Expert Opinion on Pharmacotherapy最新文献_第10页

Examining the safety and efficacy of imetelstat in low-risk myelodysplastic syndrome. 检查依美他他治疗低危骨髓增生异常综合征的安全性和有效性。

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-04-01 Epub Date: 2025-02-27 DOI: 10.1080/14656566.2025.2471518

Xavier Thomas

引用次数: 0

Pharmacotherapy of type 1 diabetes - part 2 Today. 1型糖尿病的药物治疗-第2部分。

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-04-01 Epub Date: 2025-03-28 DOI: 10.1080/14656566.2025.2479598

Marc Rendell

{"title":"Pharmacotherapy of type 1 diabetes - part 2 Today.","authors":"Marc Rendell","doi":"10.1080/14656566.2025.2479598","DOIUrl":"10.1080/14656566.2025.2479598","url":null,"abstract":"Introduction: In the 100 years since isolation and administration of animal insulin to sustain life in Type 1 diabetes, there has been increasing progress in the administration of exogenous insulin to lower glucose levels.Areas covered: We reviewed using standard search engines and PubMed present-day techniques of management of type 1 diabetes.Expert opinion: Long-acting insulin formulations have been developed to maintain basal glucose levels in the normal range, while rapid acting insulins have been synthesized to address the sharp rise in glucose levels after a meal. Insulin pumps administer insulin continuously subcutaneously guided by continuous glucose monitoring systems. These almost closed loop systems achieve near normal glucose levels other than at meal times where the rapid glucose rise and then fall pose a significant challenge due to the extended duration of subcutaneous insulin depots. Implanted insulin pumps with intraperitoneal delivery may eventually permit improved post meal glucose control. Type 1 diabetes has now been redefined as an autoimmune disease which may be diagnosed purely from the presence of anti-beta cell antibodies with no abnormality of glucose levels. The future will see an intensification of efforts to combat the immune process which destroys beta cells.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"719-730"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624004","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

Effectiveness of Analgesics in Dental Whitening Pain Management: A Systematic Review and Meta-Analysis. 镇痛药在牙齿美白疼痛管理中的有效性：一项系统回顾和荟萃分析。

IF 2.7 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-04-01 Epub Date: 2025-03-05 DOI: 10.1080/14656566.2025.2472021

Gabriella Alves Julião Costa, Caio Ferreira Freire Caetano, Ravy Jucá Farias, Diana Araújo Cunha, Dayrine Silveira de Paula, Edson Luiz Cetira Filho, Paulo Goberlânio de Barros Silva

{"title":"Effectiveness of Analgesics in Dental Whitening Pain Management: A Systematic Review and Meta-Analysis.","authors":"Gabriella Alves Julião Costa, Caio Ferreira Freire Caetano, Ravy Jucá Farias, Diana Araújo Cunha, Dayrine Silveira de Paula, Edson Luiz Cetira Filho, Paulo Goberlânio de Barros Silva","doi":"10.1080/14656566.2025.2472021","DOIUrl":"10.1080/14656566.2025.2472021","url":null,"abstract":"Introduction: This study evaluated the impact of anti-inflammatory and analgesic agents on managing pain and sensitivity related to dental bleaching.Methods: A PROSPERO-registered systematic review (CRD42024528788) searched PubMed, Scopus, Web of Science, LILACS, EBSCOhost, LIVIVO, Embase, and Grey literature (Google Scholar) up to March 2024. From 3,185 articles screened, 16 placebo-controlled RCTs involving 823 patients were included. NSAIDs were the most commonly used drugs, with some studies incorporating corticosteroids. Risk of Bias (RoB) was assessed using Rob-2, and a meta-analysis evaluated mean differences and relative risks across subgroups. GRADE-pro assessed evidence certainty.Results: Findings revealed no significant improvement in pain or sensitivity scores (VAS: p = 0.770; NRS: p = 0.980) or tooth sensitivity incidence (p = 0.750) compared to placebo. However, 1 hour post-bleaching, the intervention group showed a slight VAS score reduction (mean difference: -0.49, CI95% = -0.83 to -0.16; p = 0.004). Whitening results (ΔE: p = 0.140) and NSGU perception showed no differences, but the VITA scale slightly favored the placebo (p = 0.030). Ibuprofen or paracetamol-plus-codeine were the only that showed any clinical benefit.Conclusions: Anti-inflammatory or analgesic agents provided minimal benefit for controlling post-bleaching pain/sensitivity reducing 0.49-VAS-scores (clinically insignificant). There is a need to optimize pain management in dental bleaching, especially focusing on COX-2 selective NSAIDs.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"639-652"},"PeriodicalIF":2.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491437","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

