Journal of Clinical Pharmacy and Therapeutics最新文献

{"title":"Effect of Two Different ART Regimens on AIDS Patients With Lymphoma","authors":"Guangjing Ruan,&nbsp;Qisi Su,&nbsp;Zhiman Xie,&nbsp;Huawei He,&nbsp;Yuming Lu,&nbsp;Ningmei Liu,&nbsp;Dandan Ni,&nbsp;Bin He","doi":"10.1155/jcpt/6644473","DOIUrl":"https://doi.org/10.1155/jcpt/6644473","url":null,"abstract":"<p><b>Objective:</b> To explore the impact of two different ART regimens on AIDS patients with lymphoma.</p><p><b>Methods:</b> A retrospective study was carried out involving 60 patients diagnosed with AIDS and lymphoma and treated in our hospital during the period from June 2022 to December 2023. All patients underwent DA-EPOCH chemotherapy. According to the differences in ART treatment regimens, patients receiving the DTG + lamivudine (3TC) regimen will be categorized into the DTG + 3TC group, and patients receiving the TDF + 3TC + efavirenz (EFV) regimen will be classified into the TDF + 3TC + EFV group, with 30 cases in each group. The HIV viral load was compared between the two groups pretreatment and posttreatment (at 12, 24, and 26 weeks). The immunological indices (CD4⁺ and CD8⁺), liver function indices (serum total bilirubin [TBIL], alanine transaminase [ALT], aspartate transaminase [AST], serum albumin [ALB], and prothrombin time [PT]), and blood creatinine (Scr) levels of the two groups were compared before and after treatment (at 36 weeks). The occurrence of adverse reactions was documented.</p><p><b>Results:</b> After 12, 24, and 36 weeks of treatment, the HIV viral load in the DTG + 3TC group was consistently lower than that in the EFV + TDF + 3TC group (<i>p</i> &lt; 0.05). At week 36 posttreatment, compared with the EFV + TDF + 3TC group, the DTG + 3TC group showed higher CD4⁺ counts and lower CD8⁺ counts (<i>p</i> &lt; 0.05). Following treatment at week 36, levels of AST, ALT, TBiL, and PT were elevated in both groups but lower in the DTG + 3TC group (<i>p</i> &lt; 0.05). The levels of ALB in both groups were decreased, but the DTG + 3TC group was significantly higher (<i>p</i> &lt; 0.05). Additionally, at week 36 posttreatment, Scr levels were significantly better in the DTG + 3TC group compared to the EFV + TDF + 3TC group (<i>p</i> &lt; 0.05). The incidence of adverse reactions in the DTG + 3TC group and EFV + TDF + 3TC group differed significantly, with rates of 13.33% and 23.33%, respectively (<i>p</i> &gt; 0.05).</p><p><b>Conclusion:</b> There is no difference in the safety of DTG + 3TC in the treatment of AIDS patients with ARL compared with TDF +3TC + EFV. However, the combination of DTG + 3TC simplified regimen is superior to the three-drug regimen of TDF + 3TC + EFV in reducing viral load and has positive effects on the improvement of liver function and blood creatinine, with no obvious side effects.</p>","PeriodicalId":15381,"journal":{"name":"Journal of Clinical Pharmacy and Therapeutics","volume":"2025 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jcpt/6644473","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145146566","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":"Real-World Data Analysis of Vascular and Lymphatic Adverse Events Associated With Antitumor Angiogenesis Drugs: A WHO-VigiAccess Study","authors":"Yue Zu,&nbsp;Lingling Dai,&nbsp;Peng Meng","doi":"10.1155/jcpt/9501977","DOIUrl":"https://doi.org/10.1155/jcpt/9501977","url":null,"abstract":"<p>Antiangiogenic therapy plays a critical role in cancer treatment. This study analyzed vascular and lymphatic adverse events linked to four FDA-approved agents—aflibercept, bevacizumab, olaratumab, and ramucirumab—using WHO-VigiAccess data. Disproportionality analysis (ROR and PRR) identified drug-specific risks, focusing on hypertension, hemorrhage, thrombosis, and flushing, to inform safer and personalized clinical use.