Expert Opinion on Pharmacotherapy最新文献_第9页

Management of Parkinson's disease psychosis: first-line antipsychotic selection and rationale for continuing, combining, or switching. 帕金森病精神病的治疗：一线抗精神病药物的选择和继续、联合或转换的理由

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-04-01 Epub Date: 2025-03-27 DOI: 10.1080/14656566.2025.2481205

Stuart H Isaacson, Henry Nasrallah, Rajesh Pahwa, Gustavo Alva, Daniel Kremens, Stephen M Stahl

{"title":"Management of Parkinson's disease psychosis: first-line antipsychotic selection and rationale for continuing, combining, or switching.","authors":"Stuart H Isaacson, Henry Nasrallah, Rajesh Pahwa, Gustavo Alva, Daniel Kremens, Stephen M Stahl","doi":"10.1080/14656566.2025.2481205","DOIUrl":"10.1080/14656566.2025.2481205","url":null,"abstract":"Introduction: The past decade has seen a paradigm shift in the evaluation and management of Parkinson's disease psychosis (PDP), with the first approval of an antipsychotic in the US in 2016. An evidence-based review by the Movement Disorder Society found pimavanserin and clozapine to be clinically useful, (low-dose) quetiapine to be possibly useful, and all other antipsychotics to be avoided due to motor worsening. Clozapine and quetiapine use can be limited by provoking Parkinson's disease (PD) nonmotor symptoms of somnolence and hypotension. Quetiapine may also be limited by its risk in cognitive impairment. Pimavanserin is not associated with these symptoms. Despite advances in the understanding of PDP and the approval of pimavanserin in the US, clinical questions concerning patient selection, treatment timing, switch strategies, and combination therapy remain.Areas covered: To develop a consensus on first-line and subsequent treatment strategies for PDP, a panel of experts reviewed the clinical presentation and course of PDP, then discussed clinical trial evidence and experience.Expert opinion: PDP is a common but still undertreated sequela of PD progression. Pimavanserin is recommended as a first-line antipsychotic therapy based on its established safety and efficacy. While switching strategies are suggested, further study is needed to assess combination antipsychotic therapy.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"707-717"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729438","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

Asciminib: the tyrosine kinase inhibitor with a unique mechanism of action. 阿西米尼：具有独特作用机制的酪氨酸激酶抑制剂。

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-04-01 Epub Date: 2025-03-26 DOI: 10.1080/14656566.2025.2480762

Akriti G Jain, Jorge E Cortes

{"title":"Asciminib: the tyrosine kinase inhibitor with a unique mechanism of action.","authors":"Akriti G Jain, Jorge E Cortes","doi":"10.1080/14656566.2025.2480762","DOIUrl":"10.1080/14656566.2025.2480762","url":null,"abstract":"Introduction: Management of chronic phase chronic myeloid leukemia (CML-CP) was revolutionized with the development of tyrosine kinase inhibitors (TKIs). Imatinib (first generation), dasatinib, nilotinib and bosutinib (second generation), and ponatinib (third generation) are the five approved TKIs that inhibit BCR::ABL1 by binding to the ATP binding site of ABL1. About half of the resistance to TKIs develops through acquisition of mutations in the ATP binding site, including T315I. Hence, a novel TKI with a distinct mechanism of action that inhibits bcr-abl1 by specifically targeting the ABL1 myristoyl pocket (STAMP inhibitor) was developed.Areas covered: Asciminib was first approved for treatment of CML-CP in the third line setting or beyond and in patients with T315I mutation in October, 2021. More recently, in October, 2024, asciminib was approved for newly diagnosed CML-CP based on ASC4FIRST data showing MMR rate of 67.7% in the asciminib arm compared to 49% in the investigator choice TKI arm (p < 0.001) at 48 weeks. In this review we detail the mechanism of action, preclinical data, clinical data, safety, and tolerability of asciminib.Expert opinion: Due to its mechanism of action, asciminib has fewer off-target effects, resulting in an improved safety and tolerability profile.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"677-684"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633836","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

Factor XI/XIa inhibitors: a potential solution to anticoagulation dilemmas. 因子XI/XIa抑制剂：抗凝困境的潜在解决方案。

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-04-01 Epub Date: 2025-03-05 DOI: 10.1080/14656566.2025.2475192

Caitlin M Gibson, Umesh R Desai, Megan E Wesling

{"title":"Factor XI/XIa inhibitors: a potential solution to anticoagulation dilemmas.","authors":"Caitlin M Gibson, Umesh R Desai, Megan E Wesling","doi":"10.1080/14656566.2025.2475192","DOIUrl":"10.1080/14656566.2025.2475192","url":null,"abstract":"Introduction: Antithrombotic therapy is the cornerstone of stroke prevention, but standard of care therapies are underutilized and use is limited by bleeding rates, drug interactions, and renal elimination. Factor XI/XIa (FXI/XIa) inhibitors are a novel anticoagulation class that purportedly target thrombosis more than hemostasis, thereby raising the hope of reducing bleeding consequences while maintaining efficacy.Areas covered: This review covers the mechanistic rationale for FXI/XIa inhibitors, describes the various molecule sub-classes, addresses barriers to current anticoagulation use, and reviews clinical trial data to date for this novel class of anticoagulants.Expert opinion: FXI/XIa inhibitors offer several advantages over DOACs in stroke prevention such as reduced bleeding, fewer drug interactions, and less renal elimination. However, clinical trials must demonstrate non-inferior efficacy and improved safety compared to DOACs. Additional barriers to use will include cost, inadequacy of antidotes, and overall anticoagulant underutilization. The potential for a small molecule or monoclonal antibody to reach the clinic is very high.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"605-616"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540756","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

