Expert Opinion on Pharmacotherapy最新文献_第4页

Weighing up GnRH agonist therapy for endometriosis: outcomes and the treatment paradigm.

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

Controversies and challenges of anticoagulation therapy in obesity.

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-03-01 Epub Date: 2025-03-17 DOI: 10.1080/14656566.2025.2462766

Thomas Salmon, Gregory Y H Lip

引用次数: 0

Challenges in the care of patients with systemic lupus erythematosus and lupus nephritis in Latin America.

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-03-01 Epub Date: 2025-02-10 DOI: 10.1080/14656566.2025.2464913

Claudia Elera-Fitzcarrald, Graciela S Alarcón, Manuel F Ugarte-Gil

{"title":"Challenges in the care of patients with systemic lupus erythematosus and lupus nephritis in Latin America.","authors":"Claudia Elera-Fitzcarrald, Graciela S Alarcón, Manuel F Ugarte-Gil","doi":"10.1080/14656566.2025.2464913","DOIUrl":"10.1080/14656566.2025.2464913","url":null,"abstract":"Introduction: Systemic lupus erythematosus is a rare disease; however, it is one of the leading causes of death in young women, in particular those with a larger percentage of Amerindian ancestry.Areas covered: This article provides a review of the epidemiology of systemic lupus erythematosus and lupus nephritis in the Latin American population, as well as the challenges for the appropriate management of these patients, including delays in diagnosis, healthcare access, and access to new drugs in the region. We propose potential solutions to these problems, including activities to be done by governments, healthcare systems, and healthcare professionals.Expert opinion: Systemic lupus erythematosus, in particular lupus nephritis, is more severe in patients with a larger percentage of Amerindian ancestry; this is influenced not only by their ancestry but also by their sociodemographic characteristics, including access to healthcare and the availability of new drugs. Several strategies to improve diagnosis, management, and access to medication need to be done to reduce these disparities.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"447-455"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364169","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 future of topical JAK inhibitors in the treatment of atopic dermatitis.

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-03-01 Epub Date: 2025-02-12 DOI: 10.1080/14656566.2025.2465869

Joanna Mazgaj, Magdalena Kotewicz, Andrzej Jaworek, Jacek C Szepietowski

{"title":"The future of topical JAK inhibitors in the treatment of atopic dermatitis.","authors":"Joanna Mazgaj, Magdalena Kotewicz, Andrzej Jaworek, Jacek C Szepietowski","doi":"10.1080/14656566.2025.2465869","DOIUrl":"10.1080/14656566.2025.2465869","url":null,"abstract":"Introduction: Atopic dermatitis (AD) is a chronic inflammatory skin condition, rising in prevalence and significantly impacting quality of life. Janus kinase (JAK) inhibitors are small molecules targeting the JAK-STAT signaling pathway, responsible for immune response and cell proliferation. Therapy with topical JAK inhibitors (JAKinibs) improves AD itch and skin lesions and is well tolerated with no major side effects, making it an interesting novel therapy for AD.Areas covered: This review provides a comprehensive look at the available research on topical JAK inhibitors, primarily for atopic dermatitis, based on clinical trial outcomes.Expert opinion: In this review, we summarize research on topical JAKinibs, including ruxolitinib, tofacitinib, delgocitinib, cerdulatinib, and bredocitinib, which target multiple cytokine pathways and have been shown to reduce the itch and inflammation. Their low bioavailability contributes to infrequent and mild side effects. The main limitation of predominantly short-term studies is that the long-term effects of JAK inhibitor therapy are not yet fully known. The body of research is growing, and more information about their effectiveness and safety is being added each year.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"473-480"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382073","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 management of venous thromboembolism during pregnancy and cesarean section.

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-03-01 Epub Date: 2025-02-10 DOI: 10.1080/14656566.2025.2464100

Davide Santagata, Eleonora Tamborini Permurian, Lucia Maria Caiano, Alessandro Squizzato, Walter Ageno, Marco Paolo Donadini