</p>","PeriodicalId":15381,"journal":{"name":"Journal of Clinical Pharmacy and Therapeutics","volume":"2025 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jcpt/9501977","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144927665","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":"Identification and Resolution of Drug-Related Problems by Clinical Pharmacist Interventions in an Occupational Health Setting: A Study on Pharmacy Staff","authors":"Bita Shahrami,&nbsp;Mahta Alimadadi,&nbsp;Soma Rahimi,&nbsp;Mona Abutalebzadeh,&nbsp;Soheila Tayefeh,&nbsp;Romina Kaveh-Ahangaran,&nbsp;Farhad Najmeddin,&nbsp;Elham Hadidi","doi":"10.1155/jcpt/5540546","DOIUrl":"https://doi.org/10.1155/jcpt/5540546","url":null,"abstract":"<p><b>Background:</b> Occupational health programs play a critical role in maintaining employee well-being, particularly for healthcare workers exposed to unique risks. Clinical pharmacists are well-positioned to address drug-related problems (DRPs) in these settings, yet their role in occupational health remains underexplored. This study assesses the frequency and resolution of DRPs following clinical pharmacist interventions among pharmacy staff in an occupational health setting.</p><p><b>Methods:</b> This experimental study was conducted at the 13-Aban Pharmacotherapy Clinic of Tehran University of Medical Sciences, Tehran, Iran. Pharmacy staff with chronic diseases or abnormal test results was identified based on medical records. A single clinical pharmacist reviewed DRPs using the DOCUMENT classification system, provided interventions, and followed up. Recommendations were made directly to participants, and adherence to these recommendations was assessed. Data were analyzed using descriptive statistics and correlation tests.</p><p><b>Results:</b> Among 601 medical records reviewed, 239 participants met inclusion criteria, and 139 attended pharmacotherapy visits. A total of 277 DRPs were identified, averaging 1.99 DRPs per participant. The most common DRPs were the need for preventative therapy (37.2%), untreated conditions (15.9%), and laboratory monitoring (14.8%). A total of 443 recommendations were provided to participants, with an adherence rate of 76.4%. Among those who fully adhered to the recommendations, 97.2% of DRPs were resolved. While adherence was initially higher among female participants, overall compliance rates did not significantly differ by gender.</p><p><b>Conclusion:</b> Clinical pharmacist interventions effectively identified and resolved DRPs among pharmacy staff, improving medication management. These findings highlight the value of integrating clinical pharmacists into occupational health programs to enhance medication safety and adherence.</p>","PeriodicalId":15381,"journal":{"name":"Journal of Clinical Pharmacy and Therapeutics","volume":"2025 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jcpt/5540546","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144888152","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":"A Systematic Assessment of Drug Repurposing Efforts Against COVID-19: Limited Successes and Key Challenges","authors":"Andreas Riedel,&nbsp;Peter Ruth,&nbsp;Markus W. Löffler,&nbsp;Nicolai Stransky","doi":"10.1155/jcpt/3796111","DOIUrl":"https://doi.org/10.1155/jcpt/3796111","url":null,"abstract":"<p><b>Objective:</b> Drug repurposing is a promising alternative for the development of new treatment options. During the COVID-19 pandemic, multiple repurposed drugs were tested and some became pillars of treatment and the standard of care. However, whether the benefits of drug repurposing over <i>de novo</i> drug development actually materialize remains an open question, especially since former analyses have been complicated by challenges to attract enough funding for late-stage clinical trials.</p><p><b>Methods:</b> We conducted a systematic analysis of repurposing efforts against COVID-19 focusing on the 100 most frequently prescribed drugs in the United States including both preclinical and clinical work.</p><p><b>Results:</b> In total, we identify (pre)clinical research for 42 drugs and evidence of anti-COVID-19 effects for 33 drugs. The rate of studies with positive results decreased from in vitro to animal studies to randomized clinical trials. While we find positive RCTs for 12 drugs, these trials had mostly low participant numbers and several reported endpoints of minor clinical relevance. Assessment of the methodological quality assessment indicates that preregistration, blinding, and power calculations are currently still an exception in preclinical studies. In the end, none of these drugs were recommended by treatment guidelines.