Expert Opinion on Pharmacotherapy最新文献_第6页

Reply to 'fezolinetant: a novel nonhormonal therapy for vasomotor symptoms due to menopause requiring careful evaluation of the benefit-risk balance'. 回复 "非索内酯：一种治疗更年期血管运动症状的新型非激素疗法，需要仔细评估其效益与风险的平衡"。

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2024-10-01 Epub Date: 2024-10-14 DOI: 10.1080/14656566.2024.2416034

Megan Z Roberts, Miranda R Andrus

引用次数: 0

The role of corticosteroids in the current treatment paradigm for myelofibrosis. 皮质类固醇在当前骨髓纤维化治疗模式中的作用。

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2024-10-01 Epub Date: 2024-10-11 DOI: 10.1080/14656566.2024.2415710

Antonella Bruzzese, Enrica Antonia Martino, Caterina Labanca, Francesco Mendicino, Eugenio Lucia, Virginia Olivito, Teresa Rossi, Antonino Neri, Fortunato Morabito, Ernesto Vigna, Massimo Gentile

{"title":"The role of corticosteroids in the current treatment paradigm for myelofibrosis.","authors":"Antonella Bruzzese, Enrica Antonia Martino, Caterina Labanca, Francesco Mendicino, Eugenio Lucia, Virginia Olivito, Teresa Rossi, Antonino Neri, Fortunato Morabito, Ernesto Vigna, Massimo Gentile","doi":"10.1080/14656566.2024.2415710","DOIUrl":"10.1080/14656566.2024.2415710","url":null,"abstract":"Introduction: Myelofibrosis (MF) is a clonal hematological disorder characterized by bone marrow fibrosis, splenomegaly, and inflammatory cytokine dysregulation. While the role of steroids in MF is not fully defined, their anti-inflammatory properties may offer therapeutic benefits, particularly in managing anemia and other cytopenias. Steroids exert their effects by suppressing pro-inflammatory cytokines such as IL1, IL6, and TNF, and by enhancing anti-inflammatory cytokines like IL4 and IL10. Elevated levels of IL6 and other cytokines in MF are associated with anemia and poor prognosis, suggesting that steroid therapy could mitigate these effects.Areas covered: In this manuscript, we review clinical studies which evaluated the safety and efficacy of steroids in MF patients. Moreover, we examine clinical data of the combination of steroids with immunomodulatory agents and JAK inhibitors. Our literature search consisted of an extensive review of PubMed and clinicaltrials.gov.Expert opinion: The role of steroids in the management of MF remains poorly defined, though emerging evidence suggests a potential therapeutic benefit, particularly in managing anemia and other cytopenias. The combination with IMIDs has also yielded positive outcomes as demonstrated in several studies. Steroids may also play a crucial role in managing cytopenias in MF patients receiving JAKi.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"2015-2022"},"PeriodicalIF":2.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142389212","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

Rheumatoid arthritis in Latin America: pharmacotherapy and clinical challenges. 拉丁美洲的类风湿关节炎：药物治疗和临床挑战。

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2024-10-01 Epub Date: 2024-10-10 DOI: 10.1080/14656566.2024.2412247

Enrique R Soriano, Eduardo Mysler, Carlos Rios, Ricardo M Xavier, Mario H Cardiel, Gustavo Citera

