Expert Opinion on Pharmacotherapy最新文献

Vepdegestrant for the treatment of HR+/HER2- breast cancer.

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-04-09 DOI: 10.1080/14656566.2025.2488456

Toru Mukohara

{"title":"Vepdegestrant for the treatment of HR+/HER2- breast cancer.","authors":"Toru Mukohara","doi":"10.1080/14656566.2025.2488456","DOIUrl":"10.1080/14656566.2025.2488456","url":null,"abstract":"Introduction: The treatment of advanced hormone receptor-positive (HR+) and human epidermal growth factor receptor 2-negative (HER2-) breast cancer has been improved through the development of endocrine therapy (ET) and targeted agents. However, resistance to ET, particularly caused by ESR1 mutations, has not been fully addressed.Areas covered: Vepdegestrant is a first-in-class, selective, and orally bioavailable PROteolysis TArgeting Chimera (PROTAC) estrogen receptor (ER) degrader. Preclinical studies have suggested promising activity of vepdegestrant irrespective of ESR1 genotypes. Phase I and II clinical studies have revealed a favorable safety profile and encouraging efficacy of vepdegestrant as a single agent and in combination with other targeted agents.Expert opinion: The results of the phase III VERITAC-2 study, comparing vepdegestrant with fulvestrant, are expected to be available in 2025, and will provide the first data on the true clinical significance of vepdegestrant. Several phase III studies of combinations with vepdegestrant including + atirimociclib (a cyclin-dependent kinase 4 inhibitor) have been or are planned to be conducted. The results of these may not only transform the treatment landscape for advanced HR+/HER2- breast cancer but may pave the way for PROTAC as a new class of anti-cancer drugs that may make previously undruggable targets druggable.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"1-9"},"PeriodicalIF":2.5,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771623","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

Treating pediatric aggressive behaviors and comorbid conditions.

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-04-08 DOI: 10.1080/14656566.2025.2487157

Ekaterina Stepanova, Joshua A Langfus, R James Blair, Eric A Youngstrom, Robert L Findling

{"title":"Treating pediatric aggressive behaviors and comorbid conditions.","authors":"Ekaterina Stepanova, Joshua A Langfus, R James Blair, Eric A Youngstrom, Robert L Findling","doi":"10.1080/14656566.2025.2487157","DOIUrl":"10.1080/14656566.2025.2487157","url":null,"abstract":"Introduction: Aggressive behaviors in children and adolescents can significantly impair quality of life, leading to disruptions in both academic and social functioning. Despite decades of research, a standardized nosology for aggressive behaviors remains lacking, resulting in considerable variability in the design of treatment trials for aggression.Areas covered: A comprehensive literature review was conducted to identify studies evaluating pharmacological treatments for aggressive behaviors in children and adolescents. Articles were sourced from multiple databases, focusing studies that investigated the use of medications for treating aggression, conduct problems, and disruptive behaviors.Expert opinion: A significant barrier to effectively treating childhood aggression is the absence of a clear and standardized nosology. Aggression is frequently regarded as a symptom rather than a distinct clinical entity, complicating treatment decisions and hindering the ability to predict outcomes and develop targeted interventions. Notably, impulsive aggression has been the primary focus of research as a target for pharmacotherapy, highlighting the need to expand our understanding of aggression subtypes. A paradigm shift is necessary, emphasizing the development of operational definition of aggression diagnosis based on the type of aggressive behavior, the creation of screening tools, and the prediction of treatment outcomes to enhance both clinical practice and research.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"1-11"},"PeriodicalIF":2.5,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751805","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

An update on the pharmacotherapy of osteoporosis.

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-04-07 DOI: 10.1080/14656566.2025.2489122

Anush Shashidhara, Syed Haider Tahir, Zain Abbas Syed, Jeffrey Lee, Hasan Tahir

{"title":"An update on the pharmacotherapy of osteoporosis.","authors":"Anush Shashidhara, Syed Haider Tahir, Zain Abbas Syed, Jeffrey Lee, Hasan Tahir","doi":"10.1080/14656566.2025.2489122","DOIUrl":"10.1080/14656566.2025.2489122","url":null,"abstract":"Introduction: Osteoporosis is a chronic metabolic bone disease characterized by progressive bone loss and structural deterioration, increasing fracture risk and morbidity. As the global population ages, its incidence is rising, underscoring the urgent need for more effective prevention and treatment strategies.Areas covered: This review synthesizes the latest evidence and guidelines from leading international societies, establishing a contemporary framework for osteoporosis pharmacotherapy. It emphasizes best practices and explores future directions in treatment optimization and fracture prevention.Expert opinion: To optimize outcomes, enhancing early detection, refining treatment strategies, and prioritizing patient-centered care are essential. Improving diagnosis through increased use of bone mineral density (BMD) assessments and identifying secondary causes are critical steps to addressing underdiagnosis, particularly in men. Pharmacotherapies play a vital role in management; while bisphosphonates serve as a cost-effective first-line treatment, denosumab and anabolic agents like Teriparatide and romosozumab are essential alternatives for high-risk patients. Future directions in osteoporosis management emphasize advancing treatment strategies through novel drug targets and innovative delivery systems, alongside personalized medicine approaches considering individual genetic and comorbidity profiles. Enhanced adherence strategies and further research into combination therapies and monitoring tools are crucial for improving prevention and treatment outcomes, ultimately reducing the fragility fracture burden worldwide.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"1-13"},"PeriodicalIF":2.5,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779524","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

