Expert Review of Clinical Pharmacology最新文献_第8页

Optimizing valganciclovir dosing strategies: a comprehensive review. 优化缬更昔洛韦给药策略：一项综合综述。

IF 3.6 3区医学

Expert Review of Clinical Pharmacology Pub Date : 2026-03-01 Epub Date: 2026-03-03 DOI: 10.1080/17512433.2026.2640124

Kotaro Itohara, Ikuko Yano

{"title":"Optimizing valganciclovir dosing strategies: a comprehensive review.","authors":"Kotaro Itohara, Ikuko Yano","doi":"10.1080/17512433.2026.2640124","DOIUrl":"10.1080/17512433.2026.2640124","url":null,"abstract":"Introduction: Orally administered valganciclovir (VGCV) is rapidly metabolized to ganciclovir (GCV) and is used to prevent and treat cytomegalovirus (CMV) infection. Although GCV exposure is related to efficacy or toxicity, therapeutic drug monitoring (TDM) for GCV has not yet been clinically implemented. This review was conducted to summarize relevant current issues for implementing the optimization of VGCV therapy based on TDM.Areas covered: The current knowledge on the population pharmacokinetics of GCV after oral administration of VGCV, the relationships between GCV exposure with efficacy and toxicity, and the available evidence for TDM was comprehensively reviewed. The limited sampling strategy (LSS) and microsampling methods for clinically implementing TDM are summarized. The relationship between nucleoside-diphosphate-linked moiety X-type motif 15 (NUDT15) polymorphisms and toxicity is discussed. Relevant literature published before 2025 was searched in PubMed.Expert opinion: Accumulating evidence indicates that GCV exposure is associated with both efficacy and safety, and exposure-guided dosing (target area under the time-concentration curve (AUC) of 40-60 μg·h/mL) may provide a reliable approach for maximizing VGCV therapy. However, several methodological and practical challenges, including standardization of LSS and improvement of microsampling technologies, are required for practical VGCV dose optimization in all patient populations.","PeriodicalId":12207,"journal":{"name":"Expert Review of Clinical Pharmacology","volume":" ","pages":"255-267"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147325127","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

Pharmacological interventions for alcohol use disorder: novel insights from recent clinical trials. 酒精使用障碍的药物干预：来自最近临床试验的新见解。

IF 3.6 3区医学

Expert Review of Clinical Pharmacology Pub Date : 2026-01-01 Epub Date: 2026-02-03 DOI: 10.1080/17512433.2026.2625341

Kaitlin R McManus, Lara A Ray

{"title":"Pharmacological interventions for alcohol use disorder: novel insights from recent clinical trials.","authors":"Kaitlin R McManus, Lara A Ray","doi":"10.1080/17512433.2026.2625341","DOIUrl":"10.1080/17512433.2026.2625341","url":null,"abstract":"Introduction: 27.1 million adults in the United States have alcohol use disorder (AUD). However, current medications for AUD have mixed efficacy. As such, a shift in treatment approach and the development of novel pharmacotherapies for AUD is imperative.Areas covered: This review addresses novel insights on treating AUD through precision medicine that identifies subgroups of individuals most responsive to existing single or combination pharmacotherapies for AUD. In parallel, this review synthesizes the emergence of pharmacological agents for AUD that are on the treatment horizon. These include glucagon-like peptide 1 receptor agonists, classic psychedelics, ketamine, immune modulators, and cannabinoids. Data reviewed were culled from searches of the PubMed database and clinicaltrials.gov registry.Expert opinion: Adopting a precision medicine approach and investigating novel compounds for AUD treatment requires a shift in systems of care. Precision medicine navigates away from the traditional 'one size fits all' health care model to emphasize the individual, leading to long-term cost-effectiveness and improved patient outcomes. Moreover, novel pharmacotherapies face challenges in the scale of their distribution throughout healthcare settings. The developments reviewed in this paper elucidate a paradigm shift necessary to facilitate the integration of precision medicine and the adoption of novel pharmacotherapies within the AUD field.","PeriodicalId":12207,"journal":{"name":"Expert Review of Clinical Pharmacology","volume":" ","pages":"105-115"},"PeriodicalIF":3.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146085067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Shaping future deprescribing priorities: outcomes of a World Café stakeholder workshop. 塑造未来，描述优先事项：世界咖啡利益相关者研讨会的成果。

