Expert Opinion on Pharmacotherapy最新文献_第10页

Microdomain-resolved potassium channel gating as a controllable process: patient-specific excitability landscapes, attractor stability, and closed-loop therapeutic optimization. 微域分解钾通道门控作为一个可控过程：患者特异性兴奋性景观，吸引子稳定性和闭环治疗优化。

IF 3.4 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2026-07-01 Epub Date: 2026-06-19 DOI: 10.1080/14656566.2026.2689546

Guido Attilio Condorelli, Roberto Genova, Ottavio D'Urso, Oana-Maria Dragostin

{"title":"Microdomain-resolved potassium channel gating as a controllable process: patient-specific excitability landscapes, attractor stability, and closed-loop therapeutic optimization.","authors":"Guido Attilio Condorelli, Roberto Genova, Ottavio D'Urso, Oana-Maria Dragostin","doi":"10.1080/14656566.2026.2689546","DOIUrl":"10.1080/14656566.2026.2689546","url":null,"abstract":"Introduction: Potassium conductances regulate neuronal excitability across heterogeneous disorders, controlling thresholds, repolarization, adaptation, and bursting at a low energetic cost. However, translating this biology into therapeutic stratification remains incompletely validated. This reviewdistinguishes established potassium-channel mechanisms from conceptual integration and future-facing translational proposals.Areas covered: Based on the literature identified through searches for PubMed/MEDLINE, Embase, Web of Science Core Collection, and Scopus (inception-May 2026), this review advances an 'excitability fingerprint' translational framework, linking microdomain-resolved gating to network stability and future biomarker-enriched therapeutic development. Voltage-gated potassium channels, big- and small-conductance Ca2+ -activated K+ channels , inwardly rectifying , ATP-sensitive and two-pore domain potassium channels are gated by phosphatidylinositol 4,5-bisphosphate (PIP2), Ca2+, redox, and pH across neural and glial microdomains. A tri-axial fingerprint is defined: electroencephalography (EEG)/high-frequency oscillation (HFO) and transcranial magnetic stimulation (TMS) metrics; microdomain tone (PIP2/redox); and astroglial K+ buffering, modulated by age, sex, genetics, and metabolic-inflammatory comorbidities. Biomarker-anchored titration uses electrophysiology, molecular panels of redox and acid-base status, and patient-derived induced pluripotent stem cell (iPSC) assays of PIP2-dependent M-current rescue.Expert opinion: Fingerprint-guided K+ modulation can compress time-to-response and manage network-level risk, supporting standardized pipelines, practical microdomain assays, and response-adaptive trials to implement individualized therapeutic windows.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"875-898"},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148257783","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

Crofelemer for chronic noninfectious diarrhea in adults with HIV/AIDS receiving antiretroviral therapy: a review of plant-derived antisecretory pharmacotherapy. Crofelemer治疗接受抗逆转录病毒治疗的成人HIV/AIDS慢性非感染性腹泻：植物源性抗分泌药物治疗的综述

IF 3.4 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2026-07-01 Epub Date: 2026-06-29 DOI: 10.1080/14656566.2026.2695090

Adnan Amin, Anam Haneef, Sidra Altaf, M R M Rasny

{"title":"Crofelemer for chronic noninfectious diarrhea in adults with HIV/AIDS receiving antiretroviral therapy: a review of plant-derived antisecretory pharmacotherapy.","authors":"Adnan Amin, Anam Haneef, Sidra Altaf, M R M Rasny","doi":"10.1080/14656566.2026.2695090","DOIUrl":"10.1080/14656566.2026.2695090","url":null,"abstract":"Introduction: Chronic noninfectious diarrhea remains a clinically important but often underrecognized complication in patients receiving long-term antiretroviral therapy (ART). Although modern human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) treatment has transformed survival, gastrointestinal adverse effects can impair adherence, quality of life, nutrition, social functioning, and treatment satisfaction. Crofelemer is an oral, plant-derived botanical drug developed as a non-systemic antisecretory therapy for noninfectious diarrhea in adults with HIV/AIDS receiving ART.Areas covered: This review evaluates crofelemer as a plant-derived pharmacotherapy for chronic noninfectious diarrhea. It discusses the clinical need, limitations of current antidiarrheal approaches, botanical origin, chloride-channel mechanism, pharmacology, clinical efficacy evidence, safety and tolerability, practical prescribing considerations, real-world positioning, and investigational expansion into cancer therapy-related diarrhea and rare intestinal-failure disorders.Expert opinion: Crofelemer offers a mechanistically distinct option for selected patients with chronic watery, noninfectious diarrhea whose symptoms remain burdensome despite appropriate clinical evaluation and supportive care. However, its use should be guided by realistic expectations, careful patient selection, and recognition that response is not universal. Future clinical value will depend on phenotype-based prescribing, real-world effectiveness data, comparative studies, affordability, and patient-reported outcomes.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"1009-1018"},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148307833","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

