Expert Review of Clinical Pharmacology最新文献_第4页

Obese and overweight patients with type 2 diabetes mellitus are not treated optimally - an overview of current clinical practice and future perspectives. 肥胖和超重的2型糖尿病患者没有得到最佳治疗——是时候重新考虑临床实践了吗？

IF 3.6 3区医学

Expert Review of Clinical Pharmacology Pub Date : 2026-07-01 Epub Date: 2026-07-21 DOI: 10.1080/17512433.2026.2706660

Tanja Miličević Milardović, Ivna Cvitković, Špela Volčanšek, Niki Katsiki, Dimitri P Mikhailidis, Dimitrios Patoulias, Emir Muzurović

{"title":"Obese and overweight patients with type 2 diabetes mellitus are not treated optimally - an overview of current clinical practice and future perspectives.","authors":"Tanja Miličević Milardović, Ivna Cvitković, Špela Volčanšek, Niki Katsiki, Dimitri P Mikhailidis, Dimitrios Patoulias, Emir Muzurović","doi":"10.1080/17512433.2026.2706660","DOIUrl":"10.1080/17512433.2026.2706660","url":null,"abstract":"Introduction: Type 2 diabetes mellitus (T2DM) pharmacotherapy guidelines recommend the assessment of individual cardiovascular (CV) risk. However, obesity still seems of lesser importance in the context of CV risk. Importantly, obesity-targeting pharmacotherapy use is limited.Areas covered: A PubMed database search, up to August 2025, was performed. This review explores the rationale for prioritizing weight reduction as a key treatment strategy for overweight/obese T2DM patients and provides evidence supporting a weight-centric approach. Furthermore, it addresses the challenges associated with implementing weight management strategies in clinical practice. Higher doses of medications approved for obesity treatment may be indicated compared with those recommended for T2DM therapy. Additionally, the high cost and the lack of reimbursement policies for these drugs create a significant financial burden. Drug side effects may also minimize their use.Expert opinion: The effectiveness of available pharmacotherapy in treating obesity in T2DM patients is discussed. There is still an urgent need to raise awareness regarding the importance of weight-centric management in overweight/obese T2DM patients. There is a need for a multidisciplinary approach, including health-care providers, the health system and policy makers, taking into consideration the multiple challenges, health inequity concerns and disparities in medication accessibility.","PeriodicalId":12207,"journal":{"name":"Expert Review of Clinical Pharmacology","volume":" ","pages":"671-686"},"PeriodicalIF":3.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148469852","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

Tirzepatide in type 1 diabetes: beyond mere weight loss. 替西帕肽治疗1型糖尿病：不仅仅是减轻体重。

IF 3.6 3区医学

Expert Review of Clinical Pharmacology Pub Date : 2026-07-01 Epub Date: 2026-06-11 DOI: 10.1080/17512433.2026.2685653

Theodoros Panou, Evanthia Gouveri, Djordje S Popovic, Nikolaos Papanas

{"title":"Tirzepatide in type 1 diabetes: beyond mere weight loss.","authors":"Theodoros Panou, Evanthia Gouveri, Djordje S Popovic, Nikolaos Papanas","doi":"10.1080/17512433.2026.2685653","DOIUrl":"10.1080/17512433.2026.2685653","url":null,"abstract":"Background: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have revolutionized treatment for type 2 diabetes mellitus (T2DM), obesity and beyond. Current research focuses on the use of the dual agonist of glucagon-like peptide-1 receptor (GLP-1R) and glucose-dependent insulinotropic polypeptide receptor (GIPR), tirzepatide.Areas covered: This narrative review focuses on the clinical potential of tirzepatide in type 1 diabetes mellitus (T1DM). A literature search in PubMed/MEDLINE, Scopus and Google Scholar until March 2026 was conducted using appropriate keywords. Glycated hemoglobin (HbA1c) was reduced by up to 0.9% and body weight by up to 23.4% corresponding to a reduction in body-mass index by up to 9.0 kg/m2. Continuous glucose monitoring (CGM) has shown that time in range (TIR) increased by up to 18.0%, almost exclusively due to reduced time above range (TAR). Daily insulin requirements were reduced by up to 38 units/day.Expert opinion: Tirzepatide was associated with optimized glycemic control and reduced insulin requirements. These benefits were partly, but not exclusively, mediated by weight loss. Currently available studies are largely observational and have included subjects with overweight or obesity. Future randomized controlled trials are now required to further corroborate these promising findings.","PeriodicalId":12207,"journal":{"name":"Expert Review of Clinical Pharmacology","volume":" ","pages":"687-696"},"PeriodicalIF":3.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148155897","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

