Expert Review of Clinical Pharmacology最新文献

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Correction. 更正。
IF 4.4 3区 医学
Expert Review of Clinical Pharmacology Pub Date : 2024-04-01 Epub Date: 2023-12-14 DOI: 10.1080/17512433.2023.2295153
{"title":"Correction.","authors":"","doi":"10.1080/17512433.2023.2295153","DOIUrl":"10.1080/17512433.2023.2295153","url":null,"abstract":"","PeriodicalId":12207,"journal":{"name":"Expert Review of Clinical Pharmacology","volume":" ","pages":"413"},"PeriodicalIF":4.4,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138801857","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
Treatment resistance in pancreatic and biliary tract cancer: molecular and clinical pharmacology perspectives. 胰腺癌和胆道癌的耐药性:分子和临床药理学视角。
IF 4.4 3区 医学
Expert Review of Clinical Pharmacology Pub Date : 2024-04-01 Epub Date: 2024-03-15 DOI: 10.1080/17512433.2024.2319340
Belén Toledo, Chiara Deiana, Fabio Scianò, Giovanni Brandi, Juan Antonio Marchal, Macarena Perán, Elisa Giovannetti
{"title":"Treatment resistance in pancreatic and biliary tract cancer: molecular and clinical pharmacology perspectives.","authors":"Belén Toledo, Chiara Deiana, Fabio Scianò, Giovanni Brandi, Juan Antonio Marchal, Macarena Perán, Elisa Giovannetti","doi":"10.1080/17512433.2024.2319340","DOIUrl":"10.1080/17512433.2024.2319340","url":null,"abstract":"<p><strong>Introduction: </strong>Treatment resistance poses a significant obstacle in oncology, especially in biliary tract cancer (BTC) and pancreatic cancer (PC). Current therapeutic options include chemotherapy, targeted therapy, and immunotherapy. Resistance to these treatments may arise due to diverse molecular mechanisms, such as genetic and epigenetic modifications, altered drug metabolism and efflux, and changes in the tumor microenvironment. Identifying and overcoming these mechanisms is a major focus of research: strategies being explored include combination therapies, modulation of the tumor microenvironment, and personalized approaches.</p><p><strong>Areas covered: </strong>We provide a current overview and discussion of the most relevant mechanisms of resistance to chemotherapy, target therapy, and immunotherapy in both BTC and PC. Furthermore, we compare the different strategies that are being implemented to overcome these obstacles.</p><p><strong>Expert opinion: </strong>So far there is no unified theory on drug resistance and progress is limited. To overcome this issue, individualized patient approaches, possibly through liquid biopsies or single-cell transcriptome studies, are suggested, along with the potential use of artificial intelligence, to guide effective treatment strategies. Furthermore, we provide insights into what we consider the most promising areas of research, and we speculate on the future of managing treatment resistance to improve patient outcomes.</p>","PeriodicalId":12207,"journal":{"name":"Expert Review of Clinical Pharmacology","volume":" ","pages":"323-347"},"PeriodicalIF":4.4,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139982729","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
Next-generation sequencing in pharmacogenomics - fit for clinical decision support? 药物基因组学中的新一代测序--是否适合临床决策支持?
IF 4.4 3区 医学
Expert Review of Clinical Pharmacology Pub Date : 2024-03-01 Epub Date: 2024-01-23 DOI: 10.1080/17512433.2024.2307418
Yitian Zhou, Volker M Lauschke
{"title":"Next-generation sequencing in pharmacogenomics - fit for clinical decision support?","authors":"Yitian Zhou, Volker M Lauschke","doi":"10.1080/17512433.2024.2307418","DOIUrl":"10.1080/17512433.2024.2307418","url":null,"abstract":"<p><strong>Introduction: </strong>The technological advances of sequencing methods during the past 20 years have fuelled the generation of large amounts of sequencing data that comprise common variations, as well as millions of rare and personal variants that would not be identified by conventional genotyping. While comprehensive sequencing is technically feasible, its clinical utility for guiding personalized treatment decisions remains controversial.</p><p><strong>Areas covered: </strong>We discuss the opportunities and challenges of comprehensive sequencing compared to targeted genotyping for pharmacogenomic applications. Current pharmacogenomic sequencing panels are heterogeneous and clinical actionability of the included genes is not a major focus. We provide a current overview and critical discussion of how current studies utilize sequencing data either retrospectively from biobanks, databases or repurposed diagnostic sequencing, or prospectively using pharmacogenomic sequencing.