Expert Opinion on Pharmacotherapy最新文献_第2页

Polypharmacology of carbonic anhydrase inhibitors and activators.

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-04-01 Epub Date: 2025-03-01 DOI: 10.1080/14656566.2025.2474574

Alessandro Bonardi, Claudiu T Supuran

{"title":"Polypharmacology of carbonic anhydrase inhibitors and activators.","authors":"Alessandro Bonardi, Claudiu T Supuran","doi":"10.1080/14656566.2025.2474574","DOIUrl":"10.1080/14656566.2025.2474574","url":null,"abstract":"Introduction: Carbonic anhydrases (CAs) are enzymes involved in many physiologic and pathological processes connected with a diversity of conditions. Many of their inhibitors are used clinically for the management of glaucoma, epilepsy, obesity, and cancer. Some of these compounds also show significant polypharmacological effects. CA activators (CAAs) are not in clinical use.Areas covered: PubMed and ScienceDirect databases were searched for articles published over the past 20 years. Several antiepileptics (topiramate, zonisamide, lacosamide, and levetiracetam), some atypical antipsychotics (sulpiride, veralipride), celecoxib, polmacoxib, pazopanib, the antiulcer agent famotidine, and compounds in clinical trials (epacadostat and PCI-27483) as antitumor agents significantly inhibit several CA isoforms of the 15 human ones, apart their action on several other targets. The possible role of CA inhibition in the therapeutic effects of these drugs, their side effects, and the possibility to use this information for drug design are discussed. CAAs belonging to a variety of aminergic classes (histaminergic, dopaminergic, and serotoninergic) are also discussed.Expert opinion: Polypharmacology involving CA inhibitors/CAAs is understood from the chemical, structural, and pharmacological viewpoints. The many other drug targets with which these modulators of activity interact allow for de novo design of such agents for the management of multifactorial conditions in need of innovative drugs.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"567-580"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531566","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 evaluation of sebetralstat as the first oral on-demand therapy for Hereditary Angioedema.

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-04-01 DOI: 10.1080/14656566.2025.2482737

Henriette Farkas, Zsuzsanna Balla

{"title":"An evaluation of sebetralstat as the first oral on-demand therapy for Hereditary Angioedema.","authors":"Henriette Farkas, Zsuzsanna Balla","doi":"10.1080/14656566.2025.2482737","DOIUrl":"10.1080/14656566.2025.2482737","url":null,"abstract":"Introduction: Hereditary Angioedema (HAE) is a rare genetic disease characterized by sudden episodes of edema that do not respond to conventional treatments. Modern therapies targeting the kallikrein-kinin system aim to alleviate HAE attacks, reduce their frequency and severity, and enhance patients' quality of life. Sebetralstat, a novel oral plasma kallikrein inhibitor, offers a promising option for rapid and effective on-demand treatment of HAE attacks.Areas covered: This article evaluates the pharmacokinetics, pharmacodynamics, efficacy, and tolerability of sebetralstat based on developmental studies. We reviewed and analyzed seven pertinent original studies focusing on sebetralstat trials.Expert opinion: Oral sebetralstat provides a convenient alternative to injectable treatments, allowing patients to take the drug at the first sign of an attack, improving management of acute symptoms by helping to resolve them quickly. Clinical trials demonstrated that sebetralstat exhibits rapid absorption, effective plasma kallikrein inhibition, and a favorable safety and efficacy profile. Its pharmacokinetic and pharmacodynamic properties suggest its potential for reliable control of HAE attacks.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"1-9"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663116","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 pharmacotherapy approaches for the treatment of systemic sclerosis.

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-04-01 Epub Date: 2025-02-27 DOI: 10.1080/14656566.2025.2470846

Stefano Di Donato, Zsuzsanna H McMahan, Michael Hughes

{"title":"Systemic pharmacotherapy approaches for the treatment of systemic sclerosis.","authors":"Stefano Di Donato, Zsuzsanna H McMahan, Michael Hughes","doi":"10.1080/14656566.2025.2470846","DOIUrl":"10.1080/14656566.2025.2470846","url":null,"abstract":"Introduction: Systemic sclerosis (SSc) represents a complex, multisystem rheumatologic disorder characterized by immune dysregulation, vascular dysfunction, and multi-organ fibrosis. This review discusses the efficacy of the available therapeutic options and the significance of developing effective strategies against its varied manifestations, pivotal to improving patient outcomes.Areas covered: The review elaborates on the pharmacological treatments available for managing key manifestations of SSc, including skin and lung involvement, and vascular complications, as well as the most recent findings in the field. We evaluated recent literature and clinical trials from the past decade, as well as most recent guidelines from entities like EULAR and the ACR, to provide a comprehensive overview of current management strategies.Expert opinion: Despite advancements in therapeutic options, SSc remains a challenging disease to manage due to its complexity, our relatively limited understanding of disease pathogenesis, and its severe impact on quality of life. The development of targeted therapies and the refinement of existing treatment protocols offer hope for better management. Future research should focus on personalized medicine approaches and refining treatment algorithms to optimize outcomes for patients.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"551-566"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467479","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

Intravenous peptides and amino acids for erectile dysfunction: a narrative review of current applications and future directions.