{"title":"Pharmacotherapeutic management of venous thromboembolism during pregnancy and cesarean section.","authors":"Davide Santagata, Eleonora Tamborini Permurian, Lucia Maria Caiano, Alessandro Squizzato, Walter Ageno, Marco Paolo Donadini","doi":"10.1080/14656566.2025.2464100","DOIUrl":"10.1080/14656566.2025.2464100","url":null,"abstract":"Introduction: Venous thromboembolism (VTE) pharmacological management during pregnancy can be challenging due to concerns for both maternal and fetal safety.Areas covered: We performed a narrative review to evaluate the most updated therapeutic options for pregnancy-related VTE treatment, also assessing peri-partum management in the case of cesarean section.Expert opinion: The correct management of acute VTE in pregnancy starts with an accurate diagnosis followed by anticoagulant therapy, with low-molecular-weight heparin (LMWH) at therapeutic dose being the preferred option. Similar to the non-pregnant population, thrombolytic therapy is reserved to life-threatening pulmonary embolism. Secondary prophylaxis with LMWH at a prophylactic dose during pregnancy is recommended in women with a history of unprovoked or hormone-associated VTE, while postpartum prophylaxis is recommended for all women with a previous VTE. Primary prophylaxis remains more controversial. Peripartum management of women receiving anticoagulants requires collaboration among multiple specialists, especially in cases of unscheduled cesarean section, where both thrombotic and hemorrhagic risks are elevated.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"433-445"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373951","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

Investigating osimertinib plus chemotherapy in EGFR-mutated advanced non-small cell lung cancer.

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-03-01 Epub Date: 2025-02-12 DOI: 10.1080/14656566.2025.2464903

Alessia Spagnuolo, Cesare Gridelli

{"title":"Investigating osimertinib plus chemotherapy in EGFR-mutated advanced non-small cell lung cancer.","authors":"Alessia Spagnuolo, Cesare Gridelli","doi":"10.1080/14656566.2025.2464903","DOIUrl":"10.1080/14656566.2025.2464903","url":null,"abstract":"Introduction: Worldwide, 15-40% of advanced-stage non-small cell lung cancers (NSCLCs) have an activating EGFR mutation, treatable with tyrosine-kinase inhibitors (TKIs) such as osimertinib, recommended as front-line therapy. Despite the efficacy of first-line osimertinib, most patients will experience disease progression. Therefore, combining it with chemotherapy has become an area of interest.Areas covered: Osimertinib is a third-generation EGFR-TKI that has extended survival in NSCLC patients with EGFR mutation. However, resistance eventually leads to treatment failure. This has driven the advancement of strategies to overcome resistance to osimertinib. In this setting, the FLAURA2 trial yielded positive results by combining osimertinib with chemotherapy. Additionally, a range of other approaches, including the use of bispecific antibodies and antibody-drug conjugates alongside third-generation EGFR-TKIs or chemotherapy, support the development of novel therapeutic combinations, some of which have already been approved for EGFR-mutated advanced NSCLC.Expert opinion: Next to osimertinib monotherapy, expanded upfront treatment options for patients with EGFR-mutated advanced NSCLC require patient selection considering disease extent, toxicity and tolerability, dosing schedule and what the patient can expect through shared decision-making. Further studies are needed to identify the patients who will benefit the most from combination therapies and to sequence the new drugs into the treatment algorithm.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"491-501"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398866","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

Selecting optimal therapy for higher-risk myelodysplastic syndromes: present and future projections.

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-03-01 Epub Date: 2025-02-19 DOI: 10.1080/14656566.2025.2468467

Farzad Teymouri, Constantin A Dasanu

引用次数: 0

Oral mucosal toxicities in oncology.

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-03-01 Epub Date: 2025-02-13 DOI: 10.1080/14656566.2025.2464106

Alessandro Villa, Michele Lodolo, Stephen Sonis

{"title":"Oral mucosal toxicities in oncology.","authors":"Alessandro Villa, Michele Lodolo, Stephen Sonis","doi":"10.1080/14656566.2025.2464106","DOIUrl":"10.1080/14656566.2025.2464106","url":null,"abstract":"Introduction: Oral mucosal toxicities are serious complications associated with conventional cytotoxic radiation and drug-based cancer regimens, and novel treatments such as immunotherapy and targeted agents. These toxicities, including oral mucositis, mammalian target of rapamycin inhibitor-associated stomatitis, oral immune-related adverse events, oral lichenoid lesions secondary to rituximab or imatinib, and geographic tongue associated with bevacizumab, sorafenib, sunitinib, or axitinib, can lead to significant morbidity, potentially compromising cancer treatment outcomes by necessitating treatment dose reductions, interruptions, or discontinuation.Areas covered: This review discusses the epidemiology, clinical presentation, pathobiology, and current management strategies for these oral mucosal toxicities.Expert opinion: With the evolution of novel cancer therapies, including immunotherapy and targeted agents, oral mucosal toxicities have become more prevalent, presenting significant management challenges. Advances in understanding the pathobiology of these complications have led to the development of promising therapeutic strategies. However, variability in patient responses underscores the need for precision medicine approaches that tailor treatments to individual molecular and immunological profiles. While the standardization of clinical trials has improved the comparability of interventions, therapies must be rigorously tested to ensure they do not interfere with the oncologic efficacy of cancer treatments. Ongoing research is essential to refine preventive and therapeutic approaches.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"481-489"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382069","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 options for coronary thrombosis treatment: where are we today? 冠状动脉血栓治疗的药物治疗选择：我们今天在哪里？