</p><p><strong>Expert opinion: </strong>While sequencing-based pharmacogenomics has provided important insights into genetic variations underlying the safety and efficacy of a multitude pharmacological treatments, important hurdles for the clinical implementation of pharmacogenomic sequencing remain. We identify gaps in the interpretation of pharmacogenetic variants, technical challenges pertaining to complex loci and variant phasing, as well as unclear cost-effectiveness and incomplete reimbursement. It is critical to address these challenges in order to realize the promising prospects of pharmacogenomic sequencing.</p>","PeriodicalId":12207,"journal":{"name":"Expert Review of Clinical Pharmacology","volume":" ","pages":"213-223"},"PeriodicalIF":4.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139512015","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
Pharmacogenomics - a minor rather than major force in clinical medicine. 药物基因组学--临床医学的次要力量而非主要力量。
IF 4.4 3区 医学
Expert Review of Clinical Pharmacology Pub Date : 2024-03-01 Epub Date: 2024-02-06 DOI: 10.1080/17512433.2024.2314726
Thomas M Polasek
{"title":"Pharmacogenomics - a minor rather than major force in clinical medicine.","authors":"Thomas M Polasek","doi":"10.1080/17512433.2024.2314726","DOIUrl":"10.1080/17512433.2024.2314726","url":null,"abstract":"<p><strong>Introduction: </strong>Pharmacogenomics (PGx) is touted as essential for the future of precision medicine. But the opportunity cost of PGx from the prescribers' perspective is rarely considered. The aim of this article is to critique PGx-guided prescribing using clinical pharmacology principles so that important cases for PGx testing are not missed by doctors responsible for therapeutic decision making.</p><p><strong>Areas covered: </strong>Three categories of PGx and their limitations are outlined - exposure PGx, response PGx, and immune-mediated safety PGx. Clinical pharmacology reasons are given for the narrow scope of PGx-guided prescribing apart from a few medical specialties. Clinical problems for doctors that may arise from PGx are then explained, including mismatch between patients' expectations of PGx testing and the benefits or answers it provides.</p><p><strong>Expert opinion: </strong>Contrary to popular opinion, PGx is unlikely to become the cornerstone of precision medicine. Sound clinical pharmacology reasons explain why PGx-guided prescribing is unnecessary for most drugs. Pharmacogenomics is important for niche areas of prescribing but has limited clinical utility more broadly. The opportunity cost of PGx-guided prescribing is currently too great for most doctors.</p>","PeriodicalId":12207,"journal":{"name":"Expert Review of Clinical Pharmacology","volume":" ","pages":"203-212"},"PeriodicalIF":4.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139671605","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
Influence of N-acetyltransferase 2 polymorphisms and clinical variables on liver function profile of tuberculosis patients. N- 乙酰转移酶 2 多态性和临床变量对肺结核患者肝功能状况的影响
IF 4.4 3区 医学
Expert Review of Clinical Pharmacology Pub Date : 2024-03-01 Epub Date: 2024-02-01 DOI: 10.1080/17512433.2024.2311314
Levin Thomas, Arun Prasath Raju, S Chaithra, Shrivathsa Kulavalli, Muralidhar Varma, Chidananda Sanju Sv, Mithu Baneerjee, Kavitha Saravu, Surulivelrajan Mallayasamy, Mahadev Rao
{"title":"Influence of <i>N</i>-acetyltransferase 2 polymorphisms and clinical variables on liver function profile of tuberculosis patients.","authors":"Levin Thomas, Arun Prasath Raju, S Chaithra, Shrivathsa Kulavalli, Muralidhar Varma, Chidananda Sanju Sv, Mithu Baneerjee, Kavitha Saravu, Surulivelrajan Mallayasamy, Mahadev Rao","doi":"10.1080/17512433.2024.2311314","DOIUrl":"10.1080/17512433.2024.2311314","url":null,"abstract":"<p><strong>Background: </strong>Single nucleotide polymorphisms (SNPs) in the N-acetyltransferase 2 (<i>NAT2</i>) gene as well as several other clinical factors can contribute to the elevation of liver function test values in tuberculosis (TB) patients receiving antitubercular therapy (ATT).</p><p><strong>Research design and methods: </strong>A prospective study involving dynamic monitoring of the liver function tests among 130 TB patients from baseline to 98 days post ATT initiation was undertaken to assess the influence of pharmacogenomic and clinical variables on the elevation of liver function test values. Genomic DNA was extracted from serum samples for the assessment of <i>NAT2</i> SNPs. Further, within this study population, we conducted a case control study to identify the odds of developing ATT-induced drug-induced liver injury (DILI) based on <i>NAT2</i> SNPs, genotype and phenotype, and clinical variables.