Difference in healthcare resource utilization and health-related quality of life between patients with major depressive disorder (MDD) and treatment-resistant depression (TRD) in a public hospital in Malaysia - a retrospective case-note review and cross-sectional survey. 马来西亚一家公立医院重度抑郁症（MDD）和难治性抑郁症（TRD）患者的医疗资源利用和健康相关生活质量差异——回顾性病例回顾和横断面调查

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-04-01 Epub Date: 2025-02-28 DOI: 10.1080/14656566.2025.2472976

Kenneth Kwing Chin Lee, Nik Nur Eliza Mohamed, Salina Abdul Aziz, Duratul'ain Mohamad Nazri, Akramul Zikri Abdul Malek, Jing-Sheng Lim, David Bin-Chia Wu, Raja Ahsan Aftab, Subramaniam Thanimalai, Meyyammai Swaminathan, June Wai Yee Choon, Renukha Sellappans

{"title":"Difference in healthcare resource utilization and health-related quality of life between patients with major depressive disorder (MDD) and treatment-resistant depression (TRD) in a public hospital in Malaysia - a retrospective case-note review and cross-sectional survey.","authors":"Kenneth Kwing Chin Lee, Nik Nur Eliza Mohamed, Salina Abdul Aziz, Duratul'ain Mohamad Nazri, Akramul Zikri Abdul Malek, Jing-Sheng Lim, David Bin-Chia Wu, Raja Ahsan Aftab, Subramaniam Thanimalai, Meyyammai Swaminathan, June Wai Yee Choon, Renukha Sellappans","doi":"10.1080/14656566.2025.2472976","DOIUrl":"10.1080/14656566.2025.2472976","url":null,"abstract":"Background: Major depressive disorder (MDD) is a growing global health concern, with its economic impact projected to reach USD 6.0 trillion by 2030. Treatment-resistant depression (TRD), characterized by non-responsiveness to initial treatments, adds a significant cost burden. In Malaysia, the National Health and Morbidity Survey 2023 reported a rising prevalence of depression in Malaysia, affecting approximately one million individuals.Research design and methods: A combined retrospective chart review and cross-sectional survey was conducted at the Psychiatry and Mental Health Clinic of Hospital Kuala Lumpur (HKL) over an 18-month period, examining 286 patients diagnosed with MDD or TRD. Data were analyzed from governmental and societal perspectives, including direct medical costs, indirect costs, and other resource utilization.Results: TRD patients exhibited significantly higher health-care utilization, including a fivefold increase in the likelihood of attending more than 10 consultations (p = 0.035) and greater use of second-generation antipsychotics (p < 0.001). The average healthcare cost per TRD patient (RM1,845) was 55% higher than that of MDD patients (RM839).Conclusion: Early and effective management of MDD is essential to prevent progression to TRD, reducing healthcare resource utilization and costs. Adequate resource allocation for early intervention is critical to mitigate the economic impact of depression.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"653-662"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523019","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

Systemic therapy in metastatic pediatric rhabdomyosarcoma: a history of challenges and the search for promising approaches. 转移性儿童横纹肌肉瘤的全身治疗：挑战的历史和寻找有前途的方法。

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-04-01 Epub Date: 2025-03-31 DOI: 10.1080/14656566.2025.2484319

Daniela Di Carlo, Maria Carmen Affinita, Elena Poli, Gianni Bisogno

引用次数: 0

Melanoma and pediatric drug development: clinical progress vs. regulatory activism in minors - a narrative review. 黑色素瘤和儿科药物开发：未成年人的临床进展与监管激进主义-叙述回顾。

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-04-01 Epub Date: 2025-03-09 DOI: 10.1080/14656566.2025.2475184

Earl B Ettienne, Jane M Grant-Kels, Pasquale Striano, Emilio Russo, David Neubauer, Klaus Rose

