Expert Review of Clinical Pharmacology最新文献

Considerations for the treatment of older adults with chronic lymphocytic leukemia. 老年人慢性淋巴细胞白血病治疗的考虑。

IF 3 3区医学

Expert Review of Clinical Pharmacology Pub Date : 2025-10-05 DOI: 10.1080/17512433.2025.2566834

Anna Pula, Tadeusz Robak

{"title":"Considerations for the treatment of older adults with chronic lymphocytic leukemia.","authors":"Anna Pula, Tadeusz Robak","doi":"10.1080/17512433.2025.2566834","DOIUrl":"10.1080/17512433.2025.2566834","url":null,"abstract":"Introduction: Chronic lymphocytic leukemia (CLL) primarily affects older adults, with a median age at diagnosis around 70 years. While targeted therapies have improved outcomes, treatment decisions in the elderly are complicated by comorbidities, fraility, and underrepresentation in clinical trials.Areas covered: This review integrates geriatric oncology principles with therapeutic evidence to guide management of older adults with CLL. It summarizes frontline and relapsed/refractory strategies, drawing from landmark trials and real-world studies, and incorporates consensus on frailty assessment, polypharmacy, cardiovascular risk, and supportive care. Novel agents and treatment approaches are discussed in the context of functional status, patient preference, and quality of life, offering a practical age-adapted framework not addressed in prior reviews.Expert opinion: While modern therapies allow longer survival with improved tolerability, several controversies remain. One challenge is managing patients with borderline fitness - those not formally frail yet with significant comorbidities or organ dysfunction. Another is sequencing after intolerance or progression on both BTK and BCL2 inhibitors, where evidence is sparse. Emerging options such as non-covalent BTK inhibitors, bispecific antibodies, and CAR-T hold promise, but their role in older or frail patients is unclear. Future age-adapted trials and biomarker-driven strategies are needed to balance survival with quality of life.","PeriodicalId":12207,"journal":{"name":"Expert Review of Clinical Pharmacology","volume":" ","pages":"1-14"},"PeriodicalIF":3.0,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137005","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

Genotype-guided pharmacotherapy: the challenges of integrating pharmacogenomic testing into routine healthcare with a focus on experiences at a single site. 基因型引导药物治疗：将药物基因组学测试整合到常规医疗保健中的挑战，重点是在单个站点的经验。

IF 3 3区医学

Expert Review of Clinical Pharmacology Pub Date : 2025-09-30 DOI: 10.1080/17512433.2025.2568089

Larisa H Cavallari, Emily J Cicali, Madeline Norris, Khoa A Nguyen, Julio D Duarte

{"title":"Genotype-guided pharmacotherapy: the challenges of integrating pharmacogenomic testing into routine healthcare with a focus on experiences at a single site.","authors":"Larisa H Cavallari, Emily J Cicali, Madeline Norris, Khoa A Nguyen, Julio D Duarte","doi":"10.1080/17512433.2025.2568089","DOIUrl":"10.1080/17512433.2025.2568089","url":null,"abstract":"Introduction: Pharmacogenetic (PGx) testing remains widely underutilized despite strong evidence of genetic contributions to drug response and the availability of guidelines for integrating results into prescribing decisions. Challenges hindering PGx implementation include concerns about test reimbursement, knowledge gaps among patients and providers, and difficulty with effectively incorporating PGx data into the electronic health record (EHR). Our institution was an early adopter of PGx testing, with testing and clinical decision support available to guide multiple drug therapies, including clopidogrel, antidepressants, tacrolimus, and fluoropyrimidines.Areas covered: This paper describes challenges our team and others have faced with PGx implementation and how we have addressed challenges common across implementations and those unique to specific gene-drug pairs.Expert opinion: While we have demonstrated feasible solutions to overcome many implementation challenges, several key obstacles remain, including limited reimbursement for PGx testing as well as for pharmacist time in providing PGx consultations, challenges with EHR integration and portability of results, and demands for outcomes data. We anticipate broader implementation with legislative efforts to support reimbursement for testing and consultation. EHR vendors are also taking steps to better handle PGx data. Addressing genetic exceptionalism is particularly challenging but ultimately important for broad acceptance of PGx testing.","PeriodicalId":12207,"journal":{"name":"Expert Review of Clinical Pharmacology","volume":" ","pages":"1-14"},"PeriodicalIF":3.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185168","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

A systematic mapping review on the capability of large language models in drug-drug interaction analysis. 大型语言模型在药物-药物相互作用分析中的能力综述。

IF 3 3区医学

Expert Review of Clinical Pharmacology Pub Date : 2025-09-29 DOI: 10.1080/17512433.2025.2568090

Himel Mondal, Ipsita Dash, Shaikat Mondal, Seshadri Reddy Varikasuvu, Rintu Kumar Gayen, Shreya Sharma, Sairavi Kiran Biri