IF 3 3区医学

Expert Review of Clinical Pharmacology Pub Date : 2026-01-01 Epub Date: 2025-12-29 DOI: 10.1080/17512433.2025.2609659

William Manning Olsen, Kitty St Pierre, Wade Thompson, Kristie Rebecca Weir, Christopher Robert Freeman, Ruth Bohill, Barbara Farrell, Aili Veronica Langford, Lisa Kouladjian O'Donnell, Emily Reeve, Shin J Liau, Aisling Mary McEvoy, Shakti Shrestha, Wubshet Tesfaye, Juanita Breen, Christopher Etherton-Beer, Jerry Yik, Justin Turner, Nagham J Ailabouni

{"title":"Shaping future deprescribing priorities: outcomes of a World Café stakeholder workshop.","authors":"William Manning Olsen, Kitty St Pierre, Wade Thompson, Kristie Rebecca Weir, Christopher Robert Freeman, Ruth Bohill, Barbara Farrell, Aili Veronica Langford, Lisa Kouladjian O'Donnell, Emily Reeve, Shin J Liau, Aisling Mary McEvoy, Shakti Shrestha, Wubshet Tesfaye, Juanita Breen, Christopher Etherton-Beer, Jerry Yik, Justin Turner, Nagham J Ailabouni","doi":"10.1080/17512433.2025.2609659","DOIUrl":"10.1080/17512433.2025.2609659","url":null,"abstract":"Introduction: Medicine-related harm associated with polypharmacy is a pertinent global health challenge. Deprescribing (reducing or stopping) medicines that cause more potential harm than benefit could mitigate the risk of medicine-related harm. However, the existing deprescribing research-to-practice gap threatens the long-term sustainability and scalability of deprescribing efforts.Research design and methods: To address this, key stakeholders including healthcare practitioners, academics, policymakers and representatives of peak professional organizations, gathered at a World Café workshop to reflect on progress achieved in the deprescribing research and practice landscape while exploring the top future priorities for deprescribing.Results: Thirty participants agreed on three top priorities: improving the clinical management of deprescribing; engaging consumers and gaining their perspectives; and raising awareness to enhance communication. Emerging themes and related barriers and catalysts were derived and mapped to a socio-ecological model offering a bird-eye's view of these factors on an individual, interpersonal, organizational, and societal level.Conclusions: Our World Cafe' highlights opportunities for future deprescribing research and practice. To promote the uptake of deprescribing in practice, catalysts could include leveraging new technology, promoting deprescribing via social media and optimizing workforce staff and knowledge. Ultimately, this knowledge may motivate deprescribing efforts and bridge the research-to-practice gap.","PeriodicalId":12207,"journal":{"name":"Expert Review of Clinical Pharmacology","volume":" ","pages":"85-96"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145827133","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

CYP2C19 genotype-guided dosing of proton pump inhibitors: progress in clinical trials and real-world use. CYP2C19基因型引导质子泵抑制剂给药：临床试验和实际应用进展

IF 3.6 3区医学

Expert Review of Clinical Pharmacology Pub Date : 2026-01-01 Epub Date: 2026-02-08 DOI: 10.1080/17512433.2026.2626454