{"title":"Rheumatoid arthritis in Latin America: pharmacotherapy and clinical challenges.","authors":"Enrique R Soriano, Eduardo Mysler, Carlos Rios, Ricardo M Xavier, Mario H Cardiel, Gustavo Citera","doi":"10.1080/14656566.2024.2412247","DOIUrl":"10.1080/14656566.2024.2412247","url":null,"abstract":"Introduction: Rheumatoid arthritis (RA) poses significant healthcare challenges in Latin America (LA) due to its high prevalence and unique healthcare dynamics. Despite global advancements, LA faces specific hurdles in effectively managing RA.Areas covered: This review examines RA epidemiology, treatment strategies, and clinical challenges in LA. RA prevalence varies, with higher rates among indigenous populations. While conventional disease-modifying antirheumatic drugs (csDMARDs) are recommended as first-line therapy, access remains inconsistent. Biologics and targeted synthetic DMARDs are available, but biosimilars have limited accessibility, with drug prices varying significantly. Key barriers include supply interruptions, diagnosis delays, and high non-adherence rates driven by socioeconomic factors. A severe shortage of rheumatologists, particularly in rural areas, affects patient care. Cardiovascular events, comorbidities, and endemic infections further complicate RA management.Expert opinion: Although RA care in LA has improved through better use of csDMARDs and advanced treatments, major challenges persist, such as a shortage of specialists, limited medical education, and fragmented healthcare systems. Expanding training programs, enhancing telemedicine, and ensuring drug supply continuity are essential. Strengthening clinical research, improving access to affordable treatments, and developing comprehensive, region-specific strategies are crucial to closing the gap between LA and more developed regions in RA care..","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"2023-2033"},"PeriodicalIF":2.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142375358","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

Evaluating pimavanserin tartrate as a treatment in Parkinson's disease. 评估酒石酸匹马伐林作为帕金森病治疗药物的疗效。

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2024-10-01 Epub Date: 2024-10-16 DOI: 10.1080/14656566.2024.2417733

Thomas Müller

{"title":"Evaluating pimavanserin tartrate as a treatment in Parkinson's disease.","authors":"Thomas Müller","doi":"10.1080/14656566.2024.2417733","DOIUrl":"10.1080/14656566.2024.2417733","url":null,"abstract":"Introduction: Pimavanserin is an efficacious, atypical neuroleptic. It ameliorates the frequency and severity of hallucinations and delusions in patients with Parkinson's disease with psychosis. Most antipsychotic drugs directly block dopamine receptors and thus worsen motor behavior. In contrast, pimavanserin reduces the activity of excitatory serotonin receptor subtypes. They stimulate dopaminergic pathways in the mesolimbic system. As a result, onset of psychosis may occur particularly in patients on a chronic dopamine-substituting treatment regimen, like in Parkinson's disease.Areas covered: This narrative drug evaluation describes the properties and effects of pimavanserin. It is approved for the treatment of psychosis in Parkinson's disease. A literature search was performed using the terms dopamine, levodopa, psychosis, and Parkinson's disease without standardized selection of cited references.Expert opinion: An essential advantage of pimavanserin is the focus in the pivotal trials on the treatment of psychosis in patients with Parkinson's disease. Main competitors for the use in clinical practice are the atypical neuroleptic compounds quetiapine and clozapine. Both share considerable structural and pharmacological similarities, i.e. certain anticholinergic properties. They are recommended in guidelines. Once pimavanserin will become available as a generic drug, its use will probably increase worldwide.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"1999-2003"},"PeriodicalIF":2.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142461369","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

Evolution of antiplatelet therapy in Japan for the management of cerebrovascular and cardiovascular disease: a survey using data from an insurance claims data information service. 日本用于治疗脑血管和心血管疾病的抗血小板疗法的演变：一项利用保险理赔数据信息服务数据进行的调查。

IF 3.2 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2024-09-18 DOI: 10.1080/14656566.2024.2404108

Kosuke Miyake,Shuhei Ikeda,Yu Sadachi,Masako Sugimoto,Taketoshi Furugori,Tetsuya Kimura,Yusuke Yakushiji