</p><p><b>Conclusions:</b> Our analysis underlines the large efforts undertaken to repurpose commonly prescribed drugs against COVID-19, which eventually proved futile. This finding may serve as a cautionary example for drug repurposing also for other fields of biomedicine. However, it should be noted that a limitation of this study is its focus on only the 100 most prescribed drugs in the United States, as we chose to analyze widely available and generally affordable medications.</p>","PeriodicalId":15381,"journal":{"name":"Journal of Clinical Pharmacy and Therapeutics","volume":"2025 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jcpt/3796111","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144814737","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":"Chronic Wound Care: A Comprehensive Meta-Analysis on the Therapeutic Potential of Cold Atmospheric Plasma Technology","authors":"Muhammad Shahzad Aslam,&nbsp;Mudassar Iqbal Arain","doi":"10.1155/jcpt/5357147","DOIUrl":"https://doi.org/10.1155/jcpt/5357147","url":null,"abstract":"<div>\u0000 <p><b>Background:</b> Cold atmospheric plasma (CAP) therapy has emerged as a novel nonthermal modality for managing chronic wounds. However, its clinical efficacy relative to standard wound care remains uncertain. This systematic review and meta-analysis aimed to evaluate the effectiveness of CAP in promoting complete wound healing.</p>\u0000 <p><b>Method:</b> An extensive literature search was performed across major databases for randomized controlled trials (RCTs) published between January 2005 and January 2025. Eligible studies included adult patients with chronic wounds treated with CAP compared to standard care or placebo. The primary outcome was complete wound healing. Risk ratios (RRs) with 95% confidence intervals (CIs) were synthesized using a random-effects model in RStudio with the metafor package.</p>\u0000 <p><b>Results:</b> Three RCTs comprising 149 participants (CAP group: 76; control group: 73) were included. The fixed-effects meta-analysis demonstrated that CAP therapy radically improved wound healing outcomes compared to standard care, with a pooled RR of 3.53 (95% CI: 2.12–5.89; <i>p</i> &lt; 0.001). However, the random-effects model yielded a nonsignificant result (RR = 3.31; 95% CI: 0.35–31.59; <i>p</i> = 0.150) and revealed substantial heterogeneity (<i>I</i>² = 68.9%, <i>Q</i> = 6.44, <i>p</i> = 0.040). Random-effects analysis was nonsignificant; findings are suggestive and require confirmation through larger, rigorous randomized trials.</p>\u0000 <p><b>Conclusions:</b> CAP therapy significantly enhances complete wound healing in patients with chronic wounds and demonstrates a favorable safety and efficacy profile. These findings support CAP as a promising adjunct to standard wound care.</p>\u0000 </div>","PeriodicalId":15381,"journal":{"name":"Journal of Clinical Pharmacy and Therapeutics","volume":"2025 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jcpt/5357147","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144767814","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":"Quercetin Modulates the p53 Signaling Pathway to Induce Apoptosis: Combating Vemurafenib Resistance in Melanoma","authors":"Ching Wen Huang,&nbsp;Gong Yau Chu,&nbsp;Chieh Chen Huang,&nbsp;Chung Hua Hsu","doi":"10.1155/jcpt/2635281","DOIUrl":"https://doi.org/10.1155/jcpt/2635281","url":null,"abstract":"<div>\u0000 <p><b>Background:</b> Melanoma is an aggressive skin cancer with a high potential for developing resistance to targeted therapies. One such therapy, vemurafenib, specifically inhibits the B-Raf proto-oncogene, serine/threonine kinase (BRAF) V600E mutation, a key driver of melanoma progression. However, acquired resistance to vemurafenib remains a major challenge, necessitating alternative treatment strategies. Quercetin, a natural flavonoid with well-documented anticancer properties, has demonstrated potential in overcoming drug resistance, making it a promising candidate for melanoma therapy.