Expert Opinion on Pharmacotherapy最新文献_第2页

Pharmacotherapy options and drug development in bronchiectasis: spotlight on dipeptidyl-peptidase inhibitors. 支气管扩张的药物治疗选择和药物开发：聚焦于二肽基肽酶抑制剂。

IF 2.7 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2026-04-28 DOI: 10.1080/14656566.2026.2664617

Chiara Premuda, Andrea Gramegna, Sofia Misuraca, Federica Piedepalumbo, Leonardo Terranova, Martina Santambrogio, Martina Contarini, Margherita Ori, Francesco Blasi

{"title":"Pharmacotherapy options and drug development in bronchiectasis: spotlight on dipeptidyl-peptidase inhibitors.","authors":"Chiara Premuda, Andrea Gramegna, Sofia Misuraca, Federica Piedepalumbo, Leonardo Terranova, Martina Santambrogio, Martina Contarini, Margherita Ori, Francesco Blasi","doi":"10.1080/14656566.2026.2664617","DOIUrl":"https://doi.org/10.1080/14656566.2026.2664617","url":null,"abstract":"Introduction: In recent years, the central role of inflammation in the development and persistence of the vicious vortex of bronchiectasis has become increasingly evident, gradually reshaping the therapeutic landscape. Historically, treatment strategies have focused mainly on controlling infection, alleviating symptoms, and enhancing mucociliary clearance. However, accumulating evidence indicates that targeting the inflammatory component represents an important complementary strategy in bronchiectasis management.Areas covered: Within this evolving framework, novel anti-inflammatory approaches are emerging, including the inhibition of dipeptidyl peptidase-1 (DPP-1) which can reduce neutrophil-driven airway inflammation and, consequently, exacerbations. The recent regulatory approval of brensocatib, a DPP-1 inhibitor, represents a milestone in the development of targeted therapies for bronchiectasis.This review provides a narrative overview of available treatments for bronchiectasis, with a particular focus on DPP-1 inhibitors, and discusses their potential role and integration into clinical practice.Expert opinion: The emergence of DPP-1 inhibitors reflects a paradigm shift in bronchiectasis care. While promising, their role remains to be fully defined due to a lack of long-term real-world evidence and comparative studies against established strategies. A major challenge will be identifying the patients most likely to benefit. Despite uncertainties, these agents have the potential to redefine treatment for this complex disease.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"1-9"},"PeriodicalIF":2.7,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147766834","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

Is supplemental vitamin D useful in the clinically isolated syndrome (CIS) typical of multiple sclerosis? 补充维生素D对多发性硬化症的临床孤立综合征（CIS）有用吗？

IF 2.7 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2026-04-26 DOI: 10.1080/14656566.2026.2662946

Sheila A Doggrell

{"title":"Is supplemental vitamin D useful in the clinically isolated syndrome (CIS) typical of multiple sclerosis?","authors":"Sheila A Doggrell","doi":"10.1080/14656566.2026.2662946","DOIUrl":"https://doi.org/10.1080/14656566.2026.2662946","url":null,"abstract":"Introduction: Although vitamin D deficiency is a risk factor for multiple sclerosis (MS), vitamin D has only limited benefit in MS. It is now being considered in clinically isolated syndrome (CIS) prior to MS.Areas covered: In the D-Lay MS clinical trial, supplemental vitamin D3 reduced disease activity in CIS and the early stages of relapsing-remitting (RR) MS without causing any serious adverse events.Expert opinion: The race/ethnicity of participants is not given in D-Lay MS and should be included in future studies of vitamin D supplementation in CIS. It will be of interest to investigate the long-term effects of supplementation, initially given in CIS, on the disease and physical activity associated with the progression to RRMS. Interferon beta and teriflunomide are effective in CIS, and due to their different mechanisms of action to vitamin D, may have additive effects with the supplement. As vitamin D supplementation is associated with low or no adverse effects, this supplementation should be considered further in clinical trial and in real life treatment of CIS.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"1-6"},"PeriodicalIF":2.7,"publicationDate":"2026-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147766809","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 approaches to difficult-to-manage axial spondyloarthritis. 难以控制的轴性脊柱性关节炎的新方法。

IF 2.7 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2026-04-21 DOI: 10.1080/14656566.2026.2657996