</p><p><strong>Results: </strong><i>NAT2</i> slow acetylators had higher mean [90%CI] liver function test values for 8-28 days post ATT and higher odds of developing DILI (OR: 2.73, 90%CI: 1.05-7.09) than intermediate acetylators/rapid acetylators.</p><p><strong>Conclusion: </strong>The current study findings provide evidence for closer monitoring among TB patients with specific <i>NAT2</i> SNPs, genotype and phenotype, and clinical variables, particularly between the period of more than a week to one-month post ATT initiation for better treatment outcomes.</p>","PeriodicalId":12207,"journal":{"name":"Expert Review of Clinical Pharmacology","volume":" ","pages":"263-274"},"PeriodicalIF":4.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139575295","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-related neurocognitive disorder: a real-world pharmacovigilance study based on the FDA adverse event reporting system. 他汀类药物相关神经认知障碍:基于美国食品药品管理局不良事件报告系统的真实世界药物警戒研究。
IF 4.4 3区 医学
Expert Review of Clinical Pharmacology Pub Date : 2024-03-01 Epub Date: 2024-01-31 DOI: 10.1080/17512433.2024.2311875
Min Xiao, Li Li, Weiwei Zhu, Fengbo Wu, Bin Wu
{"title":"Statin-related neurocognitive disorder: a real-world pharmacovigilance study based on the FDA adverse event reporting system.","authors":"Min Xiao, Li Li, Weiwei Zhu, Fengbo Wu, Bin Wu","doi":"10.1080/17512433.2024.2311875","DOIUrl":"10.1080/17512433.2024.2311875","url":null,"abstract":"<p><strong>Background: </strong>Concerns regarding statin-related neurocognitive disorders have emerged in recent years. However, previous studies have reported inconsistent results. We evaluated the association between statins and neurocognitive disorders using the FDA Adverse Event Reporting System (FAERS).</p><p><strong>Research design and methods: </strong>Data from 2004 to 2022 were obtained from the FAERS database. After deduplication and standardization of drug names, we extracted neurocognitive disorder event (NCDE) cases reported with statins as the suspected drugs. The significant association between statins and NCDE was evaluated using the reporting odds ratio (ROR) and information component.</p><p><strong>Results: </strong>In total, 6,959 NCDE cases with statins as the primary suspected drugs were identified. Signals were detected in pravastatin (ROR, 1.49; 95% CI: 1.32-1.67), atorvastatin (ROR, 1.39; 95% CI: 1.34-1.44), and simvastatin (ROR, 1.31; 95% CI: 1.25-1.38). Age-stratified analysis showed that (1) in the population aged 65 years and older, signals were detected for atorvastatin, simvastatin, rosuvastatin, pravastatin, lovastatin, fluvastatin, and pitavastatin; and (2) in populations under 65 years of age, signals were detected for atorvastatin, simvastatin, rosuvastatin, pravastatin, and lovastatin.</p><p><strong>Conclusions: </strong>This study suggests a significant association between the NCDE and statins, including atorvastatin, simvastatin, and pravastatin. The intensity of the association increased with age.</p>","PeriodicalId":12207,"journal":{"name":"Expert Review of Clinical Pharmacology","volume":" ","pages":"255-261"},"PeriodicalIF":4.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139563567","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
Revolutionizing diabetes care: unveiling tirzepatide's potential in glycemic control and beyond. 糖尿病护理的革命:揭示替扎帕肽在血糖控制及其他方面的潜力。
IF 4.4 3区 医学
Expert Review of Clinical Pharmacology Pub Date : 2024-03-01 Epub Date: 2024-01-31 DOI: 10.1080/17512433.2024.2310070
Aayushi Sood, Purnoor Kaur, Omar Syed, Akshit Sood, Wilbert S Aronow, Benjamin Borokhovsky, Vishal Bhatia, Rahul Gupta