{"title":"Evolution of antiplatelet therapy in Japan for the management of cerebrovascular and cardiovascular disease: a survey using data from an insurance claims data information service.","authors":"Kosuke Miyake,Shuhei Ikeda,Yu Sadachi,Masako Sugimoto,Taketoshi Furugori,Tetsuya Kimura,Yusuke Yakushiji","doi":"10.1080/14656566.2024.2404108","DOIUrl":"https://doi.org/10.1080/14656566.2024.2404108","url":null,"abstract":"BACKGROUNDNon-cardioembolic ischemic stroke (NCIS) and ischemic heart disease (IHD) require secondary prevention with antiplatelet therapy (APT). We investigated APT prescription status for patients with NCIS and IHD.RESEARCH DESIGN AND METHODSThis retrospective study utilized claims data from patients with NCIS and those who underwent percutaneous coronary intervention for IHD and received antiplatelet drugs. The study included Phases A (2015-2016), B (2017-2018), and C (2019-2020). We evaluated patient characteristics, APT prescription rates (dual [DAPT] and single [SAPT]), and prescriptions by NCIS subtype.RESULTSIn the NCIS cohort, the initial DAPT prescription rate increased over time (Phase A: 14.9%, B: 19.2%, C: 28.0%), but decreased to 6% after 3 months. Subsequently, 25% of patients did not receive APT. For IHD, DAPT duration decreased over time, with 12-month prescription rates of 48.0%, 43.1%, and 32.6% for Phases A, B, and C, respectively. SAPT prescriptions, predominantly aspirin, increased, and use of P2Y12 inhibitors also rose. Few patients (10%) did not receive APT.CONCLUSIONSShorter DAPT duration/earlier switching to SAPT for NCIS and IHD have gained acceptance in regional medical care. A higher proportion of NCIS vs IHD patients did not receive APT in the chronic phase.TRIAL REGISTRATIONUMIN000052198.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":"10 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142247832","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

Expanding therapeutic options: overview of novel pharmacotherapies for dyslipidemia. 扩大治疗选择：血脂异常新型药物疗法概述。

IF 3.2 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2024-09-17 DOI: 10.1080/14656566.2024.2406270

Naif Saad ALGhasab,Federica Fogacci,Ashot Avagimyan,Arrigo F G Cicero

引用次数: 0

Pharmacogenomics and pediatric drug development: science and political power. A narrative review 药物基因组学与儿科药物开发：科学与政治权力。叙述性综述

IF 3.2 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2024-09-13 DOI: 10.1080/14656566.2024.2401429

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

引用次数: 0

Current approaches to the pharmacological management of metastatic breast cancer in older women. 目前对老年妇女转移性乳腺癌的药物治疗方法。

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2024-09-01 Epub Date: 2024-09-16 DOI: 10.1080/14656566.2024.2402022

Carlos A Carmona-Gonzalez, Sudhir Kumar, Ines B Menjak

{"title":"Current approaches to the pharmacological management of metastatic breast cancer in older women.","authors":"Carlos A Carmona-Gonzalez, Sudhir Kumar, Ines B Menjak","doi":"10.1080/14656566.2024.2402022","DOIUrl":"10.1080/14656566.2024.2402022","url":null,"abstract":"Introduction: A substantial majority of patients diagnosed with metastatic breast cancer consists of individuals 65-year-old or above. Emerging treatment approaches, which utilize genomics-guided therapy and innovative biomarkers, are currently in development. Given the numerous choices in the metastatic context, it is necessary to adopt a personalized approach to decision-making for these patients.Areas covered: The authors provide a comprehensive analysis of the existing literature on the use of systemic anticancer treatments in older women, specifically those aged 65 and above, who have metastatic breast cancer, focusing on the reported effectiveness and adverse effects of these treatments in this population.Expert opinion: The evidence to treat older patients with metastatic breast cancer primarily relies on subgroup analyses, whose interpretation should be approached with caution. In several clinical trials subgroup analysis, it has been observed that this population seem to have comparable benefits and toxicities to younger patients, but real-world data have showed older women exhibit worse rates of survival compared to younger women. Multiple factors are likely involved in this, but we postulate this is related to lower rates of guideline concordant, and factors such as comorbidity, lack of social supports, malnutrition, and geriatric factors like frailty and/or vulnerability. This underscores the importance of a broader assessment for patients with a geriatric perspective and involvement of multi-disciplinary team.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"1785-1794"},"PeriodicalIF":2.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142282678","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

Revisiting PPAR agonists: novel perspectives in the treatment of primary biliary cholangitis. 重温 PPAR 激动剂：治疗原发性胆汁性胆管炎的新视角。