{"title":"A systematic mapping review on the capability of large language models in drug-drug interaction analysis.","authors":"Himel Mondal, Ipsita Dash, Shaikat Mondal, Seshadri Reddy Varikasuvu, Rintu Kumar Gayen, Shreya Sharma, Sairavi Kiran Biri","doi":"10.1080/17512433.2025.2568090","DOIUrl":"10.1080/17512433.2025.2568090","url":null,"abstract":"Background: Drug-drug interaction (DDI) is a global health concern affecting patient safety and treatment outcomes. Large language models (LLMs), such as ChatGPT, offer accessible alternatives; however, their effectiveness in DDI analysis remains unclear. This review evaluates the current evidence on the performance of LLM-based chatbots in identifying DDIs.Methods: A PRISMA-compliant systematic review (PROSPERO: CRD420251020360) was conducted using PubMed, Scopus, and Web of Science (studies published between 1 January 2015, and 31 March 2025). Eligible studies included those using publicly accessible LLM chatbots for DDI detection.Results: Nine studies (2023-2025) evaluated publicly accessible LLM chatbots, including ChatGPT, Bing AI, and Google Bard, for DDI identification. Methods varied from patient-level polypharmacy screening to single-drug checks and case vignettes. Chatbot performance was inconsistent: ChatGPT identified many potential DDIs, with ChatGPT-4.0 generally identifying more potential DDIs, but with variable accuracy, while Bing AI and Google Bard were less reliable.Conclusion: Publicly accessible LLM chatbots demonstrate variable and partial effectiveness in detecting DDIs. There is a clear need to develop dedicated, freely available chatbots designed specifically for DDI identification. Future research should focus on standardizing evaluation methods and expanding access to improve medication safety in clinical practice.Prospero: CRD420251020360.","PeriodicalId":12207,"journal":{"name":"Expert Review of Clinical Pharmacology","volume":" ","pages":"1-8"},"PeriodicalIF":3.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145148340","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

N-methyl-D-aspartate receptor as a therapeutic target for burning mouth syndrome. n -甲基- d -天冬氨酸受体作为灼口综合征的治疗靶点。

IF 3 3区医学

Expert Review of Clinical Pharmacology Pub Date : 2025-09-25 DOI: 10.1080/17512433.2025.2566827

Takahiko Nagamine

引用次数: 0

Review of anti-amyloid-beta (Aβ) monoclonal antibodies for the treatment of Alzheimer's disease. 抗淀粉样蛋白β (Aβ)单克隆抗体治疗阿尔茨海默病的研究进展

IF 3 3区医学

Expert Review of Clinical Pharmacology Pub Date : 2025-09-22 DOI: 10.1080/17512433.2025.2556122

Emily Francis, Samantha Paylor, Cindy Van, Bindu Mathews, Millad J Sobhanian, Daniel Z Mansour, George Hennawi, Nicole J Brandt

{"title":"Review of anti-amyloid-beta (Aβ) monoclonal antibodies for the treatment of Alzheimer's disease.","authors":"Emily Francis, Samantha Paylor, Cindy Van, Bindu Mathews, Millad J Sobhanian, Daniel Z Mansour, George Hennawi, Nicole J Brandt","doi":"10.1080/17512433.2025.2556122","DOIUrl":"10.1080/17512433.2025.2556122","url":null,"abstract":"Introduction: Alzheimer's disease (AD) remains a major public health challenge, with growing prevalence and limited treatment options that modify disease progression. Recent advances have led to the development and approval of Anti-amyloid-β (Aβ) monoclonal antibodies, which represent a paradigm shift from symptomatic management to targeted disease modification.Areas ccovered: Agents such as lecanemab and donanemab selectively bind aggregated forms of Aβ and have demonstrated modest but statistically significant slowing of cognitive and functional decline in early AD. However, these therapies are associated with amyloid-related imaging abnormalities (ARIA), particularly in individuals carrying the APOE ε4 allele, necessitating close monitoring and individualized risk assessment. Implementation challenges, including high treatment burden, cost, and real-world applicability, have limited broad clinical adoption. This review examines the mechanistic differences, clinical trial outcomes, and safety considerations of Aβ monoclonal antibodies, while also highlighting emerging therapies and the need for inclusive, precision-guided approaches.Expert opinion: As research continues to evolve, balancing clinical benefits with safety and accessibility will be critical in defining the role of anti-amyloid-β therapies within the broader landscape of AD care.","PeriodicalId":12207,"journal":{"name":"Expert Review of Clinical Pharmacology","volume":" ","pages":"1-16"},"PeriodicalIF":3.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145052654","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

Statin associated muscle symptoms in older adults. 老年人他汀类药物相关肌肉症状

IF 3 3区医学

Expert Review of Clinical Pharmacology Pub Date : 2025-09-22 DOI: 10.1080/17512433.2025.2565619

Elizabeth K Pogge, Nicole K Early

引用次数: 0

Pharmacological strategies for managing dementia with Lewy bodies: an expert review of symptom-targeted care. 治疗路易体痴呆的药理学策略：症状靶向治疗的专家综述。

IF 3 3区医学

Expert Review of Clinical Pharmacology Pub Date : 2025-09-19 DOI: 10.1080/17512433.2025.2562151