{"title":"Revolutionizing diabetes care: unveiling tirzepatide's potential in glycemic control and beyond.","authors":"Aayushi Sood, Purnoor Kaur, Omar Syed, Akshit Sood, Wilbert S Aronow, Benjamin Borokhovsky, Vishal Bhatia, Rahul Gupta","doi":"10.1080/17512433.2024.2310070","DOIUrl":"10.1080/17512433.2024.2310070","url":null,"abstract":"<p><strong>Introduction: </strong>Diabetes is a global public health challenge with rising prevalence. This review explores current diabetes understanding, diagnostic and management guidelines, economic impact, and lifestyle modifications as the primary approach.</p><p><strong>Areas covered: </strong>Focusing on pharmacological interventions, we discuss the roles of GLP-1 agonists and GLP/GIP agonists in diabetes management and cardiovascular risk reduction. Tirzepatide, a novel medication, is highlighted for its unique mechanism of action. Clinical trials demonstrate its effectiveness in glucose control, weight reduction, and its potential impact on diabetes, obesity, NASH, and cardiovascular risks.</p><p><strong>Expert opinion: </strong>Tirzepatide shows promise in diabetes treatment, offering glucose control and weight loss. It also holds potential for addressing comorbidities. However, cautious use is vital due to potential adverse effects and contraindications, including hypersensitivity reactions, pregnancy, and breastfeeding precautions. This review underscores tirzepatide as a valuable addition to diabetes therapies, with evolving prospects for enhanced patient outcomes as research advances.</p>","PeriodicalId":12207,"journal":{"name":"Expert Review of Clinical Pharmacology","volume":" ","pages":"235-246"},"PeriodicalIF":4.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139541750","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 of pharmacological agents for the management of treatment-resistant schizophrenia: a network meta-analysis. 治疗耐药性精神分裂症的药理药剂治疗耐药性精神分裂症的药理药剂治疗耐药性精神分裂症的药理药剂治疗耐药性精神分裂症的药理药剂治疗耐药性精神分裂症的药理药剂的疗效:网络荟萃分析。
IF 4.4 3区 医学
Expert Review of Clinical Pharmacology Pub Date : 2024-03-01 Epub Date: 2024-01-26 DOI: 10.1080/17512433.2024.2310715
Archana Mishra, Rituparna Maiti, Biswa Ranjan Mishra, Anand Srinivasan
{"title":"Efficacy of pharmacological agents for the management of treatment-resistant schizophrenia: a network meta-analysis.","authors":"Archana Mishra, Rituparna Maiti, Biswa Ranjan Mishra, Anand Srinivasan","doi":"10.1080/17512433.2024.2310715","DOIUrl":"10.1080/17512433.2024.2310715","url":null,"abstract":"<p><strong>Objective: </strong>The present network meta-analysis (NMA) was conducted to compare and generate evidence for the most efficacious treatment among available pharmacological interventions for treatment-resistant schizophrenia (TRS).</p><p><strong>Methods: </strong>Reviewers extracted data from 47 studies screened from PubMed/MEDLINE, Embase, Cochrane databases and clinical trial registries fulfilling the eligibility criteria. Random effects Bayesian NMA was done with non-informative priors. Network geometry was visualized, and node splitting was done for the closed triangles. Standardized mean difference and 95% credible interval(95%CrI) were reported for the reduction in symptom severity scores. The probability of each intervention for each rank was plotted. Meta-regression was done for the duration of the therapy.</p><p><strong>Results: </strong>Augmentation of antipsychotics with escitalopram (SMD: -1.7[95%CrI: -2.8, -0.70]), glycine (SMD: -1.2 [95%CrI: -2.2, -0.28]) and Yokukansan (SMD: -1.3 [95%CrI: -2.4, -0.24]) shows a statistically significant reduction in symptom severity when compared to clozapine. As per surface under cumulative ranking curve analysis, escitalopram in combination with antipsychotics appeared to be the best intervention with moderate certainty of evidence. There was no significant effect of the duration of therapy on the treatment effects.</p><p><strong>Conclusion: </strong>Escitalopram augmentation of antipsychotics appears to be the most efficacious treatment with moderate certainty of evidence among the available pharmacological interventions.</p><p><strong>Prospero registration: </strong>CRD42022380292.</p>","PeriodicalId":12207,"journal":{"name":"Expert Review of Clinical Pharmacology","volume":" ","pages":"293-302"},"PeriodicalIF":4.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139546096","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
Pharmacokinetic correlates of clinical response in a naturalistic sample of escitalopram-treated patients. 艾司西酞普兰治疗患者自然样本临床反应的药代动力学相关性。
IF 4.4 3区 医学
Expert Review of Clinical Pharmacology Pub Date : 2024-03-01 Epub Date: 2024-02-05 DOI: 10.1080/17512433.2024.2314211
Nicholas Kasperk, Ekkehard Haen, Christoph Hiemke, Thomas Frodl, Georgios Schoretsanitis, Michael Paulzen, Nazar Kuzo