Amyloidosis of the heart: pathophysiology, diagnosis, and treatment. 心脏淀粉样变：病理生理、诊断与治疗。

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-04-01 Epub Date: 2025-03-25 DOI: 10.1080/14656566.2025.2480254

Andy Wang, Uzair Mahmood, Jared Feldman, Stephen Pan, Wilbert S Aronow, Diwakar Jain

引用次数: 0

Addressing the long-term risks of administering antenatal steroids. 解决使用产前类固醇的长期风险。

IF 2.5 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-04-01 Epub Date: 2025-03-18 DOI: 10.1080/14656566.2025.2475190

Sean W D Carter, Agnihotri Biswas, Hannah R S Watson, Han Lin Chelsea Ip, Erin L Fee, Kay Yi Michelle Seah, Yusaku Kumagai, Zubair Amin, Mahesh A Choolani, Alan H Jobe, Sebastian E Illanes, Matthew W Kemp

{"title":"Addressing the long-term risks of administering antenatal steroids.","authors":"Sean W D Carter, Agnihotri Biswas, Hannah R S Watson, Han Lin Chelsea Ip, Erin L Fee, Kay Yi Michelle Seah, Yusaku Kumagai, Zubair Amin, Mahesh A Choolani, Alan H Jobe, Sebastian E Illanes, Matthew W Kemp","doi":"10.1080/14656566.2025.2475190","DOIUrl":"10.1080/14656566.2025.2475190","url":null,"abstract":"Introduction: A single course of antenatal steroid (ANS) therapy is standard of care for women at risk of preterm birth, reducing the risk of neonatal respiratory distress syndrome, neonatal morbidity, and mortality. An unresolved challenge relates to the potential risk of adverse long-term effects, and how these risks might be balanced with therapeutic benefit.Areas covered: We outline key concepts in glucocorticoid signaling, pharmacokinetics/pharmacodynamics, and clinical use before presenting data on the potential long-term harms of ANS therapy.Expert opinion: Our assessment is that: i) Currently used, high dose ANS regimens can induce multi-system changes in the fetus that alter growth and development, potentially increasing long-term disease risk; and ii) relative risks likely increase proportionally to the magnitude and duration of steroid exposure, in late preterm and term ANS use, and in off-target treatments. A single course of ANS therapy to at risk women between 24- and 34-weeks' gestation is well justified. Efforts should be made to improve dosing and patient selection. At periviable gestations, the high immediate risk of serious disease or death justifies modest long-term risks. At late preterm and term gestations, where steroids do not provide notable survival or health benefits, supporting routine ANS use is more difficult.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"617-629"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540754","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

Polypharmacology of carbonic anhydrase inhibitors and activators. 碳酸酐酶抑制剂和激活剂的多药理学研究。

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

Efficacy and safety of taletrectinib for treatment of ROS1 positive non-small cell lung cancer: A systematic review. 他来替尼治疗ROS1阳性非小细胞肺癌的疗效和安全性：一项系统评价。

IF 2.7 3区医学

Expert Opinion on Pharmacotherapy Pub Date : 2025-04-01 Epub Date: 2025-04-03 DOI: 10.1080/14656566.2025.2487150

Irtiqa Khan, Atiya Sahar, Suhaiba Numra, Nilanjan Saha, Nidhi, Rizwana Parveen

{"title":"Efficacy and safety of taletrectinib for treatment of ROS1 positive non-small cell lung cancer: A systematic review.","authors":"Irtiqa Khan, Atiya Sahar, Suhaiba Numra, Nilanjan Saha, Nidhi, Rizwana Parveen","doi":"10.1080/14656566.2025.2487150","DOIUrl":"10.1080/14656566.2025.2487150","url":null,"abstract":"Introduction: Approximately 85% of all instances of lung cancer are non-small-cell lung cancer (NSCLC). Crizotinib and entrectinib are the preferred first line therapy for treating ROS1 fusion-positive NSCLC (ROS1+NSCLC). However, not all patients react to these treatments and most of the patients acquire resistance to the medications. Taletrectinib is intended to address few of the issues with these treatments, such as lowering tyrosine receptor kinase B TRKB-related neurological side events by selectively inhibiting ROS1 over TRKB, addressing tumor treatment resistance and brain metastases through blood-brain barrier penetration.Methods: A systematic literature search was conducted across PubMed, ScienceDirect, Cochrane, and ClinicalTrials.gov upto September 2024. Studies were included if they investigated taletrectinib for ROS1-positive NSCLC.Results: Out of 392 identified records, three studies involving 234 participants (102 males, 132 females) met inclusion criteria. Taletrectinib demonstrated high overall response rates (ORR) in treatment-naïve patients (upto 90.6%) and moderate ORR (51.5%) in crizotinib-pretreated patients. It showed manageable adverse events, such as mild liver enzyme elevations and gastrointestinal symptoms.Conclusions: Taletrectinib shows significant efficacy and favorable safety profile for ROS1-positive NSCLC, particularly in treatment-naïve or tyrosine kinase inhibitor TKI-resistant patients. Further large-scale trials are warranted to confirm its long-term safety and efficacy.","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"765-772"},"PeriodicalIF":2.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763298","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. 系统性硬化症的全身药物治疗方法。

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. 静脉注射肽和氨基酸治疗勃起功能障碍：目前的应用和未来的发展方向。

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

An evaluation of sebetralstat as the first oral on-demand therapy for Hereditary Angioedema. sebetralstat作为遗传性血管性水肿的首个口服治疗的评价。

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":"685-693"},"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