Emerging pharmacotherapies for large-vessel vasculitis. 大血管炎的新兴药物疗法。

IF 3.4 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2026-07-01 Epub Date: 2026-06-19 DOI: 10.1080/14656566.2026.2690109

Esther F Vicente-Rabaneda, Marina Dueñas-Ochoa, Patricia Muñoz Hernández, Juan C Sáez-Martínez, José M Serra López-Matencio, Santos Castañeda, Miguel A González-Gay

{"title":"Emerging pharmacotherapies for large-vessel vasculitis.","authors":"Esther F Vicente-Rabaneda, Marina Dueñas-Ochoa, Patricia Muñoz Hernández, Juan C Sáez-Martínez, José M Serra López-Matencio, Santos Castañeda, Miguel A González-Gay","doi":"10.1080/14656566.2026.2690109","DOIUrl":"10.1080/14656566.2026.2690109","url":null,"abstract":"Introduction: Large-vessel vasculitis (LVV) constitutes a heterogeneous group of diseases including giant cell arteritis (GCA), Takayasu's arteritis (TAK), isolated aortitis, and the aortitis associated with other systemic autoimmune or inflammatory diseases.Areas covered: This narrative review shows briefly the main epidemiological and clinical features of LVV and discusses in depth both the classic and the new therapeutic options used in LVV. With this objective, a structure literature search of the main original manuscripts and reviews published in English in major medical databases, including PubMed, EMBASE, and Cochrane Library from 2016 to now was conducted.Expert opinion: Treatment should always follow a T2T strategy, aimed at reaching clinical remission. In general, patients with LVV experience a rapid response to high doses of glucocorticoids, but relapses frequently occur when the dose is reduced or discontinued. Tocilizumab has been successfully used as a glucocorticoid-sparing agent in both GCA and TAK. Besides, JAK inhibitors have demonstrated efficacy in LVV, both inducing remission and reducing glucocorticoid doses. Apart from these drugs, no other agents have yet been approved for the treatment of these conditions. This review examines classic and new therapeutic options with greatest potential for the future treatment of LVV.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"909-927"},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148249806","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

Therapeutic management of osteoporosis in Parkinson's disease. 帕金森病骨质疏松症的治疗管理。

IF 3.4 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2026-07-01 Epub Date: 2026-06-25 DOI: 10.1080/14656566.2026.2695101

Eric Toussirot, Charline Compagne, Yoshimasa Sagawa, Matthieu Bereau

{"title":"Therapeutic management of osteoporosis in Parkinson's disease.","authors":"Eric Toussirot, Charline Compagne, Yoshimasa Sagawa, Matthieu Bereau","doi":"10.1080/14656566.2026.2695101","DOIUrl":"10.1080/14656566.2026.2695101","url":null,"abstract":"Introduction: Parkinson's disease (PD) is frequently complicated by osteoporosis (OP). PD is associated with a high risk of falls, meaning PD patients with osteoporosis have an increased risk of fractures, particularly hip fractures. Osteoporosis in PD is multifactorial, involving nutritional factors and vitamin deficiencies, weight loss associated with sarcopenia, and PD treatments such as levodopa.Areas covered: This review addresses the assessment of bone involvement in PD and the therapeutic strategies that should be considered to reduce fracture risk. The literature was identified through a structured search of Medline/PubMed, prioritizing original articles, randomized trials, systematic reviews and meta-analyses.Expert opinion: The assessment and management of osteoporosis in PD are multidisciplinary. Evaluation of bone involvement should be considered early in patient management, including assessment of risk factors, fracture history, fall risk, and specific bone evaluation (bone densitometry and calculation of FRAX score). Management involves general measures including fall prevention, as well as non-pharmacological and pharmacological interventions. Pharmacological treatments for osteoporosis have rarely been studied in patients with PD, highlighting the need for dedicated studies. International recommendations for the management of osteoporosis in PD would be valuable for this condition associated with a high risk of falls and fractures.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"899-907"},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148307851","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