Han Minh Thuy, Mitsushige Sugimoto, Pham Minh Ngoc Quang, Yoshio Yamaoka

{"title":"CYP2C19 genotype-guided dosing of proton pump inhibitors: progress in clinical trials and real-world use.","authors":"Han Minh Thuy, Mitsushige Sugimoto, Pham Minh Ngoc Quang, Yoshio Yamaoka","doi":"10.1080/17512433.2026.2626454","DOIUrl":"10.1080/17512433.2026.2626454","url":null,"abstract":"Introduction: Proton pump inhibitors (PPIs) are widely used to treat acid-related disorders; however, treatment response varies significantly due to Cytochrome P450 2C19 (CYP2C19) genetic polymorphisms that alter individual drug metabolism. Such variation can lead to insufficient acid suppression, resulting in treatment failure or adverse events. Genotype-guided PPI therapy represents an important step toward personalized gastroenterology by optimizing drug efficacy and safety.Areas covered: This review summarizes evidence from clinical trials and meta-analyses examining CYP2C19-mediated differences in the pharmacokinetics and pharmacodynamics of PPIs in both adults and children. Relevant literature was identified primarily through PubMed and clinical guidelines, covering publications from 1989 to 2025. The review focuses on outcomes related to gastroesophageal reflux disease (GERD), Helicobacter pylori eradication, and eosinophilic esophagitis. Current trials indicate that genotype-guided, tailored PPI therapy - through dose adjustment, drug selection, or regimen modification - can improve treatment efficacy and control abdominal symptoms without increasing safety risks or costs.Expert opinion: CYP2C19 genotype-guided therapy constitutes a practical approach to personalized medicine for acid-related disorders. Barriers to widespread implementation include limited test availability, uncertain cost-effectiveness, and insufficient clinician awareness. Future directions include integrating multi-gene pharmacogenomic testing, model-informed dosing, and artificial intelligence-based decision support to advance individualized acid suppression and personalized gastroenterology.","PeriodicalId":12207,"journal":{"name":"Expert Review of Clinical Pharmacology","volume":" ","pages":"133-150"},"PeriodicalIF":3.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146092219","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

Evaluation of drug-drug interactions associated with metamizole in clinical practice. 在临床实践中评价与安咪唑相关的药物-药物相互作用。

IF 3.6 3区医学

Expert Review of Clinical Pharmacology Pub Date : 2026-01-01 Epub Date: 2026-02-12 DOI: 10.1080/17512433.2026.2630755

Tom G Jacobs, Sharon E J D van den Eijnde, Laura Nijboer, Anke Kylstra, Steven B Nicia, David M Burger, Paul D van der Linden, Merel van Nuland

{"title":"Evaluation of drug-drug interactions associated with metamizole in clinical practice.","authors":"Tom G Jacobs, Sharon E J D van den Eijnde, Laura Nijboer, Anke Kylstra, Steven B Nicia, David M Burger, Paul D van der Linden, Merel van Nuland","doi":"10.1080/17512433.2026.2630755","DOIUrl":"10.1080/17512433.2026.2630755","url":null,"abstract":"Background: Metamizole, a non-steroidal anti-inflammatory drug and moderate inducer of cytochrome P450 enzymes (CYP3A4, CYP2B6, CYP2C19), has gained increased use in clinical practice. This retrospective study evaluates the number of drug-drug interactions (DDIs) associated with metamizole when prescribed for ≥24 h.Research design and methods: Data were collected from the electronic healthcare records of adult patients prescribed metamizole at Tergooi Medical Center between June 2017 and May 2024. Relevant DDIs with metamizole were identified using the Metamizole DDI Manager developed by Global DDI Solutions. Only clinically relevant, i.e. orange (action may be needed) and red (contra-indicated), DDIs that occurred during or within seven after discontinuation of metamizole treatment in a hospital setting were considered.Results: A total of 37,110 unique patients received at least one metamizole prescription of which 2.6% (n = 968) were treated for ≥24 h. Of these, 98.6% (n = 954) were prescribed at least one interacting medication. In total, 3680 DDIs were identified, corresponding to an average of 3.8 DDIs per metamizole prescription. Of the 98 interacting medications identified, 95% were classified as orange, and 5% as red.Conclusions: In conclusion, metamizole is associated with a many DDIs in clinical practice. This highlights the need for careful monitoring when prescribed.","PeriodicalId":12207,"journal":{"name":"Expert Review of Clinical Pharmacology","volume":" ","pages":"191-197"},"PeriodicalIF":3.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146149523","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

Non-implantable neuromodulation therapies compared to conventional treatments for major depression. 非植入式神经调节疗法与传统治疗重度抑郁症的比较。

