Expert Review of Clinical Pharmacology最新文献

{"title":"Theranostics in the management of prostate cancer: from concept to clinical practice.","authors":"Kannan Sridharan, Teresa Alonso-Gordoa, Gowri Sivaramakrishnan, Javier Molina Cerrillo, Ondrej Fiala, Farah Rehan, Danny Mena Cortes, Matteo Santoni","doi":"10.1080/17512433.2026.2737765","DOIUrl":"10.1080/17512433.2026.2737765","url":null,"abstract":"<p><strong>Introduction: </strong>Radiotheranostics, integrating diagnostic imaging with targeted radiotherapy using molecularly matched radioactive agents, has emerged as a transformative approach in the management of prostate cancer. Prostate-specific membrane antigen (PSMA) is the dominant clinically validated target, and PSMA-targeted radioligand therapy has rapidly reshaped the treatment landscape across disease states.</p><p><strong>Areas covered: </strong>This is a comprehensive overview of the prostate cancer theranostics landscape, with a primary focus on PSMA. We synthesized evidence from landmark randomized trials, guideline documents, and emerging data on alpha-emitting agents, combination strategies, and next-generation constructs. Literature search encompassed pivotal phase II/III trials, guideline documents, and contemporary mechanistic studies. Patient selection, distinguishing clinical-trial eligibility, regulatory indications, and guideline recommendations, is critically appraised.</p><p><strong>Expert opinion: </strong>PSMA-targeted radioligand therapy has fundamentally reshaped the treatment paradigm, with [¹⁷⁷Lu]Lu-PSMA-617 established in PSMA-positive metastatic castration-resistant prostate cancer and now expanding into earlier disease states, including metastatic hormone-sensitive prostate cancer. The future lies in biomarker refinement, rational combinations with poly(ADP-ribose) polymerase inhibitors, androgen receptor pathway inhibitors, and immunotherapy, and next-generation platforms including alpha-emitters and bispecific agents. Multidisciplinary integration and structured monitoring will be essential for optimizing outcomes as theranostics becomes a sequence-defining therapeutic platform.</p>","PeriodicalId":12207,"journal":{"name":"Expert Review of Clinical Pharmacology","volume":" ","pages":"837-854"},"PeriodicalIF":3.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016087","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}

{"title":"Keeping the weight off: can oral orforglipron maintain all the weight loss following glucagon-like peptide-1 receptor agonist (GLP-1 RA) discontinuation?","authors":"Abdulhameed Alhazmi, Carel W le Roux","doi":"10.1080/17512433.2026.2731087","DOIUrl":"10.1080/17512433.2026.2731087","url":null,"abstract":"","PeriodicalId":12207,"journal":{"name":"Expert Review of Clinical Pharmacology","volume":" ","pages":"773-775"},"PeriodicalIF":3.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905636","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}

{"title":"The impact of parathyroid hormone replacement with palopegteriparatide on synthesis of 1,25-dihydroxy vitamin D in hypoparathyroidism.","authors":"Michael A Levine, Jenny Ukena, Christopher T Sibley, Mads Kjelgaard-Hansen","doi":"10.1080/17512433.2026.2718374","DOIUrl":"10.1080/17512433.2026.2718374","url":null,"abstract":"<p><strong>Introduction: </strong>Parathyroid hormone (PTH) is the primary regulator of calcium and phosphate balance via direct action on the kidneys and bones and indirect action on the intestine. Hypoparathyroidism is caused by insufficient levels of PTH, leading to 1,25-dihydroxy vitamin D (1,25[OH]₂D) deficiency. PTH-induced 1,25(OH)₂D production is a highly regulated process essential for physiological functions that is reduced or absent in hypoparathyroidism.</p><p><strong>Areas covered: </strong>Physiological synthesis of 1,25(OH)₂D requires 25-hydroxy vitamin D (25[OH]D) 1-α-hydroxylation via the renal CYP27B1 enzyme. Enzyme activity is dependent on CYP27B1 transcription, which is induced by specific PTH-1 receptor (PTH1R) activation that results in endosomal-derived intracellular cyclic adenosine monophosphate formation. Palopegteriparatide, a prodrug of PTH(1-34) used as replacement therapy in hypoparathyroidism, is designed to provide active PTH that exerts its physiological effect through the same affinity and binding to receptors as endogenous PTH. Throughout 3.5 years in the phase 3 PaTHway trial, 25(OH)D and 1,25(OH)₂D levels were maintained within normal limits as a result of restoring endogenous production of 1,25(OH)₂D and physiological signaling with palopegteriparatide treatment, thereby facilitating independence from active vitamin D.</p><p><strong>Expert opinion: </strong>1,25(OH)₂D production can be compromised by even small changes to PTH that bias the physiological interaction between PTH and PTH1R. Thus, ensuring formation of 1,25(OH)₂D should be a key outcome of interest in drug development of PTH replacement therapies. Data from clinical trials demonstrate active PTH released from palopegteriparatide interacts with PTH1R to ensure adequate 1,25(OH)₂D synthesis, enabling independence from active vitamin D analogues, and confirms its position as a PTH replacement therapy.</p>","PeriodicalId":12207,"journal":{"name":"Expert Review of Clinical Pharmacology","volume":" ","pages":"705-715"},"PeriodicalIF":3.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758252","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}