Jack Shi Jie Yuan-Doré, Lucia Yin, Syed Haider Tahir, Sian Bamford, Hasan Tahir

{"title":"Emerging approaches to difficult-to-manage axial spondyloarthritis.","authors":"Jack Shi Jie Yuan-Doré, Lucia Yin, Syed Haider Tahir, Sian Bamford, Hasan Tahir","doi":"10.1080/14656566.2026.2657996","DOIUrl":"10.1080/14656566.2026.2657996","url":null,"abstract":"Introduction: Difficult-to-manage (D2M) axial spondyloarthritis (axSpA) is a recently published Assessment of SpondyloArthritis International Society (ASAS) consensus definition, defined by persistent symptoms despite 2 or more biological or targeted synthetic DMARD (b/tsDMARD) therapies. This affects 10-20% of patients in clinical practice, representing a substantial unmet healthcare need.Areas covered: We review the updated ASAS D2M classification and its subset classification of treatment-refractory (TR) axSpA, as well as the latest studies into axSpA cohorts characterizing the cohort of D2M patients. We will review the evidence pointing toward the multitude of pathophysiological mechanisms driving D2M disease, including structural damage, nociplastic pain, and comorbidities, before then reviewing the literature for potential strategies to best manage this D2M population. We will also highlight gaps in the literature and areas of further research that are needed.Expert opinion: Management of D2M axSpA should shift from a 'next biologic' to a 'right mechanism' paradigm, with mechanistic stratification informing treatment allocation. Patients with TR-axSpA warrant pharmacological escalation or novel therapeutic approaches; conversely, the majority of D2M patients require multidisciplinary care prioritizing evidence-based non-pharmacological interventions, which are substantially underutilized despite robust efficacy data. This must be underpinned by further research targeting D2M axSpA cohorts.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"1-14"},"PeriodicalIF":2.7,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147632926","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

Pharmacotherapeutic landscape for the management of agitation associated with Alzheimer's disease. 阿尔茨海默病相关躁动的药物治疗景观管理。

IF 2.7 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2026-04-21 DOI: 10.1080/14656566.2026.2662949

Samir Jain, Ece Buyuksandalyaci Tunc, George T Grossberg

{"title":"Pharmacotherapeutic landscape for the management of agitation associated with Alzheimer's disease.","authors":"Samir Jain, Ece Buyuksandalyaci Tunc, George T Grossberg","doi":"10.1080/14656566.2026.2662949","DOIUrl":"https://doi.org/10.1080/14656566.2026.2662949","url":null,"abstract":"Introduction: Agitation associated with Alzheimer's disease (AAD) is common, persistent, and strongly linked to caregiver burden, emergency care, and institutionalization. Pharmacologic options have historically been limited by modest efficacy and safety liabilities in the geriatric population, creating a major treatment gap.Areas covered: This narrative review summarizes established and emerging pharmacotherapies for AAD, emphasizing comparative efficacy, geriatric-relevant safety, and real-world feasibility. A literature search was conducted in PubMed/MEDLINE and ClinicalTrials.gov from database inception through 31 January 2026, prioritizing the most recent decade when applicable, and complemented these searches with hand searches of key trials, meta-analyses, guidelines, and publicly available regulatory or sponsor communications for late-stage programs. Evidence is synthesized qualitatively due to heterogeneity in definitions and outcomes. We discuss antipsychotics, serotonergic agents, drugs with negative trials, and pipeline approaches such as dextromethorphan-based combinations and adrenergic strategies.Expert opinion: The field is shifting from broad off-label prescribing toward phenotype-informed, trial-validated treatments. Brexpiprazole establishes regulatory feasibility, while dextromethorphan-based combinations, particularly AXS-05, appear promising, including signals for durability. Progress will depend on harmonized outcomes, longer-term safety data, and pragmatic trials that prioritize function, caregiver impact, and crisis prevention.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"1-14"},"PeriodicalIF":2.7,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147766796","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

Phenotypic response surface-guided pharmacotherapy for personalized combination treatment in complex diseases. 表型反应表面引导药物治疗在复杂疾病个体化联合治疗中的应用。

IF 2.7 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2026-04-17 DOI: 10.1080/14656566.2026.2660981

