International journal of clinical pharmacology and therapeutics最新文献

{"title":"Analysis of the clinical characteristics and risk factors for dabigatran-induced bleeding in patients with nonvalvular atrial fibrillation.","authors":"Xiaojuan Wang, Xiaoying Wang, Ya Li, Zhenfeng Yang, Dong Wu","doi":"10.5414/CP204807","DOIUrl":"10.5414/CP204807","url":null,"abstract":"<p><strong>Objective: </strong>To explore the clinical characteristics of dabigatran-induced bleeding and analyze its risk factors in patients with nonvalvular atrial fibrillation (NVAF).</p><p><strong>Materials and methods: </strong>A retrospective analysis was conducted on patients with NVAF who received 110 mg of dabigatran twice daily from January 2020 to March 2023. Patients were divided into a long-term-use group and a first-time-use group on the basis of their duration of medication use. The impact of long-term dabigatran use on coagulation function was analyzed. Furthermore, patients in the long-term-use group were divided into bleeding and nonbleeding subgroups. Multivariate logistic regression analysis was used to determine the risk factors for bleeding. Clinical data such as underlying diseases, concomitant medications, bleeding types, and bleeding sites were collected.</p><p><strong>Results: </strong>A total of 531 cases were collected, including 214 in the long-term-use group and 317 in the first-time-use group. In addition to fibrinogen (p > 0.05), coagulation function indicators, including the prothrombin time, prothrombin time percentage, international normalized ratio, activated partial thromboplastin time, and thrombin time (TT), were greater in the long-term-use group than in the first-time-use group, whereas D-dimer values were significantly lower in the long-term-use group (p < 0.05). A total of 63 bleeding cases were found, with an overall bleeding rate of 11.86%. The bleeding type was BARC type 1 (87.30%), and the bleeding site was mainly gastrointestinal bleeding (77.78%). Multivariate logistic regression analysis revealed that a TT value &gt; 116 s (OR 0.385, 95% CI 0.150 - 0.984; p = 0.038) and the presence of heart failure (OR 0.341, 95% CI 0.133 - 0.875; p = 0.025) were risk factors for bleeding in patients on long-term dabigatran therapy.</p><p><strong>Conclusion: </strong>The probability of bleeding caused by long-term use of dabigatran is relatively high, but it is mainly minor bleeding. The long-term use of dabigatran has an impact on multiple coagulation function indicators. Clinical physicians and pharmacists need to closely monitor patients' TT values and whether they have heart failure and identify high-risk populations for bleeding as early as possible.</p>","PeriodicalId":13963,"journal":{"name":"International journal of clinical pharmacology and therapeutics","volume":" ","pages":"18-27"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145345161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrent corticosteroid-resistant cytomegalovirus infection complicating ulcerative colitis responding to antiviral treatment: Case report.","authors":"Shema Ayadi, Nadine Ghithia, Nouha Trad, Asma Mensi, Emna Belhadj Mabrouk, Leila Mouelhi, Radhouene Dabbeche","doi":"10.5414/CP204720","DOIUrl":"10.5414/CP204720","url":null,"abstract":"<p><p>Cytomegalovirus is a common opportunistic infection that often affects individuals with impaired immune function. It may present with a variety of clinical manifestations. Treatment for ulcerative colitis (UC) usually requires immunosuppressants and steroids, increasing patients' susceptibility to cytomegalovirus infection. We report the case of a 53-year-old female patient with corticosteroid-resistant UC and recurrent cytomegalovirus infection. The patient had exacerbations, and the diagnosis of cytomegalovirus infection was confirmed through serology and detection of high levels of cytomegalovirus DNA in biopsies using quantitative polymerase chain reaction (PCR). After requiring intravenous ganciclovir, the patient improved. However, she had further relapses requiring treatment with foscarnet, with marked improvement in symptoms and endoscopic results. This case shows the importance of evaluating acute cytomegalovirus infections in patients with corticosteroid resistance. Quantitative PCR appears to be a valuable tool in guiding treatment decisions. In addition, the case is evidence for the satisfactory efficacy of foscarnet in managing cytomegalovirus infections.</p>","PeriodicalId":13963,"journal":{"name":"International journal of clinical pharmacology and therapeutics","volume":" ","pages":"28-31"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145345145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expression of the genes QPRT, RAB26, and SRPRB in cancer tissue from patients with triple-negative breast cancer as a biomarker for diagnosis, pharmacotherapy strategy, and survival: Evidence from bioinformatic database analysis.","authors":"Yarui Liu, Ying Zeng","doi":"10.5414/CP204751","DOIUrl":"10.5414/CP204751","url":null,"abstract":"<p><strong>Objective: </strong>To screen differentially expressed genes (DEGs) in triple-negative breast cancer (TNBC) by bioinformatic methods and explore their relationship between TNBC prognosis and related biological functions.