Understanding the relationship between aripiprazole levels in the blood and recurrence of mood episodes in people diagnosed with bipolar I disorder treated with a once-monthly injection of aripiprazole monohydrate: a plain language summary. 了解血液中阿立哌唑水平与每月注射一次一水阿立哌唑治疗的双相I型患者的情绪发作复发之间的关系：简单的语言总结。

IF 3.6 3区医学

Expert Review of Clinical Pharmacology Pub Date : 2026-07-01 Epub Date: 2026-06-17 DOI: 10.1080/17512433.2026.2688267

Karimah S Bell Lynum, Murat Yildirim, Craig Chepke, Julie Passarell, Matthew Harlin

引用次数: 0

The systems medicine view of semaglutide: from clinical trials to molecular mechanisms. 西马鲁肽的系统医学观点：从临床试验到分子机制。

IF 3.6 3区医学

Expert Review of Clinical Pharmacology Pub Date : 2026-07-01 DOI: 10.1080/17512433.2026.2695172

Rui Vitorino

{"title":"The systems medicine view of semaglutide: from clinical trials to molecular mechanisms.","authors":"Rui Vitorino","doi":"10.1080/17512433.2026.2695172","DOIUrl":"10.1080/17512433.2026.2695172","url":null,"abstract":"Introduction: Semaglutide, a glucagon-like peptide-1 receptor agonist (GLP-1RA), is a key therapy in managing type 2 diabetes (T2D), offering significant improvements in glycemic control, weight loss, and cardiovascular protection. Beyond these clinical benefits, multi-omics research is clarifying the molecular mechanisms underlying its systemic metabolic effects.Areas covered: This review synthesizes findings from major clinical trials and recent proteomic and metabolomic studies to explain how semaglutide affects inflammatory, lipid, and extracellular matrix (ECM) pathways in multiple organs. Key molecular mediators, including adiponectin, fibroblast growth factor 21 (FGF21), apolipoprotein C-III (ApoC-III), ceramides, and ECM-remodeling proteins (MMPs, CTGF, α-SMA), are linked to improved insulin sensitivity, reduced adipose inflammation, and restored metabolic flexibility. The review also discusses the use of artificial intelligence (AI) and machine learning (ML) to connect omics biomarkers with clinical outcomes.Expert opinion: Semaglutide exemplifies a precision medicine approach for T2D by linking clinical efficacy to molecular adaptation. Longitudinal validation of omics biomarkers and their integration into AI-driven diagnostic platforms could enable personalized, mechanism-based therapy that goes beyond glucose control to deliver comprehensive cardiometabolic protection.","PeriodicalId":12207,"journal":{"name":"Expert Review of Clinical Pharmacology","volume":" ","pages":"651-669"},"PeriodicalIF":3.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148307863","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

Beyond snapshot dosing: a dynamic living digital twin framework for model-informed precision dosing in critical illness. 超越快照剂量：一个动态的生活数字双胞胎框架模型知情的精确剂量在危重疾病。

IF 3.6 3区医学

Expert Review of Clinical Pharmacology Pub Date : 2026-07-01 Epub Date: 2026-06-22 DOI: 10.1080/17512433.2026.2693120