{"title":"Melanoma and pediatric drug development: clinical progress vs. regulatory activism in minors - a narrative review.","authors":"Earl B Ettienne, Jane M Grant-Kels, Pasquale Striano, Emilio Russo, David Neubauer, Klaus Rose","doi":"10.1080/14656566.2025.2475184","DOIUrl":"10.1080/14656566.2025.2475184","url":null,"abstract":"Introduction: Melanoma is the malignancy where, in recent years, drug treatment has massively improved prognosis and quality of life. Based on genetic analysis, we differentiate today melanomas caused by cumulative solar damage (CSD) from others.Areas covered: Conventional CSD-caused melanomas affect predominantly adults and occasionally adolescents. Spitz melanoma and melanoma arising in congenital nevi, the two other pediatric melanoma types, are not CSD-caused, are genetically different, have different prognoses, and need different treatment. In contrast to the improved situation in adult melanoma, regulatory demand for pediatric labels in minors has resulted in pointless and harmful studies and has obfuscated diagnosis and treatment. Modern communication facilitates a worldwide analysis of extremely rare diseases such as melanoma in minors. Regulatory demand for on-label treatment only is demonstrably wrong for pediatric melanomas. They are too rare for randomized controlled trials but nevertheless deserve effective treatment.Expert opinion: Adolescents with conventional, CSD-caused melanoma should be treated as adults. Their bodies are already mature. For other childhood melanomas, registries and consultations with clinical specialists are better options than dogmatically demanded regulatory studies.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"595-603"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540757","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

Will elinzanetant, a neurokinin receptor antagonist, have a role in the treatment of hot flashes? 神经激肽受体拮抗剂依兰那坦对治疗潮热有作用吗？

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-03-01 Epub Date: 2025-02-15 DOI: 10.1080/14656566.2025.2465875

Sheila A Doggrell

{"title":"Will elinzanetant, a neurokinin receptor antagonist, have a role in the treatment of hot flashes?","authors":"Sheila A Doggrell","doi":"10.1080/14656566.2025.2465875","DOIUrl":"10.1080/14656566.2025.2465875","url":null,"abstract":"Introduction: The use of hormonal treatment for the vasomotor symptoms (VSM) associated with the menopause is back in favor, as the adverse effects reported in the early 2000s have been dispelled. However, many women are still reluctant to use, or have contraindications to, hormonal therapy. Elinzanetant is a combined neurokinin (NK)-1 and -3 receptor antagonist, being trialed for menopausal symptoms.Area covered: A combination of OASIS 1 and 2 in the menopause showed that elinzanetant caused a reduction in the frequency and intensity of VSM and may also independently reduce sleep disturbances. Adverse effects were low with elinzanetant.Expert opinion: Further study is needed to clarify whether elinzanetant reduces sleep disturbance and whether this is due to antagonism at NK-1 receptors. If further studies support OASIS 1 and 2, elinzanetant maybe considered for use in hot flashes associated with the menopause, in subjects where hormonal therapy is contraindicated or not accepted. Fezolinetant, an NK-3 receptor antagonist, has recently been registered for VSM associated with the menopause. Fezolinetant does not have a clear-cut effect on sleep disturbances independent of VMS. Only, if elinzanetant can be shown to independently reduce sleep disturbances, it may have an advantage over fezolinetant.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"349-354"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382076","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 dutasteride in the treatment of alopecia: a comprehensive review. 杜他雄胺治疗脱发的有效性和安全性：一项全面的综述。

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-03-01 Epub Date: 2025-02-03 DOI: 10.1080/14656566.2025.2461169

Aditya K Gupta, Mesbah Talukder

{"title":"Efficacy and safety of dutasteride in the treatment of alopecia: a comprehensive review.","authors":"Aditya K Gupta, Mesbah Talukder","doi":"10.1080/14656566.2025.2461169","DOIUrl":"10.1080/14656566.2025.2461169","url":null,"abstract":"Introduction: Alopecia affects many individuals, with androgenetic alopecia (AGA) being the most common form in both men and women. The exact etiology of AGA is unclear. The systemic treatments of AGA include 5-alpha reductase inhibitors (finasteride, dutasteride) and low-dose oral minoxidil.Areas covered: The article comprehensively reviews dutasteride's pharmacokinetics, pharmacodynamics, clinical efficacy, and side effects to support clinicians in prescribing it for alopecia.Expert opinion: Studies show dutasteride to be more effective than finasteride for AGA, with both drugs having similar safety profiles. In our view, clinicians should consider topical minoxidil and oral finasteride as first-line treatments, as they are well-studied for male and female AGA (finasteride is off label in females and should only be considered in post-menopausal females). If these options are ineffective, oral dutasteride may be considered off-label for greater efficacy in males and post-menopausal females. However, dutasteride can reduce sperm count and motility, potentially affecting fertility in men with preexisting fertility issues. Men whose partners are pregnant should avoid dutasteride.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"367-379"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064726","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