</p><p><strong>Materials and methods: </strong>Microarray dataset GSE65194 was downloaded from Gene Expression Omnibus (GEO) database. The whole TNBC-related datasets were downloaded from The Cancer Genome Atlas (TCGA) database. After screening DEGs in R software, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed to predict the function of these DEGs. The survival curve examination of the DEGs was performed based on TCGA database and Kaplan-Meier plotter website. In addition, the gene-drug interaction network was explored using the Comparative Toxicogenomics Database (CTD).</p><p><strong>Results: </strong>A total of 2,496 up-regulated and 142 down-regulated DEGs were revealed in GEO database and TCGA database simultaneously. The GO and KEGG analysis revealed enrichment in regulation of nucleobase, nucleoside, nucleic acid metabolism, DNA binding, and integrin family cell surface interactions. Furthermore, up-regulation of quinolinate phosphoribosyl transferase (<i>QPRT</i>), member RAS oncogene family (<i>RAB26</i>), and SRP receptor subunit beta (<i>SRPRB</i>) were significantly associated with survival in TNBC patients.</p><p><strong>Conclusion: </strong><i>QPRT</i>, <i>RAB26</i>, and <i>SRPRB</i> may be three potential novel prognostic biomarkers for TNBC and will provide potential guidance value for future research on TNBC.</p>","PeriodicalId":13963,"journal":{"name":"International journal of clinical pharmacology and therapeutics","volume":" ","pages":"575-583"},"PeriodicalIF":0.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144953321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of antibiotic treatment for second-trimester GBS with reduced miscarriage risk: Probiotic intervention shows no benefit.","authors":"Mei-Ling Guo, Ya-Nuan Chen, Jian-Hong Fang, Wei-Hong Qi","doi":"10.5414/CP204790","DOIUrl":"10.5414/CP204790","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the colonization rate of group B <i>Streptococcus</i> (GBS) during the second trimester of pregnancy, the correlation between GBS infection and miscarriage as well as the impact of intervention on pregnancy outcomes.</p><p><strong>Materials and methods: </strong>228 GBS-positive pregnant women at 14 - 28 weeks of gestation were divided into 3 groups according to their preferences to receive medical intervention: group A (antibiotic group, n = 54) received oral antibiotic, group B (probiotic group, n = 96) received oral probiotic, and group C (non-intervention group, n = 78) received no drug treatment. 300 GBS-negative pregnant women were selected voluntarily and randomly as the control group (group D). The incidence of miscarriage-related conditions, negative conversion rate of GBS were compared between the 4 groups. Perinatal outcomes were compared between the GBS persistent positive and negative groups.</p><p><strong>Results: </strong>GBS colonization rate was 14.7%. The incidence of threatened miscarriage and miscarriage in group A were 1.85 and 1.85%, both of which were lower than those in group B at 21.9 and 6.3%, and group C at 33.3 and 7.7%, with all differences being statistically significant (p < 0.05). The incidence of threatened miscarriage and miscarriage in group B and group C were significantly higher than those in group D at 3.3 and 2.7% (p < 0.05). The negative conversion rate of GBS in group A was significantly higher than that in group C (14.8 vs. 2.7%, p < 0.05). There was a difference in the incidence of fetal distress, premature delivery, premature rupture of the fetal membrane, chorioamnionitis, and neonatal infection between the continuously positive and negative pregnant women (p < 0.05).</p><p><strong>Conclusion: </strong>GBS colonization rate was 14.7% in the second trimester of pregnancy. GBS infection can increase the risk of threatened miscarriage and miscarriage as well as the risk of adverse pregnancy outcomes. Early intervention with antibiotics can increase the negative conversion rate of GBS, reduce the incidence of threatened miscarriage and miscarriage, and ameliorate the adverse outcome of pregnancy. The effect of probiotic intervention on the negative conversion of GBS was insignificant.</p>","PeriodicalId":13963,"journal":{"name":"International journal of clinical pharmacology and therapeutics","volume":" ","pages":"609-616"},"PeriodicalIF":0.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ocrelizumab use before pregnancy and neonatal B-cell depletion: A case report.","authors":"Georgios Eleftheriou, Anna Sangiovanni, Raffaella Butera, Mariapina Gallo, Andrea Giampreti, Lorella Faraoni, Marco Cirronis, Maria Gioia Contessa, Giuseppe Bacis","doi":"10.5414/CP204853","DOIUrl":"10.5414/CP204853","url":null,"abstract":"<p><p>Ocrelizumab is a recombinant humanized IgG1 monoclonal antibody that depletes B lymphocytes by binding their surface antigen CD20 and is approved for the relapsing forms of multiple sclerosis (MS). Several studies report that in utero exposure to ocrelizumab is not associated with an increased risk of malformations, and very few cases of neonatal B-cell count depletion are described after therapy ending shortly before conception or during early pregnancy. We report the first case of transient and complete neonatal B-cell depletion, while conception took place 3 months after the last administration.