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-04-01 Epub Date: 2025-03-14 DOI: 10.1080/14656566.2025.2478912

Vishal Ila, Edoardo Pozzi, Miyuru Gamage, Ranjith Ramasamy

{"title":"Intravenous peptides and amino acids for erectile dysfunction: a narrative review of current applications and future directions.","authors":"Vishal Ila, Edoardo Pozzi, Miyuru Gamage, Ranjith Ramasamy","doi":"10.1080/14656566.2025.2478912","DOIUrl":"10.1080/14656566.2025.2478912","url":null,"abstract":"Introduction: Erectile dysfunction (ED) pathophysiology involves complex interactions between vasculogenic, hormonal, and neurological mechanisms, with endothelial dysfunction and oxidative stress playing crucial roles. There is growing interest in intravenous (IV) peptides and amino acids as potential therapeutic options for ED treatment.Areas covered: This narrative review examines recent developments in peptide and amino acid therapies for ED, focusing on PT-141, PnPP-19, L-arginine, and L-citrulline. The literature search utilized PubMed to identify relevant English-language publications up to October 2024, emphasizing studies from the past decade.Expert opinion: IV peptides and amino acids offer promising therapeutic options for ED through mechanisms of action distinct from PED5 inhibitors. PT-141 and PnPP-19 show efficacy through central nervous system activation and nitric oxide regulation, while L-arginine and L-citrulline enhance endothelial function. Although evidence suggests potential benefits, large-scale clinical trials are needed to establish safety profiles, optimal dosing regimens, and possible synergistic effects with existing ED treatments.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"631-637"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604436","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

Examining the safety and efficacy of imetelstat in low-risk myelodysplastic syndrome.

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

Effectiveness of Analgesics in Dental Whitening Pain Management: A Systematic Review and Meta-Analysis.

IF 2.5 3区医学

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

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":2.5,"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.

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

Melanoma and pediatric drug development: clinical progress vs. regulatory activism in minors - a narrative review.

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

Systemic therapy in metastatic pediatric rhabdomyosarcoma: a history of challenges and the search for promising approaches.

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub 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

Benefits and disadvantages of combination therapy with imeglimin and metformin in patients with type 2 diabetes.

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-03-30 DOI: 10.1080/14656566.2025.2486354

Hiroyuki Ito, Emiko Tsugami, Chiaki I, Shun Miura, Suzuko Matsumoto, Hideyuki Inoue, Shinichi Antoku, Tomoko Yamasaki, Toshiko Mori, Michiko Togane

{"title":"Benefits and disadvantages of combination therapy with imeglimin and metformin in patients with type 2 diabetes.","authors":"Hiroyuki Ito, Emiko Tsugami, Chiaki I, Shun Miura, Suzuko Matsumoto, Hideyuki Inoue, Shinichi Antoku, Tomoko Yamasaki, Toshiko Mori, Michiko Togane","doi":"10.1080/14656566.2025.2486354","DOIUrl":"10.1080/14656566.2025.2486354","url":null,"abstract":"Background: We retrospectively examined the benefits and disadvantages of adding imeglimin to metformin therapy in patients with type 2 diabetes.Research design and methods: Ninety-four patients with type 2 diabetes who had been administered imeglimin were included in the safety analysis set (SAS). Sixty-four patients who had been treated with imeglimin for over 6 months were included in the full analysis set (FAS). The primary outcome was the change in HbA1c levels in the FAS. The secondary outcomes were gastrointestinal adverse events (AEs) in the SAS and changes in body weight and FIB-4 in theFAS.Results: In the SAS, gastrointestinal AEs occurred in 15 of 40 (38%) metformin users and 6 of 54 (11%) non-users. In the FAS, HbA1c levels were significantly reduced in both metformin users (n = 27, baseline, 8.5 ± 1.1%;6 months, 7.7 ± 1.2%) and non-users (n = 37, baseline, 8.0 ± 0.9%; 6 months,7.4 ± 0.9%). While body weight (from 72.0 ± 20.5 kg to 70.9 ± 20.8 kg) and FIB-4 (from 1.27 ± 0.57 to 1.17 ± 0.49) significantly decreased in metformin users, they did not significantly differ in non-users.Conclusions: Adding imeglimin to metformin therapy demonstrated favorable reductions in HbA1c, body weight, and FIB-4 in patients with type 2 diabetes, although it was associated with the incidence of gastrointestinal AEs.Trial registration: UMIN000055241.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"1-9"},"PeriodicalIF":2.5,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729434","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