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2024-09-01 Epub Date: 2024-10-04 DOI: 10.1080/14656566.2024.2406268

Yiran Chen, Kunyu Zheng, Gahu Da, Xu Wang, Yi Wei, Guochun Wang, Fengchun Zhang, Li Wang

{"title":"Revisiting PPAR agonists: novel perspectives in the treatment of primary biliary cholangitis.","authors":"Yiran Chen, Kunyu Zheng, Gahu Da, Xu Wang, Yi Wei, Guochun Wang, Fengchun Zhang, Li Wang","doi":"10.1080/14656566.2024.2406268","DOIUrl":"10.1080/14656566.2024.2406268","url":null,"abstract":"Introduction: In primary biliary cholangitis (PBC), approximately 40% of the patients respond incompletely to first-line treatment with ursodeoxycholic acid (UDCA), resulting in a poorer prognosis. Although obeticholic acid (OCA) is approved as a second-line therapy, it is not well-tolerated by patients with significant itching or advanced cirrhosis. Peroxisome proliferator-activated receptor (PPAR) agonists, including fibrates traditionally known as antihyperlipidemic agents, have emerged as potent alternatives for treating PBC patients with an incomplete response to UDCA.Areas covered: This article provides a detailed overview of the mechanisms of PPAR agonists and evaluates their efficacy and adverse events, focusing on findings from recent phase III clinical trials.Expert opinion: PPAR agonists are significant alternatives in the treatment of PBC, showing the potential to enhance biochemical responses, reduce mortality, and alleviate pruritus. Long-term outcomes for PBC patients, particularly those with advanced disease, and longitudinal data on the antipruritic effects of PPAR agonists require further investigation. Combining PPAR agonists with other treatments and advancing personalized approaches may enhance therapeutic efficacy and patient outcomes. This study provides future perspectives on the roles of PPAR agonists in PBC management.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"1825-1834"},"PeriodicalIF":2.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142282686","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

Navigating the pharmacotherapeutic management of comorbid inflammatory bowel disease and primary sclerosing cholangitis. 为合并炎症性肠病和原发性硬化性胆管炎的药物治疗导航。

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2024-09-01 Epub Date: 2024-10-11 DOI: 10.1080/14656566.2024.2407022

Brigid Pinnuck, Kate D Lynch

{"title":"Navigating the pharmacotherapeutic management of comorbid inflammatory bowel disease and primary sclerosing cholangitis.","authors":"Brigid Pinnuck, Kate D Lynch","doi":"10.1080/14656566.2024.2407022","DOIUrl":"10.1080/14656566.2024.2407022","url":null,"abstract":"Introduction: Primary sclerosing cholangitis (PSC) is the most specific hepatobiliary extraintestinal manifestation in inflammatory bowel disease (IBD). PSC ultimately has a poor prognosis, with disease progression resulting in liver cirrhosis and subsequent liver failure. While there is current data for the medical management of IBD, the optimal approach for concurrent PSC-IBD is unclear.Areas covered: This review focuses on the current literature of pharmacotherapy in the PSC-IBD population including anti-tumor necrosis factor agents, vedolizumab, JAK inhibitors, IL-12/23 inhibitors, and thiopurines. Regarding PSC-IBD, it focuses on effectiveness of IBD therapies on liver biochemistry and IBD activity as well as the advent of clinically relevant liver outcomes and safety. The authors also address the need for further advances in research.Expert opinion: The longer-term data for pharmacological management for IBD is well established. In the concomitant PSC-IBD population there is no drug to date that has effectively reduced disease related morbidity and mortality outcomes. There are limitations in the current, mostly retrospective data on IBD drugs in PSC-IBD with respect to samples sizes, heterogenous outcomes, and lack of a high-quality surrogate endpoint in PSC. However, current data for adalimumab offers encouraging results which require further exploration with larger prospective studies.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"1835-1849"},"PeriodicalIF":2.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344278","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