</p>","PeriodicalId":13963,"journal":{"name":"International journal of clinical pharmacology and therapeutics","volume":" ","pages":"617-620"},"PeriodicalIF":0.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144992256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Personalized management of acenocoumarol dosage using eGFR: Analysis of INR data in a cohort of 204 patients.","authors":"Dzhem Farandzha, Vasil Velchev, Dobri Hazarbasanov","doi":"10.5414/CP204882","DOIUrl":"10.5414/CP204882","url":null,"abstract":"<p><strong>Background: </strong>Acenocoumarol is a widely used vitamin K antagonist, particularly in European countries. While age and body metrics are known to influence dose requirements, the role of renal function in guiding acenocoumarol dosage remains underexplored.</p><p><strong>Aims: </strong>The primary aim of this study was to investigate the relationship between renal function and the weekly dose of acenocoumarol required to maintain therapeutic international normalized ratio (INR) levels.</p><p><strong>Materials and methods: </strong>We analyzed 425 INR measurements from 204 adult patients receiving acenocoumarol, stratified by target INR ranges of 2.00 - 3.00 and 2.50 - 3.50. Renal function was assessed using the body surface area (BSA)-adjusted chronic kidney disease-epidemiology (CKD-EPI) 2021 formula. Weekly acenocoumarol doses were evaluated in relation to age, sex, estimated glomerular filtration rate (eGFR), and body size.</p><p><strong>Results: </strong>Patients with lower eGFR and older age required significantly lower weekly doses of acenocoumarol. In the INR 2.00 - 3.00 group, males required higher doses than females, correlating with both greater body size and higher eGFR. However, in the INR 2.50 - 3.50 group, males and females received the same median dose despite differing body metrics, mirroring their similar renal function. A positive correlation was found between BSA-adjusted eGFR and weekly dose, particularly when eGFR exceeded 90 mL/min (Spearman r = 0.48, p = 0.0001).</p><p><strong>Conclusion: </strong>Renal function, as measured by BSA-adjusted eGFR, is a critical determinant of acenocoumarol dose requirements. These findings support the inclusion of renal function in future acenocoumarol dose calculators and emphasize the importance of individualized dosing strategies.</p>","PeriodicalId":13963,"journal":{"name":"International journal of clinical pharmacology and therapeutics","volume":" ","pages":"569-574"},"PeriodicalIF":0.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12676958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction of silica nanoparticle biodistribution using a calibrated physiologically based model: Unbound fraction and elimination rate constants for the kidneys and phagocytosis identified as major determinants.","authors":"Madison Parrot, Joseph Cave, Maria J Pelaez, Hamidreza Ghandehari, Prashant Dogra, Venkata Yellepeddi","doi":"10.5414/CP204837","DOIUrl":"10.5414/CP204837","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to develop a minimal physiologically based pharmacokinetic (mPBPK) model to predict the biodistribution of silica nanoparticles (SiNPs) and evaluate how variations in surface charge, size, porosity, and geometry influence their systemic disposition.</p><p><strong>Materials and methods: </strong>The mPBPK model was calibrated using in vivo pharmacokinetic data from mice administered aminated, mesoporous, and rod-shaped SiNPs. Human data were collected from clinical trial data from Cornell dots. The mPBPK model incorporated physiological parameters and nanoparticle-specific characteristics to simulate SiNP biodistribution and was built in Matlab 2024a. Global sensitivity analysis identified influential parameters, including the unbound fraction and elimination rate constants for the kidneys and mononuclear phagocyte system (MPS). The model was extrapolated to predict human pharmacokinetics, with accuracy evaluated using Pearson correlation coefficients. Non-compartmental analysis (NCA) assessed organ-specific accumulation and biodistribution patterns.</p><p><strong>Results: </strong>Global sensitivity analysis revealed that the unbound fraction and elimination rate constants for the kidneys and MPS were major determinants of SiNP biodistribution. NCA indicated that aminated SiNPs initially accumulated in the liver, spleen, and kidneys but redistributed due to their high unbound fraction, while mesoporous SiNPs localized in the lungs. Rod-shaped SiNPs exhibited high lung exposure. The extrapolated model showed high predictive accuracy, with Pearson correlation coefficients of 0.98 for mice and 0.99 for humans.