Oluwatosin Atewogboye, John Paul Taylor, Judith R Harrison

{"title":"Pharmacological strategies for managing dementia with Lewy bodies: an expert review of symptom-targeted care.","authors":"Oluwatosin Atewogboye, John Paul Taylor, Judith R Harrison","doi":"10.1080/17512433.2025.2562151","DOIUrl":"10.1080/17512433.2025.2562151","url":null,"abstract":"Introduction: Dementia with Lewy Bodies (DLB) is the second most common cause of neurodegenerative dementia after Alzheimer's disease, characterized by a complex combination of cognitive, neuropsychiatric, motor, autonomic, and sleep-related symptoms. Symptom fluctuation, polypharmacy risks, and high sensitivity to commonly used drugs present unique challenges for management.Areas covered: This review provides a comprehensive overview of the symptomatic management of DLB, organized by clinical domains. It critically evaluates current pharmacological and non-pharmacological treatment strategies for cognitive impairment, hallucinations, parkinsonism, autonomic dysfunction, and sleep disturbances. Evidence is drawn from clinical trials, meta-analyses, and extrapolated findings from related disorders such as Alzheimer's disease and Parkinson's disease.Expert opinion: Effective DLB management requires an individualized, symptom-prioritized approach that carefully balances therapeutic benefit with potential adverse effects, particularly given the high risk of antipsychotic sensitivity and treatment-induced worsening of symptoms. Despite recent progress, evidence remains sparse for many symptom domains. Greater investment in DLB-specific clinical trials and development of targeted therapies is urgently needed to improve patient outcomes.","PeriodicalId":12207,"journal":{"name":"Expert Review of Clinical Pharmacology","volume":" ","pages":"1-9"},"PeriodicalIF":3.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069490","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

Oral oncolytic therapy adherence: can we shift patient behaviors and attitudes? 口服溶瘤治疗依从性：我们能改变患者的行为和态度吗？

IF 3 3区医学

Expert Review of Clinical Pharmacology Pub Date : 2025-09-17 DOI: 10.1080/17512433.2025.2558804

Solomon Ayehu, Bethel Belayneh, Benyam Muluneh

引用次数: 0

Dual incretin agonism and the gut microbiome: does the heart of metabolic regulation beat in the gut? 双肠促胰岛素激动作用与肠道微生物组：代谢调节的心脏在肠道中跳动吗？

IF 3 3区医学

Expert Review of Clinical Pharmacology Pub Date : 2025-09-10 DOI: 10.1080/17512433.2025.2559907

Theocharis Koufakis, Dimitrios Patoulias, Maria Apostolopoulou, Panagiotis Georgianos, Djordje S Popovic

引用次数: 0

Pharmacotherapy for previously treated gastric cancer patients: current options and future developments. 既往胃癌患者的药物治疗：目前的选择和未来的发展。

IF 3 3区医学

Expert Review of Clinical Pharmacology Pub Date : 2025-08-01 Epub Date: 2025-08-26 DOI: 10.1080/17512433.2025.2551748

Seiya Sato, Izuma Nakayama, Kohei Shitara

{"title":"Pharmacotherapy for previously treated gastric cancer patients: current options and future developments.","authors":"Seiya Sato, Izuma Nakayama, Kohei Shitara","doi":"10.1080/17512433.2025.2551748","DOIUrl":"10.1080/17512433.2025.2551748","url":null,"abstract":"Introduction: Several clinical trials have demonstrated that chemotherapy contributes to prolonged survival in patients with previously treated advanced gastric cancer (AGC).Areas covered: Currently, cytotoxic agents with established efficacy for previously treated AGC include paclitaxel (PTX), irinotecan (IRI), and trifluridine/tipiracil (FTD/TPI), while the anti-vascular endothelial growth factor(VEGF) agent ramucirumab (RAM) has also shown efficacy. Pembrolizumab is indicated for AGC with microsatellite instability-high (MSI-H) or high tumor mutational burden (TMB). For human epidermal growth factor receptor 2 (HER2)-positive previously treated AGC, trastuzumab deruxtecan (T-DXd) has emerged as the first molecular targeted therapy. Additionally, claudin-18 isoform 2 (CLDN18.2)-targeting antibody therapy has been established as a first-line treatment, with numerous ongoing clinical trials in later-line settings. Other promising molecular targets include trophoblast cell surface antigen 2 (TROP2), cytoplasmic activation/proliferation-associated protein 1(CAPRIN-1), and KRAS. Furthermore, innovative therapeutic approaches such as antibody-drug conjugates (ADCs), bispecific antibodies (BsAbs), and chimeric antigen receptor T-cell (CAR-T) therapy are being developed. This review summarizes the historical and established evidence from clinical trials on previously treated AGC and discusses ongoing clinical trials and future perspectives in treatment development, with a focus on targeted therapies.Expert opinion: Biomarker-driven treatment is expected to become the mainstream approach in the future.","PeriodicalId":12207,"journal":{"name":"Expert Review of Clinical Pharmacology","volume":" ","pages":"607-623"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144948239","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