Orthostatic hypotension: new frontiers in pharmacotherapeutic management. 直立性低血压：药物治疗管理的新领域。

IF 3.4 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2026-07-01 Epub Date: 2026-06-15 DOI: 10.1080/14656566.2026.2688305

Jacquie R Baker, Satish R Raj

{"title":"Orthostatic hypotension: new frontiers in pharmacotherapeutic management.","authors":"Jacquie R Baker, Satish R Raj","doi":"10.1080/14656566.2026.2688305","DOIUrl":"10.1080/14656566.2026.2688305","url":null,"abstract":"Background: Orthostatic hypotension remains one of the most disabling manifestations of autonomic failure. Current therapies can improve upright blood pressure and orthostatic tolerance, but treatment is often limited by modest efficacy, short duration of action, and worsening of coexisting supine hypertension.Areas covered: This review summarizes the contemporary management of orthostatic hypotension in adults with autonomic failure. After briefly reviewing epidemiology, hemodynamic physiology, and major etiologic categories, the discussion focuses on reviewing current non-pharmacological and pharmacological treatments for OH and supine hypertension and explores new emerging therapies for both.Expert opinion: The next phase of the field will likely depend less on identifying a single superior pressor agent and more on treating OH and supine hypertension as a coupled disorder of impaired blood pressure control. Mechanism-based treatment selection, informed by physiological phenotyping, will be increasingly important in explaining therapeutic heterogeneity and matching patients to intervention. Emerging strategies, including norepinephrine transporter inhibition, carbon dioxide-based therapy, continuous positive airway pressure, dynamic mechanical support, passive heat, and neuromodulation, may help expand treatment beyond conventional vasoconstriction.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"953-965"},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148216934","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

When metastatic colorectal cancer becomes refractory: how can we optimize treatment? 当转移性结直肠癌变得难治性时：我们如何优化治疗？

IF 3.4 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2026-07-01 Epub Date: 2026-06-25 DOI: 10.1080/14656566.2026.2689551

Jane E Rogers

引用次数: 0

Emerging synthetic drugs for the management of hidradenitis suppurativa: a comprehensive update. 用于治疗化脓性汗腺炎的新兴合成药物：全面更新。

IF 3.4 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2026-07-01 Epub Date: 2026-06-29 DOI: 10.1080/14656566.2026.2695100

Daifallah Almansouri, Alaa Naasani, Christos C Zouboulis

{"title":"Emerging synthetic drugs for the management of hidradenitis suppurativa: a comprehensive update.","authors":"Daifallah Almansouri, Alaa Naasani, Christos C Zouboulis","doi":"10.1080/14656566.2026.2695100","DOIUrl":"10.1080/14656566.2026.2695100","url":null,"abstract":"Introduction: Hidradenitis suppurativa (HS) is a chronic, debilitating inflammatory skin disorder affecting intertriginous regions. Despite its substantial impact on quality of life and association with serious systemic comorbidities, undertreatment remains a concern. Currently, only three biologic agents - adalimumab, secukinumab, and bimekizumab - hold regulatory approval for moderate-to-severe HS. A large proportion of patients, however, fail to achieve adequate or sustained responses, representing an urgent unmet therapeutic need for novel drugs. Among them, new, orally bioavailable, synthetic small-molecule agents are emerging.Areas covered: This review synthesizes current evidence on emerging oral synthetic drugs for HS, drawn from PubMed, ClinicalTrials.gov, congress abstracts, and peer-reviewed publications through March 2026. Mechanistic classes discussed include Janus kinase (JAK) inhibitors (povorcitinib, upadacitinib, ruxolitinib), TYK2 inhibitors (brepocitinib, ropsacitinib, deucravacitinib), PDE-4 inhibitors (apremilast, orismilast, roflumilast), BTK/SYK inhibitors (remibrutinib, fostamatinib), IRAK-4 inhibitors (zimlovisertib), and HSP-90 inhibitors (RGRN-305).Expert opinion: Oral JAK1 inhibition represents the most advanced small-molecule strategy for HS treatment. The emergence of topical JAK inhibitors (ruxolitinib cream) for milder HS and the progression of BTK inhibitors (remibrutinib) to Phase 3 trials signal a broadening treatment landscape. Personalized selection of synthetic drugs versus biologics - informed by patient comorbidities, disease phenotype, and biomarkers - will be involved in next-generation HS management.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"995-1008"},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148316444","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