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-02-01 Epub Date: 2025-01-09 DOI: 10.1080/14656566.2025.2450353

Mohammed Ejaz Faizur Rahman, Vidun Wedagedera, William A E Parker, Robert F Storey

{"title":"Pharmacotherapeutic options for coronary thrombosis treatment: where are we today?","authors":"Mohammed Ejaz Faizur Rahman, Vidun Wedagedera, William A E Parker, Robert F Storey","doi":"10.1080/14656566.2025.2450353","DOIUrl":"10.1080/14656566.2025.2450353","url":null,"abstract":"Introduction: Advances in pharmacotherapy for coronary thrombosis treatment and prevention have transformed the clinical outcomes of patients with coronary artery disease but increased the complexity of therapeutic decision-making. Improvements in percutaneous coronary intervention techniques and stent design have reduced the incidence of thrombotic complications, which consequently has increased the challenge of adequately powering clinical trials of novel antithrombotic strategies for efficacy outcomes. Knowledge of the pathophysiology of coronary thrombosis and the characteristics of antithrombotic drugs can help with therapeutic decisions.Areas covered: This review covers the pathophysiology of coronary thrombosis and the mechanisms of action of drugs developed for its treatment, provides an overview of the key issues in decision-making, and highlights key areas for further work in order to guide clinicians on how to individualize risk management and address gaps in the evidence base.Expert opinion: Individualization of antithrombotic therapy regimens has become a vital part of optimizing risk management in people with coronary thrombosis. A critical appraisal of the strengths and limitations of available drugs and the evidence supporting the use of different antithrombotic combinations is intended to provide direction to clinicians and point the way toward further improvements in pharmacotherapy for coronary thrombosis treatment and prevention.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"187-202"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142926952","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

Selective progesterone receptor modulators for the treatment of dysmenorrhea: an update. 选择性孕激素受体调节剂治疗痛经：最新进展。

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-02-01 Epub Date: 2025-01-16 DOI: 10.1080/14656566.2025.2451145

Anna Rosa Speciale, Kubra Ozpinar, Milo Giani, Dilruba Tureli, Massimiliano Fambrini, Silvia Vannuccini, Felice Petraglia

{"title":"Selective progesterone receptor modulators for the treatment of dysmenorrhea: an update.","authors":"Anna Rosa Speciale, Kubra Ozpinar, Milo Giani, Dilruba Tureli, Massimiliano Fambrini, Silvia Vannuccini, Felice Petraglia","doi":"10.1080/14656566.2025.2451145","DOIUrl":"10.1080/14656566.2025.2451145","url":null,"abstract":"Introduction: Dysmenorrhea is a painful symptom associated with uterine contractions and menstrual bleeding and is treated by administering analgesic drugs. Since progesterone receptors (PRs) have a major role in regulating uterine tissues (myometrium and endometrium) physiology, oral contraceptives are used off-label for treating primary or secondary dysmenorrhea. The development of selective progesterone receptor modulators (SPRMs), a class of synthetic steroids with agonistic, antagonistic, or mixed effects in targeting PRs in different tissues, stimulated their possible clinical use for treating secondary dysmenorrhea related to uterine diseases (endometriosis, adenomyosis, uterine fibroids).Areas covered: The present review examines the development of the clinical trials and observational studies done with the different SPRMs for the treatment of dysmenorrhea in patients with uterine diseases.Expert opinion: Mifepristone, telapristone acetate and vilaprisan have antagonistic activity on PRs, whereas ulipristal acetate and asoprisnil have both potent antagonist and partial agonist effects.Since no studies have been done on primary dysmenorrhea, the different SPRMs have been evaluated in the treatment of endometriosis, adenomyosis and uterine fibroid-related dysmenorrhea.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"257-264"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142978086","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