Hulya Tezel Yalcin, Nadir Yalcin

{"title":"Beyond snapshot dosing: a dynamic living digital twin framework for model-informed precision dosing in critical illness.","authors":"Hulya Tezel Yalcin, Nadir Yalcin","doi":"10.1080/17512433.2026.2693120","DOIUrl":"10.1080/17512433.2026.2693120","url":null,"abstract":"Introduction: Model-Informed Precision Dosing (MIPD) has improved individualized therapy, but in critical illness its reliance on intermittently updated data creates a temporal mismatch between pharmacokinetic (PK) models and rapidly evolving physiology.Areas covered: Synthesizing population pharmacokinetic (popPK) and data science literature, we examine the limitations of snapshot-based dosing, using vancomycin as example. We propose the Dynamic Living Digital Twin (DLDT) framework, which integrates high-frequency electronic health record data into adaptive state-space models such as Kalman filtering. Rather than adding more covariates, the DLDT reframes patient physiology as a continuously evolving latent state that can be updated using temporally dense clinical data. Methodological, infrastructural, and regulatory Software as Medical Device (SaMD) barriers are also evaluated. A non-systematic PubMed search identified relevant publications available up to March 2026.Expert opinion: The next advance in precision dosing will come from temporally adaptive PK reasoning. In this paradigm, patient physiology is treated as an evolving latent state, and clinical pharmacists may increasingly interpret exposure trajectories rather than isolated dose recommendations. Although technically feasible, implementation remains constrained by data interoperability and workflow integration challenges. Clinical pharmacists may therefore increasingly act as stewards of dynamic model outputs, using anticipated exposure trajectories to preempt PK shifts.","PeriodicalId":12207,"journal":{"name":"Expert Review of Clinical Pharmacology","volume":" ","pages":"641-650"},"PeriodicalIF":3.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148276635","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

Improving evidence-based antiseizure medication prescribing during pregnancy: strengthening research and clinical practice. 改进孕期循证抗癫痫药物处方：加强研究和临床实践。

IF 3.6 3区医学

Expert Review of Clinical Pharmacology Pub Date : 2026-07-01 Epub Date: 2026-07-24 DOI: 10.1080/17512433.2026.2705845

Adrienne Y L Chan, Ian C K Wong, Kenneth K C Man

引用次数: 0

Treatment strategies for pulmonary arterial hypertension associated with adult congenital heart diseases. 肺动脉高压合并成人先天性心脏病的治疗策略

IF 3.6 3区医学

Expert Review of Clinical Pharmacology Pub Date : 2026-06-01 Epub Date: 2026-05-26 DOI: 10.1080/17512433.2026.2678439

Satoshi Akagi, Shingo Kasahara, Kentaro Ejiri, Kazufumi Nakamura, Shinsuke Yuasa

{"title":"Treatment strategies for pulmonary arterial hypertension associated with adult congenital heart diseases.","authors":"Satoshi Akagi, Shingo Kasahara, Kentaro Ejiri, Kazufumi Nakamura, Shinsuke Yuasa","doi":"10.1080/17512433.2026.2678439","DOIUrl":"10.1080/17512433.2026.2678439","url":null,"abstract":"Introduction: The number of patients with adult congenital heart disease (ACHD) is gradually increasing worldwide due to advances in surgical techniques and pharmacological therapies. ACHD can lead to pulmonary arterial hypertension (PAH), and treatment strategies for PAH associated with ACHD have also evolved.Areas covered: Several PAH-targeted drugs including endothelin receptor antagonists, phosphodiesterase type 5 inhibitors, soluble guanylate cyclase stimulators, and prostacyclin analogs are available for treatment of PAH. In this review, we summarized the current evidence regarding the use of PAH-targeted drugs in patients with PAH associated with ACHD. We also propose a 'treat and repair' strategy, which involves initial medical treatment to improve PAH followed by surgical or interventional repair of the systemic-to-pulmonary shunt. A PubMed literature search was conducted from 2000 to 2025.Expert opinion: In cases of PAH associated with a systemic-to-pulmonary cardiac shunt, advanced PAH-targeted drugs can improve hemodynamics, and reduce the risk of cardiac defect repair and further improvement in PAH. The treat and repair strategy represents a promising therapeutic approach for PAH patients associated with systemic-to-pulmonary shunts.","PeriodicalId":12207,"journal":{"name":"Expert Review of Clinical Pharmacology","volume":" ","pages":"559-566"},"PeriodicalIF":3.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147981232","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