Povorcitinib for Hidradenitis suppurativa: a narrative review on clinical trial data with expert commentary. 波沃西替尼治疗化脓性汗腺炎：临床试验数据的叙述性回顾和专家评论。

IF 3.4 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2026-07-01 Epub Date: 2026-05-13 DOI: 10.1080/14656566.2026.2668587

Kenan Kherallah, Claire S Chung, Sharon Ontiveros, Julia M Riley, Vivian Y Shi, Jennifer L Hsiao, Katrina H Lee

{"title":"Povorcitinib for Hidradenitis suppurativa: a narrative review on clinical trial data with expert commentary.","authors":"Kenan Kherallah, Claire S Chung, Sharon Ontiveros, Julia M Riley, Vivian Y Shi, Jennifer L Hsiao, Katrina H Lee","doi":"10.1080/14656566.2026.2668587","DOIUrl":"10.1080/14656566.2026.2668587","url":null,"abstract":"Introduction: Hidradenitis suppurativa (HS) is a chronic, inflammatory skin disorder with a heterogeneous pathophysiology that typically affects intertriginous regions and presents with recurrent tender nodules, abscesses, and draining tunnels. Despite recent biologic approvals targeting tumor necrosis factor-α (TNF-α) and interleukin-17 (IL-17) pathways, some patients still experience incomplete or non-durable responses, highlighting the need for additional novel therapeutic targets.Areas covered: This review summarizes current peer-reviewed published evidence on povorcitinib, an oral selective Janus kinase 1 (JAK1) inhibitor under clinical investigation for HS. Relevant literature was identified through PubMed and clinical trial registry searches, focusing on Phase II studies evaluating povorcitinib's efficacy, safety, and clinical utility.Expert opinion: Povorcitinib has shown consistent improvement in disease activity and patient-reported outcomes, with a favorable safety profile across multiple dosing regimens. Overall, povorcitinib represents an important potential advancement in the HS treatment landscape, offering a potential oral option for patients with moderate-to-severe disease. Future research should elucidate its long-term safety, define predictive biomarkers of response, and determine its optimal role within a personalized, multimodal treatment framework.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"1019-1027"},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147863786","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

Current and emerging pharmacotherapy for rosacea: a misunderstood and undertreated condition. 目前和新兴的药物治疗酒渣鼻：一个误解和治疗不足的条件。

IF 3.4 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2026-07-01 Epub Date: 2026-07-11 DOI: 10.1080/14656566.2026.2695088

Nashali Vescovacci, Liddy Malone, Chenan A Huang, Steven R Feldman

{"title":"Current and emerging pharmacotherapy for rosacea: a misunderstood and undertreated condition.","authors":"Nashali Vescovacci, Liddy Malone, Chenan A Huang, Steven R Feldman","doi":"10.1080/14656566.2026.2695088","DOIUrl":"10.1080/14656566.2026.2695088","url":null,"abstract":"Introduction: Rosacea is a chronic inflammatory skin disease characterized by heterogeneous features, including erythema, telangiectasias, papules, pustules, ocular symptoms, and phymatous changes, which can impact quality of life. Its complex pathophysiology involves dysregulated innate immune, neurovascular, and inflammatory pathways, leading to an expanding range of therapeutic options.Areas covered: A narrative review was conducted using the PubMed database to identify peer-reviewed articles published between 2014 and 2026. Keywords such as 'rosacea,' 'advances,' 'emerging,' 'management,' 'treatment,' 'off label,' 'device,' 'lasers,' and 'pathogenesis' were used to evaluate established and emerging pharmacologic and procedural therapies for rosacea. The following article summarizes the established and emerging agents for each treatment modality available for rosacea, with emphasis placed on mechanism of action, efficacy, and safety profiles.Expert opinion: Current management reflects a phenotype-driven approach to guide personalized treatment regimens. Emerging agents targeting novel inflammatory and neurovascular pathways may address limitations in tolerability and durability of response. Cost and evidence gaps continue to limit widespread clinical adoption. Further investigation is needed to define long-term safety, comparative efficacy, and cost-effectiveness to optimize individualized treatment strategies.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"941-951"},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148420100","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

How have gamma-secretase inhibitors changed the treatment landscape for desmoid tumors? 分泌酶抑制剂如何改变硬纤维瘤的治疗前景？

IF 3.4 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2026-07-01 Epub Date: 2026-02-22 DOI: 10.1080/14656566.2026.2634966

Fernando Campos, Bernd Kasper

引用次数: 0