</p><p><strong>Conclusion: </strong>The mPBPK model effectively predicts the pharmacokinetics of diverse SiNPs, offering insights to optimize nanoparticle-based drug delivery systems and facilitating their translation from preclinical models to clinical applications.</p>","PeriodicalId":13963,"journal":{"name":"International journal of clinical pharmacology and therapeutics","volume":" ","pages":"584-600"},"PeriodicalIF":0.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12825016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144953134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analgesia using sufentanil and sufentanil plus dexmedetomidine following cesarean section and effect on placental hypoxia-inducible factors.","authors":"Xiaoling Lv, Xiaoping Lin, Long Ma","doi":"10.5414/CP204733","DOIUrl":"10.5414/CP204733","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the analgesic effect of sufentanil plus dexmedetomidine following cesarean section and to determine its influence on placental hypoxia-inducible factors.</p><p><strong>Materials and methods: </strong>A cohort of 150 puerperae who underwent prenatal examinations and cesarean section in our hospital were randomized into a control group (n = 75) and a study group (n = 75). Anesthesia and analgesia were carried out using sufentanil alone in the control group and sufentanil plus dexmedetomidine in the study group. Measurements were made before anesthesia (T0), 5 minutes (T1) and 10 minutes (T2) after anesthesia, and immediately after delivery (T3) and after the end of surgery (T4).</p><p><strong>Results: </strong>Mean arterial pressure (MAP) and heart rate (HR) decreased in both groups at T1 - T4 compared with T0, but were higher in the study group compared to the control group (p < 0.05). The visual analogue scale (VAS) score, and levels of substance P (SP), neuropeptide Y (NPY) and malondialdehyde (MDA) in the study group were lower than those in the control group (p < 0.05). The beginning and duration of labor and the dose of analgesics within the 48-hour observation period were all lower in the study group compared to the control group (p < 0.05).</p><p><strong>Conclusion: </strong>Sufentanil plus dexmedetomidine can effectively maintain hemodynamic stability during cesarean section without marked changes in placental hypoxia-inducible factors and oxidative stress responses and has a limiting effect on the secretion of pain mediators.</p>","PeriodicalId":13963,"journal":{"name":"International journal of clinical pharmacology and therapeutics","volume":" ","pages":"601-608"},"PeriodicalIF":0.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Empagliflozin and hydralazine-isosorbide dinitrate combination therapy improves outcomes in Black patients with heart failure.","authors":"Padmamalini Baskaran, Mohammed Aldhaeefi, Anahita Asaadi, Morgan Jones, Emmanuel King, Dhakrit Rungkitwattanakul, La'Marcus Wingate","doi":"10.5414/CP204854","DOIUrl":"10.5414/CP204854","url":null,"abstract":"<p><strong>Background: </strong>Black patients experience a disproportionately high incidence of heart failure with reduced ejection fraction (HFrEF), where vasodilators serve as a key therapeutic strategy.</p><p><strong>Materials and methods: </strong>A retrospective cohort study based on medical records of Black patients with HFrEF and an ex vivo analysis of mouse thoracic aorta stimulated with empagliflozin (empa) and hydralazine-isosorbide dinitrate (H-ISDN).</p><p><strong>Results: </strong>The combination synergistically activated cyclic guanosine monophosphate (cGMP) production in the ex vivo thoracic aorta and improved kidney function, reduced brain natriuretic peptide (BNP), and lowered mortality compared to H-ISDN alone in HFrEF patients.</p><p><strong>Conclusion: </strong>Empa + H-ISDN offered superior benefits in Black patients with HFrEF, possibly by reducing oxidative stress and enhancing nitric oxide (NO) bioavailability.</p>","PeriodicalId":13963,"journal":{"name":"International journal of clinical pharmacology and therapeutics","volume":" ","pages":"553-556"},"PeriodicalIF":0.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144953288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rare systemic skin hyperpigmentation associated with osimertinib: A case report.","authors":"Le Li, Lifang Yang, Guanglei Xu, Zhouqian Jiang","doi":"10.5414/CP204768","DOIUrl":"10.5414/CP204768","url":null,"abstract":"<p><p>A patient with advanced small cell lung cancer presented with systemic skin pigmentation, a rare and severe skin adverse reaction during treatment with osimertinib. Osimertinib-induced hyperpigmentation is rarely reported, According to the patient's condition, adverse drug reactions, and drug efficacy, osimertinib was the urgently needed treatment regimen, and 80 mg of osimertinib was continued. Therefore, we hope this case can provide experience for clinicians to identify adverse reactions of the drug and ensure the safety of patients.</p>","PeriodicalId":13963,"journal":{"name":"International journal of clinical pharmacology and therapeutics","volume":" ","pages":"557-560"},"PeriodicalIF":0.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}