{"title":"Trimethoprim-sulfamethoxazole-associated respiratory failure: a rapid review of the literature.","authors":"Nina Butkovich, Keri Swaggart, Jenna O Miller, Jennifer L Goldman","doi":"10.1080/17512433.2026.2716322","DOIUrl":"10.1080/17512433.2026.2716322","url":null,"abstract":"<p><strong>Introduction: </strong>Trimethoprim-sulfamethoxazole (TMP-SMX) is a widely used and generally well tolerated antibiotic. Its association with life-threatening respiratory failure was described in a 2019 case series showing high rates of morbidity and mortality. Due to this reporting, public awareness increased, leading to a safety label change by the FDA in 2021 and the publication of cases and studies evaluating this rare adverse reaction.</p><p><strong>Areas covered: </strong>In this rapid review, we performed a database search in PubMed and Embase to evaluate the progression of TMP-SMX‑associated respiratory failure research from 1 January 2019 to 27 January 2026. The original case series spurred the publication of other case series that collectively improved understanding of pathology and supportive care, and retrospective studies have recently been published. The wide-reaching impact of case reporting on adverse drug reactions has also been observed historically, such as for chloramphenicol and thalidomide.</p><p><strong>Expert opinion: </strong>Based on expert opinion, continued efforts to evaluate mechanism, clinical course, and risk would be valuable to better understand this underreported and underrecognized reaction. Altogether, the progression of TMP-SMX-associated respiratory failure research since 2019 demonstrates the importance of publishing cases of rare drug reactions and dissemination to the medical community.</p>","PeriodicalId":12207,"journal":{"name":"Expert Review of Clinical Pharmacology","volume":" ","pages":"749-760"},"PeriodicalIF":3.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148688770","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}

{"title":"Beyond migraine: CGRP inhibition at the neurovascular interface and its implications for glaucoma risk.","authors":"Chien-Chih Chou, Taemin Kim, Ssu-Yu Pan, Chien-Hsiang Weng","doi":"10.1080/17512433.2026.2716922","DOIUrl":"10.1080/17512433.2026.2716922","url":null,"abstract":"","PeriodicalId":12207,"journal":{"name":"Expert Review of Clinical Pharmacology","volume":" ","pages":"701-703"},"PeriodicalIF":3.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148701073","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}

{"title":"Could GLP-1RAs improve outcomes for patients with chronic migraine?","authors":"Tsung-Wei Hou, Vitoria Acar, Hsiangkuo Yuan","doi":"10.1080/17512433.2026.2710153","DOIUrl":"10.1080/17512433.2026.2710153","url":null,"abstract":"","PeriodicalId":12207,"journal":{"name":"Expert Review of Clinical Pharmacology","volume":" ","pages":"697-700"},"PeriodicalIF":3.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148577582","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}

{"title":"Why do bisphosphonates work in the treatment of CRPS? A translational pharmacological perspective to solve a conundrum.","authors":"Massimo Varenna, Chiara Crotti, Raffaele Di Taranto, Francesco Orsini, Francesca Zucchi","doi":"10.1080/17512433.2026.2715376","DOIUrl":"10.1080/17512433.2026.2715376","url":null,"abstract":"<p><strong>Introduction: </strong>Bisphosphonates (BPs) have consistently yielded positive results in the treatment of Complex Regional Pain Syndrome (CRPS). However, biochemical and histopathological evidence suggests that osteoclasts, the primary pharmacological target of BPs, is not a key driver in the early pathogenetic steps of CRPS.</p><p><strong>Methods: </strong>To critically review and integrate current evidence on pharmacological mechanisms of action of BPs in CRPS and to propose unifying hypotheses explaining their clinical efficacy beyond antiosteoclastic activity. Literature from <i>in vitro</i> studies, animal models, and randomized clinical trials was integrated. Approximately 80 primary and review articles were critically reviewed.</p><p><strong>Expert opinion: </strong>BPs efficacy in CRPS is best explained by a bone-driven pharmacological model by which local drug accumulation is achieved in the site of disease. This enables modulation of inflammatory and nociceptive processes on adjacent non-bone cells, including macrophages, neutrophils, keratinocytes, and nociceptive fibers. Inhibition of the mevalonate pathway in these cells may reduce inflammatory cytokines, nerve growth factor (NGF), and reactive oxygen species (ROS), while modulating nociceptive signaling pathways. Additional mechanisms, including modulation of vascular tone and neuropeptide signaling, may further contribute to therapeutic effects. This hypothesis may inform optimal treatment strategies and together improve understanding of CRPS pathophysiology.</p>","PeriodicalId":12207,"journal":{"name":"Expert Review of Clinical Pharmacology","volume":" ","pages":"717-727"},"PeriodicalIF":3.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673196","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}

