antibiotics, alone or in combination with β-lactamase inhibitors - such as ceftazidime-avibactam, ceftolozane-tazobactam, meropenem-vaborbactam, imipenem-cilastatin-relebactam, and cefiderocol - have emerged as preferred options for treating carbapenem-resistant and difficult-to-treat Gram-negative infections. Therapy should be guided by pathogen identification and resistance mechanisms, as susceptibility profiles vary widely based on the resistance-mechanism. Older agents like colistin, fosfomycin, nitrofurantoin, and aminoglycosides remain important, particularly in resource-limited settings, despite concerns over toxicity and safety.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

External control arm with real world data to assess the effect of semaglutide on chronic kidney disease risk among patients with type 2 diabetes. 用真实世界数据评估西马鲁肽对2型糖尿病患者慢性肾脏疾病风险的影响的外部对照。

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-06-13 DOI: 10.1080/14656566.2025.2518329

Onur Baser, Yuanqing Lu

{"title":"External control arm with real world data to assess the effect of semaglutide on chronic kidney disease risk among patients with type 2 diabetes.","authors":"Onur Baser, Yuanqing Lu","doi":"10.1080/14656566.2025.2518329","DOIUrl":"10.1080/14656566.2025.2518329","url":null,"abstract":"Background: Clinical trials have shown semaglutide effective in mitigating risks associated with type 2 diabetes and chronic kidney disease. However, semaglutide's real-world effectiveness and long-term outcomes are not fully established.Research design & methods: Using 2019-2024 Kythera Labs data, an external control arm was created using criteria identified in the FLOW clinical trial. Primary outcomes were major kidney disease events (kidney failure onset and ≥ 50% reduction in estimated glomerular filtration rate from baseline). Propensity score matching and Cox regression were used to determine risk-adjusted outcomes.Results: The control arm (n = 896,257) was compared with the clinical trial cohort (n = 1,766). After propensity score matching on age, sex, socioeconomic status, and comorbidities, semaglutide treatment was associated with a 26% reduction in primary event risk compared with the comparator group (702 vs 1,068 events; HR: 0.74; 95% CI, 0.67-0.81), consistent with the 24% risk reduction observed in the clinical trial.Conclusion: Semaglutide treatment was linked to a significantly lower risk of clinically relevant renal outcomes. Our findings provide robust real-world evidence that supports the FLOW trial results regarding the renoprotective effects of semaglutide, highlighting its promise as an effective therapeutic option for managing renal complications.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"1-7"},"PeriodicalIF":2.5,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Potential of cenobamate as a broad-spectrum antiseizure medication. 辛奥巴酸作为广谱抗癫痫药物的潜力。

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-06-11 DOI: 10.1080/14656566.2025.2517352

Susan M Melnick, Sunita N Misra, Marc Kamin, Louis Ferrari, Kelli J Glenn

{"title":"Potential of cenobamate as a broad-spectrum antiseizure medication.","authors":"Susan M Melnick, Sunita N Misra, Marc Kamin, Louis Ferrari, Kelli J Glenn","doi":"10.1080/14656566.2025.2517352","DOIUrl":"10.1080/14656566.2025.2517352","url":null,"abstract":"Introduction: The process of diagnosing patients with epilepsy and selecting the optimal drug remains a significant challenge. Broad-spectrum antiseizure medications (ASMs) treat focal and generalized seizures without worsening other seizure types, making them the drug of choice when the exact seizure classification for patients is unknown. Cenobamate, an ASM approved for the treatment of adult focal seizures, has demonstrated strong efficacy, including high rates of seizure freedom. Evidence suggests that cenobamate has potential to be a broad-spectrum ASM.Areas covered: Considerations for the selection of broad- versus narrow-spectrum ASMs are discussed and an overview of preclinical, clinical, and real-world evidence relating to cenobamate as a potential broad-spectrum ASM is presented.Expert opinion: Combined evidence from preclinical data, clinical study data, and real-world evidence may indicate that cenobamate may be a broad-spectrum ASM. Evidence is accumulating regarding the utility of cenobamate in treating primary generalized tonic-clonic (PGTC) and seizures associated with developmental epileptic encephalopathies such as Lennox-Gastaut syndrome and Dravet syndrome. Results from the ongoing cenobamate trial in patients with idiopathic generalized epilepsy will determine the efficacy of cenobamate for the treatment of PGTC seizures.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"1-13"},"PeriodicalIF":2.5,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Advances in understanding migraine for the development of novel pharmacotherapies: the use of human provocation migraine models. 了解偏头痛的新药物治疗进展：人类诱发偏头痛模型的使用。

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-06-09 DOI: 10.1080/14656566.2025.2505231

Nazia Karsan, Sina Marzoughi, Peter J Goadsby

{"title":"Advances in understanding migraine for the development of novel pharmacotherapies: the use of human provocation migraine models.","authors":"Nazia Karsan, Sina Marzoughi, Peter J Goadsby","doi":"10.1080/14656566.2025.2505231","DOIUrl":"10.1080/14656566.2025.2505231","url":null,"abstract":"Introduction: Whilst migraine treatment has advanced significantly over recent times, the mechanisms of attack genesis and heterogeneity in treatment response are two amidst several areas that remain poorly understood and require further development. Experimental migraine provocation is an area that holds promise in advancing this understanding.Areas covered: We conducted a literature search using PubMed, of 'human migraine triggering' and 'human migraine provocation', to identify articles of interest. We discuss therapeutic targets that have emerged from such work, including calcitonin family peptides amylin (AMY) and adrenomedullin (ADM), pituitary adenylate cyclase-activating polypeptide (PACAP), and potassium channels. We discuss our views on the clinical translation of the outcomes of such studies, and their previous and potential future impact on migraine therapeutics.Expert opinion: Migraine provocation models provide a valuable means to study human migraine phenotypically and biologically, as well as to assess treatment response. Downstream intracellular mechanisms of provocation agents can be targeted during cellular processing to alter cell function and influence migraine mechanisms. It is important to caveat the clinical translation of provocation studies, given that just because a substance triggers migraine experimentally, does not necessarily mean that the substance is involved in the spontaneous human condition.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"1-20"},"PeriodicalIF":2.5,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Predicting treatment response to GLP-1 receptor agonists: still tossing the coin or doing better? 预测GLP-1受体激动剂的治疗反应：还在掷硬币还是做得更好？

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-06-08 DOI: 10.1080/14656566.2025.2517802

Maria Apostolopoulou, Theocharis Koufakis

引用次数: 0