IF 3.6 3区医学

Expert Review of Clinical Pharmacology Pub Date : 2026-01-01 Epub Date: 2026-02-10 DOI: 10.1080/17512433.2026.2626459

Victor Fontenelle Bastos Lima, Valquíria Aparecida Silva, Rebeca Pelosof, Vanessa Malfatti, Eric Cretaz, Kallene Summer Moreira Vidal, André Russowsky Brunoni, Vitor Breseghello Cavenaghi

{"title":"Non-implantable neuromodulation therapies compared to conventional treatments for major depression.","authors":"Victor Fontenelle Bastos Lima, Valquíria Aparecida Silva, Rebeca Pelosof, Vanessa Malfatti, Eric Cretaz, Kallene Summer Moreira Vidal, André Russowsky Brunoni, Vitor Breseghello Cavenaghi","doi":"10.1080/17512433.2026.2626459","DOIUrl":"10.1080/17512433.2026.2626459","url":null,"abstract":"Introduction: Depression remains a leading cause of disability worldwide. Conventional treatments, such as pharmacotherapy and psychotherapy, are first-line interventions but are limited by partial efficacy, tolerability issues, and delayed onset of action. In this context, non-implantable neuromodulation techniques can be an important tool in clinical practice addressing some of these limitations, and are the scope of this review.Areas covered: This review synthesizes evidence on non-implantable neuromodulation for major depressive disorder, covering established modalities (ECT, MST, rTMS, tDCS, tACS) and emerging approaches (FUS, PBM, tTIS, PNS and tPEMF). Mechanisms, efficacy, tolerability, and accessibility are discussed. PubMed/MEDLINE was searched from inception to 1 November 2025, prioritizing systematic reviews, randomized trials, major guidelines, and large observational studies, with reference-list screening.Expert opinion: Non-implantable neuromodulation therapies are evolving from experimental interventions to validated clinical options. Rather than competing with pharmacotherapy, they should be viewed as complementary components within a multimodal framework. The future of depression management likely depends on the integration of pharmacological and neuromodulatory approaches to optimize response, tolerability, and functional recovery.","PeriodicalId":12207,"journal":{"name":"Expert Review of Clinical Pharmacology","volume":" ","pages":"151-165"},"PeriodicalIF":3.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146112661","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

Reconsidering molecular pathways in giant benign prostatic hyperplasia: a potential strategy for an unmet challenge. 重新考虑巨大良性前列腺增生的分子途径：一个潜在的策略来应对一个未满足的挑战。

IF 3 3区医学

Expert Review of Clinical Pharmacology Pub Date : 2026-01-01 Epub Date: 2026-03-01 DOI: 10.1080/17512433.2026.2632932

Tag Keun Yoo

引用次数: 0

GLP-1 receptor agonist safety in a perioperative setting: more questions than answers. GLP-1受体激动剂围手术期的安全性：问题多于答案。

IF 3 3区医学

Expert Review of Clinical Pharmacology Pub Date : 2026-01-01 Epub Date: 2026-01-28 DOI: 10.1080/17512433.2026.2621247

Graziella Aquilina, Sarah Valerie Casha, Maria Cordina, Ivan Debono, Anthony Fenech, Janet Mifsud, Vanessa Petroni-Magri, Cesca Vassallo, Janet Sultana

引用次数: 0

The efficacy and safety of indobufen versus aspirin in patients with acute myocardial infarction: a retrospective observational study. 吲哚布芬与阿司匹林在急性心肌梗死患者中的疗效和安全性：一项回顾性观察性研究。

IF 3 3区医学

Expert Review of Clinical Pharmacology Pub Date : 2026-01-01 Epub Date: 2026-01-04 DOI: 10.1080/17512433.2025.2611291