</p>\u0000 <p><b>Materials and Methods:</b> This study evaluated the effects of quercetin on both melanoma A375.S2 and vemurafenib-resistant A375.S2/VR cells. Cell viability was assessed using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, while apoptosis was measured through caspase-3/-7 activity and terminal deoxynucleotidyl transferase dUTP nick-end labeling (TUNEL) assay. Ribonucleic acid (RNA) sequencing and Ingenuity Pathway Analysis (IPA) were employed to identify the mechanisms underlying quercetin’s effects.</p>\u0000 <p><b>Results:</b> Quercetin significantly reduced cell viability in a dose-dependent manner in both cell lines, with A375.S2/VR cells requiring higher concentrations, while HaCaT cells, a normal keratinocyte cell line, remained unaffected, accompanied by an increase in apoptotic cell numbers and caspase-3/-7 activity. RNA sequencing revealed 379 differentially expressed genes, with IPA indicating significant involvement of the p53 signaling pathway. Increased caspase-3/-7 activity and apoptotic cell numbers confirmed apoptosis induction. Key regulators and pathways involved in apoptosis and inflammation were identified.</p>\u0000 <p><b>Conclusions:</b> Quercetin effectively induces apoptosis in vemurafenib-resistant melanoma cells by modulating the p53 signaling pathway, presenting a promising therapeutic strategy for overcoming drug resistance. Furthermore, in vivo studies are needed to validate these findings and explore clinical applications.</p>\u0000 </div>","PeriodicalId":15381,"journal":{"name":"Journal of Clinical Pharmacy and Therapeutics","volume":"2025 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jcpt/2635281","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144773449","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":"Oncolytic Viruses Reshape PD-1/PD-L1 Signaling: Mechanisms and Clinical Synergy With Immune Checkpoint Blockade","authors":"Seyedeh Nasim Mirbahari,&nbsp;Mehdi Bakhtiyaridovvombaygi,&nbsp;Hamid Mahdizadeh,&nbsp;Amirhossein Izadpanah,&nbsp;Elham Roshandel,&nbsp;Mehdi Totonchi","doi":"10.1155/jcpt/6036890","DOIUrl":"https://doi.org/10.1155/jcpt/6036890","url":null,"abstract":"<div>\u0000 <p>Oncolytic viruses (OVs) are naturally occurring or genetically engineered viruses that selectively target and destroy cancer cells. They act through multiple mechanisms, including direct tumor cell lysis, stimulation of immune-mediated cytotoxicity, and modulation of the tumor microenvironment (TME). Recent studies have shown that, beyond their direct oncolytic activity, OVs also influence the immune landscape by modulating the expression of PD-1/PD-L1 axis. In many cases, OVs trigger the release of proinflammatory cytokines, leading to increased PD-L1 levels on immune cells. This upregulation plays a key role in modulating the TME and shaping immune checkpoint signaling. While there is also evidence that OVs can directly reduce PD-L1 expression on tumor cells, the most prominent effect appears to be the boost in PD-L1 expression. This shift is thought to be crucial in influencing how the immune system responds to tumors. These changes could modulate PD-L1-mediated immune suppression and alter the exhaustion and anergy rate of the effector tumor-specific T cells infiltrated into the TME. This review discusses how OVs influence PD-1 and PD-L1 expression, with a focus on innate and adaptive immune activation, interferon signaling pathways, and engineered OVs designed to express immunomodulatory cytokines and chemokines. We explore how these mechanisms can be leveraged to enhance antitumor immunity, particularly in combination with ICIs. Furthermore, we discuss the potential of OVs to remodel the TME, modulate PD-L1 expression, and promote immune-mediated tumor clearance. Overall, this review highlights the evolving role of OVs in cancer therapy and their potential to augment the effectiveness of current immunotherapeutic strategies.