{"title":"Pharmacokinetic correlates of clinical response in a naturalistic sample of escitalopram-treated patients.","authors":"Nicholas Kasperk, Ekkehard Haen, Christoph Hiemke, Thomas Frodl, Georgios Schoretsanitis, Michael Paulzen, Nazar Kuzo","doi":"10.1080/17512433.2024.2314211","DOIUrl":"10.1080/17512433.2024.2314211","url":null,"abstract":"<p><strong>Objective: </strong>We assessed pharmacokinetic correlates of treatment response to escitalopram using a large therapeutic drug monitoring database.</p><p><strong>Methods: </strong>A large naturalistic sample of patients receiving escitalopram was analyzed. Responders were defined as 'very much improved' or 'much improved' based on the Clinical Global Impression - Improvement score, CGI-I. We compared responders (<i>n</i> = 83) vs. non-responders (<i>n</i> = 388) with the primary outcome being the escitalopram plasma concentration and concentration corrected by the daily dose (C/D ratio). Effects of age, sex, body-mass-index (BMI), and C/D ratio were assessed in a multivariate logistic regression model predicting response.</p><p><strong>Results: </strong>There were no statistically significant differences in clinical and demographic characteristics between responders vs. non-responders. There were also no differences between escitalopram daily doses or plasma concentrations, while C/D ratios were significantly higher in non-responders than in responders (1.6 ± 1.7 vs. 1.2 ± 0.9 (ng/mL)/(mg/day), <i>p</i> = 0.007); C/D ratios (odds ratio 0.52, 95% confidence interval 0.34-0.80, <i>p</i> < 0.003) were associated with response to escitalopram, after controlling for age, sex, and BMI.</p><p><strong>Conclusions: </strong>Patients with low clearance of escitalopram as reflected upon high C/D ratios may be less likely respond to escitalopram. Identifying these patients during dose titration may support clinical decision-making, including switching to a different antidepressant instead of increasing daily dose.</p>","PeriodicalId":12207,"journal":{"name":"Expert Review of Clinical Pharmacology","volume":" ","pages":"247-253"},"PeriodicalIF":4.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139650630","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
Therapeutic drug monitoring of imatinib - how far are we in the leukemia setting? 伊马替尼的治疗药物监测--我们在白血病领域走了多远?
IF 4.4 3区 医学
Expert Review of Clinical Pharmacology Pub Date : 2024-03-01 Epub Date: 2024-02-12 DOI: 10.1080/17512433.2024.2312256
Anna Sofie Buhl Rasmussen, Christen Lykkegaard Andersen, Allan Weimann, Tianwu Yang, Camille Tron, Virginie Gandemer, Kim Dalhoff, Cecilie Utke Rank, Kjeld Schmiegelow
{"title":"Therapeutic drug monitoring of imatinib - how far are we in the leukemia setting?","authors":"Anna Sofie Buhl Rasmussen, Christen Lykkegaard Andersen, Allan Weimann, Tianwu Yang, Camille Tron, Virginie Gandemer, Kim Dalhoff, Cecilie Utke Rank, Kjeld Schmiegelow","doi":"10.1080/17512433.2024.2312256","DOIUrl":"10.1080/17512433.2024.2312256","url":null,"abstract":"<p><strong>Introduction: </strong>Tyrosine kinase inhibitors (TKIs) have revolutionized survival rates of chronic myeloid leukemia (CML) and Philadelphia chromosome positive (Ph+) acute lymphoblastic leukemia (ALL) and replaced hematopoietic stem cell transplantation (hSCT) as the key treatment option for these patients. More recently, the so-called Philadelphia chromosome-like (Ph-like) ALL has similarly benefitted from TKIs. However, many patients shift from the first generation TKI, imatinib, due to treatment-related toxicities or lack of treatment efficacy. A more personalized approach to TKI treatment could counteract these challenges and potentially be more cost-effective. Therapeutic drug monitoring (TDM) has led to higher response rates and less treatment-related toxicity in adult CML but is rarely used in ALL or in childhood CML.</p><p><strong>Areas covered: </strong>This review summarizes different antileukemic treatment indications for TKIs with focus on imatinib and its pharmacokinetic/-dynamic properties as well as opportunities and pitfalls of TDM for imatinib treatment in relation to pharmacogenetics and co-medication for pediatric and adult Ph+/Ph-like leukemias.</p><p><strong>Expert opinion: </strong>TDM of imatinib adds value to standard monitoring of ABL-class leukemia by uncovering non-adherence and potentially mitigating adverse effects. Clinically implementable pharmacokinetic/-dynamic models adjusted for relevant pharmacogenetics could improve individual dosing. Prospective trials of TDM-based treatments, including both children and adults, are needed.</p>","PeriodicalId":12207,"journal":{"name":"Expert Review of Clinical Pharmacology","volume":" ","pages":"225-234"},"PeriodicalIF":4.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139722234","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
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