Osivelotor for the treatment of sickle cell disease. 治疗镰状细胞病的奥西韦洛托。

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-04-06 DOI: 10.1080/14656566.2025.2489123

Giovanna Cannas

{"title":"Osivelotor for the treatment of sickle cell disease.","authors":"Giovanna Cannas","doi":"10.1080/14656566.2025.2489123","DOIUrl":"10.1080/14656566.2025.2489123","url":null,"abstract":"Introduction: Despite advances in the treatment of sickle cell disease (SCD), an inherited disorder leading to abnormal sickle hemoglobin (HbS) polymerization, patients continue to have a shorter life expectancy comparatively to the general population. Increase in the concentration of oxygenated HbS in red blood cells (RBCs) has been considered as a novel approach to inhibit HbS polymerization and reduce RBC sickling and their complications, raising interest for novel oxygen affinity modulators.Areas covered: This review summarizes the characteristics and primary results obtained with osivelotor, a novel oxygen affinity modulator, for the treatment of SCD. Osivelotor is presented with improved pharmacokinetic properties comparatively to voxelotor. It may enable higher hemoglobin (Hb) occupancy at lower doses potentially leading to significant improvements of clinical outcomes.Expert opinion: The first clinical phase 2/3 trial with osivelotor reported increases of Hb levels and RBC counts, and decrease of RBC sickling. The treatment was apparently well tolerated. However, osivelotor shares the same mechanism of action as voxelotor, and therefore similar limitations regarding its efficacy for which the improvement in Hb level appears misleading. Several issues remain to be resolved before considering any drug approval.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"1-8"},"PeriodicalIF":2.5,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779527","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

Efficacy and safety of taletrectinib for treatment of ROS1 positive non-small cell lung cancer: A systematic review.

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-04-03 DOI: 10.1080/14656566.2025.2487150

Irtiqa Khan, Atiya Sahar, Suhaiba Numra, Nilanjan Saha, Nidhi, Rizwana Parveen

{"title":"Efficacy and safety of taletrectinib for treatment of ROS1 positive non-small cell lung cancer: A systematic review.","authors":"Irtiqa Khan, Atiya Sahar, Suhaiba Numra, Nilanjan Saha, Nidhi, Rizwana Parveen","doi":"10.1080/14656566.2025.2487150","DOIUrl":"10.1080/14656566.2025.2487150","url":null,"abstract":"Introduction: Approximately 85% of all instances of lung cancer are non-small-cell lung cancer (NSCLC). Crizotinib and entrectinib are the preferred first line therapy for treating ROS1 fusion-positive NSCLC (ROS1+NSCLC). However, not all patients react to these treatments and most of the patients acquire resistance to the medications. Taletrectinib is intended to address few of the issues with these treatments, such as lowering tyrosine receptor kinase B TRKB-related neurological side events by selectively inhibiting ROS1 over TRKB, addressing tumor treatment resistance and brain metastases through blood-brain barrier penetration.Methods: A systematic literature search was conducted across PubMed, ScienceDirect, Cochrane, and ClinicalTrials.gov upto September 2024. Studies were included if they investigated taletrectinib for ROS1-positive NSCLC.Results: Out of 392 identified records, three studies involving 234 participants (102 males, 132 females) met inclusion criteria. Taletrectinib demonstrated high overall response rates (ORR) in treatment-naïve patients (upto 90.6%) and moderate ORR (51.5%) in crizotinib-pretreated patients. It showed manageable adverse events, such as mild liver enzyme elevations and gastrointestinal symptoms.Conclusions: Taletrectinib shows significant efficacy and favorable safety profile for ROS1-positive NSCLC, particularly in treatment-naïve or tyrosine kinase inhibitor TKI-resistant patients. Further large-scale trials are warranted to confirm its long-term safety and efficacy.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"1-8"},"PeriodicalIF":2.5,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763298","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

Pharmacological treatment for children with constipation: present and future.

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-04-01 Epub Date: 2025-02-25 DOI: 10.1080/14656566.2025.2471524

Julia M J van der Zande, Ilan J N Koppen, Carlo Di Lorenzo, Peter L Lu, Marc A Benninga

引用次数: 0

Pharmacotherapy of type 1 diabetes - part 3: tomorrow.