</p>\u0000 </div>","PeriodicalId":15381,"journal":{"name":"Journal of Clinical Pharmacy and Therapeutics","volume":"2025 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jcpt/6036890","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144740540","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":"Molecular and Cellular Insights Into Retinoblastoma: Pathways, Immune Landscape, and Therapeutic Opportunities","authors":"Yixu Wang,&nbsp;Yumeng Quan,&nbsp;Shuyan Zhou,&nbsp;Yufei Dang,&nbsp;Xiaoxia Zhang,&nbsp;Cheng Pei","doi":"10.1155/jcpt/7499930","DOIUrl":"https://doi.org/10.1155/jcpt/7499930","url":null,"abstract":"<div>\u0000 <p><b>Background:</b> Retinoblastoma (RB) is the most common primary intraocular malignancy in children, primarily caused by inactivation of the RB1 tumor suppressor gene. Despite advancements in multimodal therapies, the molecular mechanisms underlying RB progression and its tumor microenvironment (TME) remain poorly understood, limiting the development of effective targeted treatments.</p>\u0000 <p><b>Methods:</b> This study integrates bulk and single-cell RNA sequencing data to characterize the molecular landscape of RB. Differential gene expression analysis, pathway enrichment analysis, and single-sample gene set enrichment analysis (ssGSEA) were performed to uncover key pathways and immune cell populations. Immune checkpoint molecules, m6A RNA modification-related genes, and ferroptosis-associated genes were analyzed to identify potential therapeutic targets. Protein-protein interaction (PPI) networks and cell-cell communication analyses were conducted to explore intercellular signaling within the TME. Additionally, functional validation was performed for CDKN1A, a candidate gene identified from transcriptomic analysis, using shRNA-mediated knockdown and in vitro assays.</p>\u0000 <p><b>Results:</b> Transcriptomic profiling revealed distinct gene expression signatures between RB and normal retinal tissues, including upregulation of oncogenic pathways (e.g., MYC targets and G2/M checkpoint regulation) and downregulation of tumor suppressor pathways (e.g., p53 signaling). Chemotherapy-induced gene expression changes were observed, notably the activation of immune-related pathways such as antigen presentation and NK cell-mediated cytotoxicity. Immune checkpoint molecules (PDCD1, CD274, HAVCR2) exhibited cell-type-specific expression, indicating potential for immunotherapy. Elevated expression of m6A regulators (METTL3, WTAP) and ferroptosis-associated genes (ACSL4, SLC7A11) pointed to novel therapeutic vulnerabilities. Among key regulatory genes, CDKN1A was identified as significantly downregulated in RB. Functional experiments demonstrated that knockdown of CDKN1A inhibited cell proliferation and induced G1 phase arrest in RB cell lines, supporting its potential tumor-promoting role in this context.</p>\u0000 <p><b>Conclusion:</b> This study provides a comprehensive molecular and cellular overview of RB progression and reveals novel therapeutic targets, including immune checkpoints, m6A modification enzymes, ferroptosis regulators, and CDKN1A. Our findings emphasize the need to address tumor heterogeneity and cell-type-specific gene expression in designing effective personalized therapies for RB patients.</p>\u0000 </div>","PeriodicalId":15381,"journal":{"name":"Journal of Clinical Pharmacy and Therapeutics","volume":"2025 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jcpt/7499930","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144673119","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":"A Comparative Study of the HbA1c Level in Prediabetic Patients With Lifestyle Modification Versus Oral Hypoglycemic Agents","authors":"Raj Kumar Thapa,&nbsp;Kushal Shrestha,&nbsp;Kanchan K. C.,&nbsp;Sirapa Maharjan,&nbsp;Shashwot Sedhain,&nbsp;Reshu B. K.,&nbsp;Sitaram Khadka","doi":"10.1155/jcpt/9947273","DOIUrl":"https://doi.org/10.1155/jcpt/9947273","url":null,"abstract":"<div>\u0000 <p><b>Background:</b> Lifestyle modifications are the cornerstone of prediabetes management, aiming to prevent or delay progression to diabetes. In addition to lifestyle interventions, pharmacologic treatment with oral hypoglycemic agents (OHAs), particularly metformin, is frequently considered.