Complement C5 inhibitor crovalimab for the treatment of paroxysmal nocturnal hemoglobinuria. 补体C5抑制剂克罗伐单抗治疗阵发性夜间血红蛋白尿。

IF 3.6 3区医学

Expert Review of Clinical Pharmacology Pub Date : 2026-06-01 Epub Date: 2026-06-04 DOI: 10.1080/17512433.2026.2677883

Tianqiao Zhang, Bo Xu, Jixiang Chen, Jiecan Zhou

{"title":"Complement C5 inhibitor crovalimab for the treatment of paroxysmal nocturnal hemoglobinuria.","authors":"Tianqiao Zhang, Bo Xu, Jixiang Chen, Jiecan Zhou","doi":"10.1080/17512433.2026.2677883","DOIUrl":"10.1080/17512433.2026.2677883","url":null,"abstract":"Introduction: Paroxysmal nocturnal hemoglobinuria (PNH) is a clonal hematopoietic stem cell disease characterized by hemolytic anemia, bone marrow failure, and thrombosis. Some PNH patients carrying the C5 mutation (Arg885) show poor response to eculizumab and ravulizumab.Areas covered: The US FDA approved PiaSky (crovalimab-akkz) on 20 June 2024, for use in adults or adolescents with PNH. It is a humanized anti-C5 monoclonal antibody, formerly known as SKY59. The main objective of this review is to examine the pharmacological properties of crovalimab and its clinical efficacy and safety.Expert opinion: Crovalimab inhibits the cleavage of complement C5 into C5a and C5b by specifically binding to complement C5, thus preventing terminal complement-mediated intravascular hemolysis in patients with PNH. Based on the pivotal trials COMMODORE 1 and COMMODORE 2, crovalimab had clinical efficacy not inferior to that of eculizumab and exhibited good tolerability and safety, including in controlling hemolysis, avoiding transfusions, and reducing or maintaining lactate dehydrogenase levels. Additionally, crovalimab showed a favorable response in PNH patients carrying C5 variants, and the response in adolescents aged ≥13 years was similar to that in adults. Common adverse events associated with crovalimab include infusion-related reactions, respiratory tract infections, and Type III hypersensitivity reactions.","PeriodicalId":12207,"journal":{"name":"Expert Review of Clinical Pharmacology","volume":" ","pages":"499-508"},"PeriodicalIF":3.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148053750","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

New therapies to treat nausea and vomiting: clinical need, progress towards novelty and research challenges. 治疗恶心和呕吐的新疗法：临床需要、新进展和研究挑战。

IF 3.6 3区医学

Expert Review of Clinical Pharmacology Pub Date : 2026-06-01 Epub Date: 2026-06-09 DOI: 10.1080/17512433.2026.2682294