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-04-01 Epub Date: 2025-03-26 DOI: 10.1080/14656566.2025.2468906

Marc Rendell

{"title":"Pharmacotherapy of type 1 diabetes - part 3: tomorrow.","authors":"Marc Rendell","doi":"10.1080/14656566.2025.2468906","DOIUrl":"10.1080/14656566.2025.2468906","url":null,"abstract":"Introduction: The last 100 years have seen type 1 diabetes, a previously fatal disease, transformed by the administration of exogenous insulin.Areas covered: A standard literature search using the Google and Microsoft search engines and PubMed was performed. The development of synthetic insulins with varying onsets and duration of action improved glucose control, essential to mitigate the microvascular and macrovascular consequences of diabetes. Today insulin pumps guided by continuous glucose monitors are approaching the objective of normalized glucose levels. The area of greatest development is now in attempting to suppress the immune process which results in progressive destruction of the beta cell. It is possible to identify family members of patients with type 1 diabetes who may eventually develop the disease by measuring several beta cell antibodies. Very recently teplizumab, a CD3 inhibitor, has been approved to delay the onset of hyperglycemia in these individuals.Expert opinion: The future will see progress in immunosuppression, possibly using specific CAR-Treg cells directed at the beta cell antigens which trigger the immune process. In parallel, stem cell-derived beta cells may eventually make it possible to replace lost beta cells, resulting in a true cure for type 1 diabetes.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"535-550"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585228","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

Promising therapies for the treatment of acromegaly.

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-04-01 Epub Date: 2025-03-11 DOI: 10.1080/14656566.2025.2474562

Sylvère Störmann, Katharina Schilbach

引用次数: 0

Factor XI/XIa inhibitors: a potential solution to anticoagulation dilemmas.

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-04-01 Epub Date: 2025-03-05 DOI: 10.1080/14656566.2025.2475192

Caitlin M Gibson, Umesh R Desai, Megan E Wesling

{"title":"Factor XI/XIa inhibitors: a potential solution to anticoagulation dilemmas.","authors":"Caitlin M Gibson, Umesh R Desai, Megan E Wesling","doi":"10.1080/14656566.2025.2475192","DOIUrl":"10.1080/14656566.2025.2475192","url":null,"abstract":"Introduction: Antithrombotic therapy is the cornerstone of stroke prevention, but standard of care therapies are underutilized and use is limited by bleeding rates, drug interactions, and renal elimination. Factor XI/XIa (FXI/XIa) inhibitors are a novel anticoagulation class that purportedly target thrombosis more than hemostasis, thereby raising the hope of reducing bleeding consequences while maintaining efficacy.Areas covered: This review covers the mechanistic rationale for FXI/XIa inhibitors, describes the various molecule sub-classes, addresses barriers to current anticoagulation use, and reviews clinical trial data to date for this novel class of anticoagulants.Expert opinion: FXI/XIa inhibitors offer several advantages over DOACs in stroke prevention such as reduced bleeding, fewer drug interactions, and less renal elimination. However, clinical trials must demonstrate non-inferior efficacy and improved safety compared to DOACs. Additional barriers to use will include cost, inadequacy of antidotes, and overall anticoagulant underutilization. The potential for a small molecule or monoclonal antibody to reach the clinic is very high.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"605-616"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540756","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

Addressing the long-term risks of administering antenatal steroids.

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-04-01 Epub Date: 2025-03-18 DOI: 10.1080/14656566.2025.2475190

Sean W D Carter, Agnihotri Biswas, Hannah R S Watson, Han Lin Chelsea Ip, Erin L Fee, Kay Yi Michelle Seah, Yusaku Kumagai, Zubair Amin, Mahesh A Choolani, Alan H Jobe, Sebastian E Illanes, Matthew W Kemp

{"title":"Addressing the long-term risks of administering antenatal steroids.","authors":"Sean W D Carter, Agnihotri Biswas, Hannah R S Watson, Han Lin Chelsea Ip, Erin L Fee, Kay Yi Michelle Seah, Yusaku Kumagai, Zubair Amin, Mahesh A Choolani, Alan H Jobe, Sebastian E Illanes, Matthew W Kemp","doi":"10.1080/14656566.2025.2475190","DOIUrl":"10.1080/14656566.2025.2475190","url":null,"abstract":"Introduction: A single course of antenatal steroid (ANS) therapy is standard of care for women at risk of preterm birth, reducing the risk of neonatal respiratory distress syndrome, neonatal morbidity, and mortality. An unresolved challenge relates to the potential risk of adverse long-term effects, and how these risks might be balanced with therapeutic benefit.Areas covered: We outline key concepts in glucocorticoid signaling, pharmacokinetics/pharmacodynamics, and clinical use before presenting data on the potential long-term harms of ANS therapy.Expert opinion: Our assessment is that: i) Currently used, high dose ANS regimens can induce multi-system changes in the fetus that alter growth and development, potentially increasing long-term disease risk; and ii) relative risks likely increase proportionally to the magnitude and duration of steroid exposure, in late preterm and term ANS use, and in off-target treatments. A single course of ANS therapy to at risk women between 24- and 34-weeks' gestation is well justified. Efforts should be made to improve dosing and patient selection. At periviable gestations, the high immediate risk of serious disease or death justifies modest long-term risks. At late preterm and term gestations, where steroids do not provide notable survival or health benefits, supporting routine ANS use is more difficult.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"617-629"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540754","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