</p>\u0000 <p><b>Objectives:</b> The objective of this study was to identify optimal strategies for the management of prediabetes in low- and middle-income countries (LMICs) like Nepal.</p>\u0000 <p><b>Methods:</b> A comparative experimental study was conducted to assess the effects of lifestyle modification and treatment with OHA separately in prediabetic patients (16 per group). The lifestyle modification group (Group A) received structured counseling on dietary modifications and physical activity, and the OHA group (Group B) was prescribed metformin. Baseline parameters were recorded for all participants, and blood pressure and HbA1c levels were reassessed at 90 days to determine changes from the baseline.</p>\u0000 <p><b>Results:</b> Significant reduction in HbA1c was observed for both the OHA group (<i>p</i> = 0.0034) and the lifestyle modification group (<i>p</i> &lt; 0.001). The lifestyle modification group achieved significantly greater reductions in HbA1c compared with the OHA group (<i>p</i> = 0.0002).</p>\u0000 <p><b>Conclusions:</b> Lifestyle modification and pharmacological therapy with metformin can lead to a significant decrease in HbA1c levels in the prediabetic population as a sole intervention. Lifestyle modification resulting in greater reduction could be a sustainable and cost-effective alternative, particularly in LMICs like Nepal.</p>\u0000 </div>","PeriodicalId":15381,"journal":{"name":"Journal of Clinical Pharmacy and Therapeutics","volume":"2025 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jcpt/9947273","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144666605","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":"Study on the Efficacy and Safety of Off-Label Dosing of Rivaroxaban in Chinese Nonvalvular Atrial Fibrillation Patients","authors":"Zhe Jiang,&nbsp;Wenmin Dong,&nbsp;Xiaoxiao Lu,&nbsp;Xiaolin Liu,&nbsp;Jingru Gong","doi":"10.1155/jcpt/5598614","DOIUrl":"https://doi.org/10.1155/jcpt/5598614","url":null,"abstract":"<div>\u0000 <p><b>Objective:</b> This prospective cohort study aimed to systematically evaluate the clinical outcomes associated with off-label rivaroxaban regimens (10 mg vs. 15 mg daily) in elderly Chinese patients with nonvalvular atrial fibrillation (NVAF).</p>\u0000 <p><b>Methods:</b> A hospital-based observational cohort was established at Pudong Hospital, Shanghai, in 2021, enrolling 247 consecutive NVAF patients receiving rivaroxaban therapy after obtaining institutional ethics approval and informed consent. Multivariable logistic regression analyses were performed to identify independent predictors of clinical outcomes.</p>\u0000 <p><b>Results:</b> The cohort comprised 155 patients in 10 mg daily group and 92 patients in 15 mg daily group, with a mean age of 79 years. During 12-month follow-up, the 15 mg daily group demonstrated superior antithrombotic efficacy with significantly lower incidence of thrombotic events (15 mg: 1.50% vs. 10 mg: 5.90%, <i>p</i> = 0.017). Both regimens showed comparable safety profiles regarding bleeding events (15 mg: 10.90% vs. 10 mg: 13.90%, <i>p</i> = 0.302). Multivariate analysis identified CHA2DS2-VASc score as the primary predictor of thrombosis, while lower BMI, elevated HAS-BLED score, and diabetes mellitus emerged as independent bleeding predictors (all <i>p</i> &lt; 0.05).</p>\u0000 <p><b>Conclusion:</b> Rivaroxaban 15 mg daily showed better thromboembolic protection than 10 mg without increasing bleeding risk, supporting its use in selected high-risk elderly NVAF patients.</p>\u0000 </div>","PeriodicalId":15381,"journal":{"name":"Journal of Clinical Pharmacy and Therapeutics","volume":"2025 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jcpt/5598614","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672829","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}