Atif Ali Khan Khalil, Muhammad Saeed Akhtar, Wajid Zaman, Adnan Amin, Sajid Ali

{"title":"Phenotypic response surface-guided pharmacotherapy for personalized combination treatment in complex diseases.","authors":"Atif Ali Khan Khalil, Muhammad Saeed Akhtar, Wajid Zaman, Adnan Amin, Sajid Ali","doi":"10.1080/14656566.2026.2660981","DOIUrl":"https://doi.org/10.1080/14656566.2026.2660981","url":null,"abstract":"Introduction: Optimizing multidrug regimens for complex diseases remains a major challenge in precision medicine because responses are shaped by interpatient heterogeneity, nonlinear drug interactions, and incomplete mechanistic knowledge. Phenotypic Response Surfaces (PRS) have emerged as a promising computational and translational framework for guiding pharmacotherapy by linking phenotypic information with the rational optimization of combination treatments.Areas covered: This review synthesizes literature identified through PubMed, Web of Science, and related biomedical databases, emphasizing PRS platforms, artificial intelligence-enabled phenotypic optimization, and personalized combination pharmacotherapy. Evidence from oncology, infectious diseases, transplantation medicine, and autoimmune disorders is examined to show how PRS-guided approaches can identify effective drug combinations and dose configurations, particularly where experimental, mechanistic, or clinical data are limited. The review also evaluates translational developments, clinical investigations, and emerging advances that may accelerate clinical implementation of PRS-guided treatment design.Expert opinion: PRS-guided pharmacotherapy represents a transformative strategy for personalized combination treatment in complex diseases by integrating phenotypic response data with computational optimization to improve therapeutic precision. However, broader clinical adoption will require rigorous external validation, integration of multimodal patient data, improved interpretability of AI-assisted models, and supportive regulatory frameworks. With these advances, PRS-based approaches may become an important component of next-generation precision pharmacotherapy.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"1-9"},"PeriodicalIF":2.7,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147698112","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

New perspectives in managing chronic pelvic pain in endometriosis: the role of GnRH antagonists versus dienogest. 管理子宫内膜异位症慢性盆腔疼痛的新观点：GnRH拮抗剂与dienogest的作用。

IF 2.7 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2026-04-15 DOI: 10.1080/14656566.2026.2657998

Mario Palumbo, Pierluigi Giampaolino, Massimiliano Pellicano, Vincenzo Graziano, Giuseppe Bifulco, Luigi Della Corte

{"title":"New perspectives in managing chronic pelvic pain in endometriosis: the role of GnRH antagonists versus dienogest.","authors":"Mario Palumbo, Pierluigi Giampaolino, Massimiliano Pellicano, Vincenzo Graziano, Giuseppe Bifulco, Luigi Della Corte","doi":"10.1080/14656566.2026.2657998","DOIUrl":"10.1080/14656566.2026.2657998","url":null,"abstract":"Introduction: Endometriosis is a chronic, estrogen-dependent inflammatory disease affecting about 10% of reproductive-age women. Chronic pelvic pain is its most disabling symptom, and available therapies often show limited long-term efficacy and tolerability. This review examines novel pharmacological strategies to improve outcomes.Areas covered: We compare the pharmacological, pharmacokinetic, and safety profiles of dienogest and oral GnRH antagonists (elagolix, relugolix, linzagolix). Mechanisms of action, levels of estrogen suppression, adverse events, particularly bone mineral density loss and hypoestrogenic symptoms, and regulatory aspects are discussed. Literature selection followed SANRA guidelines, with a comprehensive search of PubMed, MEDLINE, EMBASE, Web of Science, and Cochrane Library up to 2026. Eligible studies included randomized and observational trials reporting clinical or pharmacological outcomes. Emerging biomarkers such as progesterone receptor expression, epigenetic modifications, and pain phenotyping are also highlighted as potential tools for treatment personalization.Expert opinion: Dienogest and oral GnRH antagonists share anti-inflammatory and anti-proliferative effects but differ in pharmacodynamics and safety. Dienogest remains a well-tolerated long-term option in estrogen-sensitive patients, whereas GnRH antagonists are better suited for severe or refractory cases requiring rapid control. Integrating molecular and clinical profiling will be crucial to optimize individualized therapy and long-term outcomes.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"1-16"},"PeriodicalIF":2.7,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147644629","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

The pharmacological management of obesity in Prader-Willi syndrome: what does the future hold? 普瑞德-威利综合征肥胖的药理学管理：未来会怎样？

IF 2.7 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2026-04-01 Epub Date: 2026-04-07 DOI: 10.1080/14656566.2026.2655969

Graziano Grugni, Alessandro Sartorio, Antonino Crinò, Danilo Fintini

引用次数: 0

Treatment of giant cell arteritis: focus on upadacitinib. 巨细胞动脉炎的治疗：以upadacitinib为主。