Gareth J Sanger, John F Golding, Paul L R Andrews

{"title":"New therapies to treat nausea and vomiting: clinical need, progress towards novelty and research challenges.","authors":"Gareth J Sanger, John F Golding, Paul L R Andrews","doi":"10.1080/17512433.2026.2682294","DOIUrl":"10.1080/17512433.2026.2682294","url":null,"abstract":"Introduction: Despite the availability of drugs which prevent vomiting, treatment gaps in controlling nausea and vomiting remain. New approaches are needed.Areas covered: We identify unmet clinical needs by examining clinical reviews (last 5-years), adding our experience in drug discovery/emesis research. Mechanisms of nausea and vomiting are given. We identify emerging research and new approaches before discussing the challenges of quantifying nausea and vomiting in future trials.Expert opinion: As single agents, drugs which prevent vomiting have efficacy in some but not all groups of patients, with NK1 receptor antagonists possessing the widest spectrum of action. Drug combinations have improved efficacy in specific clinical settings. However, treatment gaps remain (e.g. gastroparesis, cyclic vomiting syndrome) and efficacy is lower against nausea compared with vomiting. The latter requires greater attention in trial design and regulatory assessments. The issue of nausea is difficult because in humans it is inadequately quantified (with high temporal resolution), there is a lack of clinical research into nausea, and animal models only measure 'nausea-like behaviours,' with challenges in translating to humans. In drug discovery, more systematic and critical analysis of the pharmacology of the diverse agents which induce or reduce nausea and vomiting may help identify new therapeutic mechanisms.","PeriodicalId":12207,"journal":{"name":"Expert Review of Clinical Pharmacology","volume":" ","pages":"535-558"},"PeriodicalIF":3.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148053795","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

Effect of terlipressin on renal outcomes in patients with liver cirrhosis and ascites: a retrospective multicenter study. 特利加压素对肝硬化和腹水患者肾脏预后的影响：一项回顾性多中心研究。

IF 3.6 3区医学

Expert Review of Clinical Pharmacology Pub Date : 2026-06-01 Epub Date: 2026-06-21 DOI: 10.1080/17512433.2026.2679596

Yong He, Xianxian Zhang, Ting Wang, Xiaohui Fang, Na Sun, Jian Zhang, Yibing Li, Frank Tacke, Wenxiu Zhang, Yanhong Gao, Han Chen, Yunhai Wu, Lichun Shao, Xingshun Qi

{"title":"Effect of terlipressin on renal outcomes in patients with liver cirrhosis and ascites: a retrospective multicenter study.","authors":"Yong He, Xianxian Zhang, Ting Wang, Xiaohui Fang, Na Sun, Jian Zhang, Yibing Li, Frank Tacke, Wenxiu Zhang, Yanhong Gao, Han Chen, Yunhai Wu, Lichun Shao, Xingshun Qi","doi":"10.1080/17512433.2026.2679596","DOIUrl":"10.1080/17512433.2026.2679596","url":null,"abstract":"Background: Terlipressin is recommended for acute kidney injury (AKI) in cirrhosis, but its role in those with ascites but without AKI is unclear.Methods: We retrospectively enrolled 905 cirrhotic patients with ascites from three hospitals, of whom 250 received terlipressin and 655 standard medical therapy. Patients were stratified by baseline serum creatinine (Scr) into stable renal function (Scr < 133 μmol/L; n = 784) and renal dysfunction (Scr ≥ 133 μmol/L; n = 121) cohorts. Primary outcomes included AKI, renal dysfunction, and renal function improvement. Propensity score matching (PSM) was performed. Multivariable logistic regression was further performed in the stable renal function cohort to assess the independent association between terlipressin and AKI. Odds ratio (OR) was calculated.Results: In the stable renal function cohort, after PSM (n = 120), terlipressin group had lower incidence of AKI (1.67% vs. 16.67%, p = 0.004) and renal dysfunction (0% vs. 8.33%, p = 0.068); and multivariate logistic regression analysis confirmed that terlipressin was independently associated with lower incidence of AKI (OR = 0.093, p = 0.027). In the renal dysfunction cohort, after PSM (n = 34), terlipressin was associated with higher incidence of renal function improvement (70.59% vs. 23.53%, p = 0.006).Conclusion: Terlipressin may be associated with favorable renal outcomes in cirrhotic patients with ascites, regardless of baseline renal function.","PeriodicalId":12207,"journal":{"name":"Expert Review of Clinical Pharmacology","volume":" ","pages":"601-613"},"PeriodicalIF":3.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147987203","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