{"title":"Profiling the pattern of medication use during pregnancy: an international scoping review of observational studies.","authors":"Irin Parvin, Hanan Abunimeh, Hisham Alshammari, Amanj Kurdi, Marion Bennie, Tanja Mueller","doi":"10.1080/17512433.2026.2710151","DOIUrl":"10.1080/17512433.2026.2710151","url":null,"abstract":"<p><strong>Introduction: </strong>Medication use during pregnancy has increased significantly worldwide. However, detailed evidence on prescribing patterns during pregnancy remains limited. This scoping review aimed to summarize and provide a comprehensive global overview of the patterns/types of medications used during pregnancy.</p><p><strong>Areas covered: </strong>The Joanna Briggs Institute (JBI) methodology was followed. PubMed, Ovid MEDLINE, Scopus, Web of Science, and EMBASE were searched for population-based and large multicentre observational studies published between January 2010 and April 2024. The included studies focused on pregnant women, investigated and quantified medications use during pregnancy. Identified medications were summarized narratively using the Anatomical Therapeutic Chemical (ATC) and the United States Food and Drug Administration (US-FDA)/Australian Therapeutic Goods Administration (AU-TGA) risk classification systems, and stratified by trimesters.</p><p><strong>Expert opinion: </strong>Of 7,552 studies, 83 were eligible. The most frequently reported ATC categories were alimentary tract and metabolism (A, 0-96%), blood and blood-forming organs (B, 0-84.5%), nervous system (N, 0-73.3%), anti-infectives (J, 0-56%), and respiratory system (R, 0-51.3%). However, limited research provided trimester-specific information. Additionally, risk category A exhibited the widest prevalence range, 0-73.1%, while the higher-risk categories, D and X, were at 0-22.6% and 0-8.3%, respectively. This review highlights the need for further trimester-specific studies.</p>","PeriodicalId":12207,"journal":{"name":"Expert Review of Clinical Pharmacology","volume":" ","pages":"729-747"},"PeriodicalIF":3.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148590950","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}

{"title":"Progress toward longer-acting antiretroviral regimens for adult HIV treatment.","authors":"Logan Flaxman, Onyema Ogbuagu, Amit C Achhra","doi":"10.1080/17512433.2026.2723009","DOIUrl":"10.1080/17512433.2026.2723009","url":null,"abstract":"<p><strong>Introduction: </strong>Long-acting injectable antiretroviral therapy may improve adherence, virologic outcomes, quality of life and treatment satisfaction for people with HIV. Cabotegravir plus rilpivirine (CAB/RPV), the first complete long-acting injectable regimen for HIV treatment, has demonstrated efficacy, safety, tolerability, and real-world feasibility. Recent studies also support its use in individuals with viremia and adherence challenges. Lenacapavir and ibalizumab provide durable efficacy for individuals with multidrug-resistant HIV.</p><p><strong>Areas covered: </strong>This review summarizes clinical trials and observational studies evaluating long-acting HIV therapies including their benefits, limitations and future implications. Literature published between 2017 and 2026 was identified through PubMed, Clinicaltrials.gov and abstracts or conference proceedings from Conference on Retroviruses and Opportunistic Infections (CROI), International Antiviral Society (IAS), IDWeek, European AIDS Clinical Society (EACS) and HIV Glasgow conferences.</p><p><strong>Expert opinion: </strong>Despite promising findings, limitations of long-acting ART include the risks of virologic failure, the prolonged pharmacologic tail, lack of hepatitis B treatment activity, limited pregnancy safety data, and implementation challenges. Ongoing research is evaluating novel combinations of long-acting agents, including emerging oral therapies, to expand treatment options. Long-acting antiretroviral treatments have the potential to address unmet needs and broaden individualized treatment options in HIV care.</p>","PeriodicalId":12207,"journal":{"name":"Expert Review of Clinical Pharmacology","volume":" ","pages":"761-772"},"PeriodicalIF":3.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148826678","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}

{"title":"Brexpiprazole for anxiety symptoms in people living with schizophrenia: a plain language summary.","authors":"Anja Farovik, Murat Yildirim, Shivani Kapadia, Anton M Palma, Zahinoor Ismail","doi":"10.1080/17512433.2026.2691591","DOIUrl":"10.1080/17512433.2026.2691591","url":null,"abstract":"","PeriodicalId":12207,"journal":{"name":"Expert Review of Clinical Pharmacology","volume":" ","pages":"629-640"},"PeriodicalIF":3.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148374954","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}