Bryan Richard Sasmita, Linfeng Xie, Yuanzhu Li, Zhu Li, Siyuan Xie, Suxin Luo

{"title":"The efficacy and safety of indobufen versus aspirin in patients with acute myocardial infarction: a retrospective observational study.","authors":"Bryan Richard Sasmita, Linfeng Xie, Yuanzhu Li, Zhu Li, Siyuan Xie, Suxin Luo","doi":"10.1080/17512433.2025.2611291","DOIUrl":"10.1080/17512433.2025.2611291","url":null,"abstract":"Background: Dual antiplatelet therapy with aspirin and P2Y12 inhibitors is the first antiplatelet of choice for acute myocardial infarction (AMI), but alternatives are needed for patients at high bleeding risk or with aspirin intolerance/hypersensitivity. This observational study investigated the efficacy and safety of indobufen, a reversible COX-1 inhibitor, among AMI patients compared to those receiving aspirin.Methods: We retrospectively enrolled 907 consecutive AMI patients treated between June 2021 and June 2024. The primary endpoints were GUSTO bleeding and MACE between aspirin and indobufen.Results: Patients receiving indobufen were older and had higher rates of comorbidities such as type 2 diabetes, gastritis, and peptic ulcers (all p < 0.05). Over a median follow-up of 462 days, aspirin was associated with a higher incidence of GUSTO mild bleeding (23.8% vs. 8.6%, p < 0.001), with no significant differences in moderate/severe bleeding, re-infarction, stroke, heart failure, rehospitalization, or MACE (all p > 0.05). Multivariate regression confirmed indobufen independently reduced GUSTO mild bleeding risk. Boruta and SHAP analyses identified antiplatelet therapy, particularly aspirin, as a predictor of GUSTO mild bleeding.Conclusions: Indobufen may be considered an alternative antiplatelet therapy for AMI patients with a high bleeding risk and/or aspirin intolerance/hypersensitivity, however, prospective studies are needed to confirm these findings.","PeriodicalId":12207,"journal":{"name":"Expert Review of Clinical Pharmacology","volume":" ","pages":"55-68"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145848903","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

Optimized therapeutic drug monitoring: the role of machine learning models. 优化治疗药物监测：机器学习模型的作用。

IF 3 3区医学

Expert Review of Clinical Pharmacology Pub Date : 2026-01-01 Epub Date: 2025-12-29 DOI: 10.1080/17512433.2025.2611431

Hamza Sayadi, Yeleen Fromage, Marc Labriffe, Cyrielle Codde, Caroline Monchaud, Pierre Marquet, Laure Ponthier, Jean-Baptiste Woillard

{"title":"Optimized therapeutic drug monitoring: the role of machine learning models.","authors":"Hamza Sayadi, Yeleen Fromage, Marc Labriffe, Cyrielle Codde, Caroline Monchaud, Pierre Marquet, Laure Ponthier, Jean-Baptiste Woillard","doi":"10.1080/17512433.2025.2611431","DOIUrl":"10.1080/17512433.2025.2611431","url":null,"abstract":"Introduction: Traditional therapeutic drug monitoring (TDM) faces limitations in accuracy and adaptability, often failing to optimize therapy for complex patients. Machine learning (ML) is emerging as a powerful tool to overcome these challenges, offering a data-driven paradigm to enhance therapeutic outcomes and minimize toxicity for drugs with narrow therapeutic indices.Areas covered: This review synthesizes the evolution of ML in TDM. We cover foundational models that predict drug exposure from sparse data using either real-world or simulation-based training. We then explore the extension of these techniques to proactive first-dose optimization and the recent development of hybrid models, which integrate the physiological interpretability of population pharmacokinetic frameworks with the corrective power of ML.Expert opinion: The future of TDM lies not in replacing mechanistic models, but in their convergence with ML. While promising, clinical translation requires overcoming critical barriers in data access, model interpretability, and workflow integration. The long-term trajectory points toward dynamic Digital Twins capable of forecasting patient-specific benefit-risk profiles. Ultimately, validated hybrid tools embedded in clinical decision support systems could establish proactive, individualized dosing as the new standard of care in personalized pharmacotherapy.","PeriodicalId":12207,"journal":{"name":"Expert Review of Clinical Pharmacology","volume":" ","pages":"17-26"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145855196","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