IF 2.7 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2026-04-01 Epub Date: 2026-04-13 DOI: 10.1080/14656566.2026.2655418

Wolfgang A Schmidt

{"title":"Treatment of giant cell arteritis: focus on upadacitinib.","authors":"Wolfgang A Schmidt","doi":"10.1080/14656566.2026.2655418","DOIUrl":"10.1080/14656566.2026.2655418","url":null,"abstract":"Introduction: Giant cell arteritis (GCA) is the most common primary vasculitis and is associated with substantial morbidity. Glucocorticoids play a central role in GCA, resulting in cumulative glucocorticoid exposures that far exceed those used in other rheumatic conditions.Areas covered: This review summarizes current treatment strategies for GCA, with a particular focus on the Janus kinase (JAK) inhibitor upadacitinib. Evidence from randomized controlled trials, observational studies, and recent conference data is discussed, including efficacy, safety, and comparative considerations with established therapies such as tocilizumab. A structured literature PubMed search was conducted using the terms 'giant cell arteritis,' 'treatment,' and 'upadacitinib,' supplemented by relevant conference abstracts and guideline documents.Upadacitinib was approved in 2025 based on a phase 3 trial, demonstrating significantly higher rates of sustained remission and lower cumulative glucocorticoid doses compared to placebo. After re-randomization of patients in sustained remission, rapid flares were observed following discontinuation of upadacitinib.Expert opinion: Upadacitinib represents an effective oral alternative to tocilizumab for reducing glucocorticoid burden, particularly in patients with relapsing GCA or in patients with GCA who have an increased risk of glucocorticoid-related toxicity, with less profound suppression of inflammatory markers than tocilizumab.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"397-407"},"PeriodicalIF":2.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147591087","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

Optimizing the use of novel systemic therapies in atopic dermatitis: an insight into therapeutic transitions. 优化特应性皮炎的新型全身疗法的使用：对治疗过渡的洞察。

IF 2.7 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2026-04-01 Epub Date: 2026-04-14 DOI: 10.1080/14656566.2026.2655967

Elena Ippoliti, Giulia Coscarella, Luisa Boeti, Ketty Peris, Niccolò Gori

引用次数: 0

Emerging treatments in hypertrophic cardiomyopathy: a focus on cardiac myosin inhibitors. 肥厚性心肌病的新疗法：关注心肌肌球蛋白抑制剂。

IF 2.7 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2026-04-01 Epub Date: 2026-04-06 DOI: 10.1080/14656566.2026.2655420

Stuti Shah, Mohammed Abusafia, Susan Keen, Milind Y Desai

{"title":"Emerging treatments in hypertrophic cardiomyopathy: a focus on cardiac myosin inhibitors.","authors":"Stuti Shah, Mohammed Abusafia, Susan Keen, Milind Y Desai","doi":"10.1080/14656566.2026.2655420","DOIUrl":"10.1080/14656566.2026.2655420","url":null,"abstract":"Introduction: Hypertrophic cardiomyopathy (HCM) is commonly driven by sarcomeric hypercontractility and may cause dynamic left ventricular outflow tract obstruction (LVOTO). Conventional therapies reduce symptoms and hemodynamics but do not directly target sarcomeric force generation.Areas covered: We reviewed translational and clinical evidence for cardiac myosin inhibitors (CMIs), which shift myosin toward energy-conserving relaxed states - disordered relaxed (DRX) 'on' and super-relaxed (SRX) 'off,' to reduce excessive cross-bridge cycling. A structured search of PubMed/MEDLINE, Embase, and ClinicalTrials.gov (January 2000-December 2025) was performed using terms related to HCM, mavacamten, aficamten, cardiac myosin inhibition, and major trial names. We summarize pivotal data in obstructive HCM for mavacamten and aficamten, discuss safety/monitoring and drug-drug interactions, and outline emerging investigational sarcomere modulators. Evidence in nonobstructive HCM is reviewed, including recent neutral phase 3 results and ongoing trials.Expert opinion: CMIs establish a mechanism-based paradigm in obstructive HCM with consistent improvements in gradients and health status in randomized trials. Their future impact will depend on long-term outcomes, real-world implementation (monitoring, interactions, access), and identifying nonobstructive phenotypes most likely to benefit.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"463-474"},"PeriodicalIF":2.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147622133","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