Weighing up GnRH agonist therapy for endometriosis: outcomes and the treatment paradigm. 权衡GnRH激动剂治疗子宫内膜异位症：结果和治疗模式。

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-03-01 Epub Date: 2025-01-29 DOI: 10.1080/14656566.2025.2459783

Márcia Mendonça Carneiro

{"title":"Weighing up GnRH agonist therapy for endometriosis: outcomes and the treatment paradigm.","authors":"Márcia Mendonça Carneiro","doi":"10.1080/14656566.2025.2459783","DOIUrl":"10.1080/14656566.2025.2459783","url":null,"abstract":"Introduction: Endometriosis is a chronic inflammatory estrogen-dependent disease affecting 10% of women worldwide leading to chronic pelvic pain and infertility which may be treated clinically or surgically.Areas covered: Current literature was reviewed using the keywords 'gonadotropin releasing hormone agonists (GnRHa),' 'endometriosis,' 'infertility' and 'chronic pelvic pain.' Relevant papers prioritizing randomized controlled clinical trials (RCT), systematic reviews, meta-analyses, as well as international guidelines were evaluated.Expert opinion: Available options for relieving endometriosis-associated pain include GnRHa, progestagens, and combined oral contraceptives, all of which block menstruation to control symptoms without curing the disease. GnRHa administration decreases pain and symptom recurrence after surgical treatment, but side effects and costs limit its use. Published studies to test its effectiveness in easing endometriosis-associated pain are heterogeneous, consider different outcomes with no long-term results. Drug choice should be individualized considering the side-effect profile, tolerability, costs, risks, and benefits as one size does not fit all. As we wait for the development of an ideal pharmacological agents, GnRHa with an add-back regimen remains a second-line option to alleviate the painful symptoms in women with endometriosis. Endometriosis management should consider the systemic nature of the disease and the complexity involved in the pathogenesis of symptoms.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"355-365"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037736","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

Have SGLT-2 inhibitors DELIVERed an EMPhatic win in heart failure and chronic kidney disease? SGLT-2抑制剂在心力衰竭和慢性肾脏疾病中有显著的疗效吗？

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-03-01 Epub Date: 2025-02-13 DOI: 10.1080/14656566.2025.2464905

Awadhesh Kumar Singh, Akriti Singh, Ritu Singh

{"title":"Have SGLT-2 inhibitors DELIVERed an EMPhatic win in heart failure and chronic kidney disease?","authors":"Awadhesh Kumar Singh, Akriti Singh, Ritu Singh","doi":"10.1080/14656566.2025.2464905","DOIUrl":"10.1080/14656566.2025.2464905","url":null,"abstract":"Introduction: Major global guidelines currently recommend sodium-glucose co-transporter-2 inhibitors (SGLT-2i) as the first-line agent in people with type 2 diabetes (T2D) who have either established cardiovascular disease (eCVD), heart failure (HF), or chronic kidney disease (CKD), regardless of baseline glycated hemoglobin (HbA1c). Moreover, SGLT-2i are currently included in guideline-directed medical therapy as one of the pillars for people with HF and CKD, regardless of T2D. These recommendations are based on positive cardio-renal outcomes from several randomized controlled trials (RCTs).Areas covered: Following an extensive search in electronic databases of PubMed, Google Scholar, and clinicaltrials.gov, we critically analyzed the RCTs that assessed cardio-renal outcome trials of SGLT-2i and put a perspective on how SGLT-2i delivered an emphatic win for people with HF and CKD, with or without T2D.Expert opinion: From thirteen high-quality RCTs, including five cardiovascular outcome trials, five HF outcome trials, three renal outcome trials, and a pooled meta-analysis, it is evident that SGLT-2i has delivered an emphatic win in people with HF and CKD, with or without T2D, with an acceptable safety profile. Ongoing RCTs shall further enlighten whether SGLT-2i will be effective in polycystic kidney disease, lupus nephritis, vasculitis, end-stage CKD with or without hemodialysis, and renal transplant.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"457-472"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370708","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