Journal of Clinical Pharmacy and Therapeutics最新文献

{"title":"Cerebrospinal Pharmacokinetic Analysis and Pharmacodynamic Evaluation of Ceftriaxone in Pediatric Patients with Bacterial Meningitis","authors":"Tetsushu Onita,&nbsp;Kazuro Ikawa,&nbsp;Noriyuki Ishihara,&nbsp;Hiroki Tamaki,&nbsp;Takahisa Yano,&nbsp;Norifumi Morikawa,&nbsp;Kohji Naora","doi":"10.1155/2024/4684986","DOIUrl":"10.1155/2024/4684986","url":null,"abstract":"<p><i>What Is Known? and Objective</i>. Ceftriaxone has been widely used to treat bacterial meningitis in pediatric patients. Ceftriaxone dosing regimens of 80–120 mg/kg/day have been recommended for bacterial meningitis in pediatric patients, and the usual duration of therapy is 7–14 days. Although the target site for meningitis is cerebrospinal fluid (CSF), a CSF pharmacokinetic (PK) model in pediatric patients has not been reported. We aimed to develop a CSF PK model of ceftriaxone, using not only serum but also CSF concentration data, and to evaluate the appropriateness of dosing regimens for pediatric patients with bacterial meningitis. <i>Methods</i>. The population PK model was developed by simultaneously fitting serum and CSF data from pediatric patients described in nine published articles. Probabilities of attaining a pharmacodynamic target (100% <i>T</i> &gt; MIC, 100% of time that drug concentrations above the minimum inhibitory concentration) in CSF were estimated for some dosing regimens. <i>Results and Discussion</i>. Twenty-four pediatric patients with meningitis were the subjects for PK modeling (0.52–13 years old, and 3.5–50 kg of body weight). Sixty-eight serum concentrations and 98 CSF samples were used to develop the CSF PK model. The CSF/serum concentration ratio at the same sampling time was 0.0628 ± 0.0689. Age was not a statistically significant covariate in the PK parameter. In the CSF PK model, 40–60 mg/kg q12 h achieved a target attainment probability &gt;90% against causative bacteria for bacterial meningitis. However, 4-h infusion (rather than 0.5-h infusion) dosing regimens were required for efficacy against antimicrobial-resistant bacteria with high MICs. <i>What Is New? and Conclusion</i>. Ceftriaxone-dosing regimens with prolonged infusion times might be reasonably effective for treating antimicrobial-resistant pathogens in empiric therapy.</p>","PeriodicalId":15381,"journal":{"name":"Journal of Clinical Pharmacy and Therapeutics","volume":"2024 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139683637","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":"Chimeric Antigen Receptor-T (CAR-T) Cells as “Living Drugs”: A Clinical Pharmacist Perspective","authors":"Ciara Murnane,&nbsp;Nicola Gardiner,&nbsp;Olga Crehan,&nbsp;Christopher L. Bacon,&nbsp;Ruth McHugh,&nbsp;John F. Gilmer,&nbsp;Athanasios Mantalaris,&nbsp;Nicki Panoskaltsis","doi":"10.1155/2024/2239888","DOIUrl":"https://doi.org/10.1155/2024/2239888","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. Chimeric antigen receptor (CAR) T cell therapy, a “living drug” immunotherapy, harnesses the power of T-cells from a patient (autologous) or healthy donor (allogeneic) to target and kill cancer cells and has shown unprecedented outcomes in patients with relapsed and refractory malignancies. Treatment with CAR-T cells requires the application of unique skillsets in recognised specialist centres for successful outcomes and requires management by the multidisciplinary team incorporating the specialist pharmacist. <i>Method</i>. A multimodal research strategy was employed for this literature review whereby PubMed, Google Scholar, Embase, Stella Library Search, EMA website, and EBMT website were sources of information. The search was limited from 2020 onwards with key terms referring to CAR-T cell therapy. <i>Results and Discussion</i>. There are six CAR-T cell products currently approved by the European Medicines Agency (EMA) and Food and Drug Administration (FDA) which target haematological malignancies with abundant clinical trials underway exploring new and improved CAR designs and antigen targets. As CAR-T cell therapy is an advanced therapy medicinal product (ATMP), there is need for an extensive regulatory framework underpinning its safety and efficacy. The clinical pharmacist plays an integral role in the provision of safe and effective CAR-T cell therapy including governance, operational and clinical aspects of treatment. Pharmacists may also be involved through provision of “Qualified Person” (QP) expertise in clinical trials and for release within hospitals under certain circumstances. There is a need for harmonised and accessible guidance on the clinical delivery of ATMPs such as CAR-T cells, with fully delineated responsibilities of pharmacists involving the oversight and supervision of CAR-T cell treatment. <i>Conclusion</i>. There is an unmet need to provide suitable and applicable literature for clinical pharmacists who are involved in the delivery of CAR-T cells. We have provided an overview of T-cell biology and an explanation of CAR-T cell design and the biomanufacturing process. We reviewed the complex and multifaceted treatment cycle requiring considerable logistics, and described the involvement of the clinical pharmacist in each part of this cycle from patient selection to postinfusion care. Finally, we look to the challenges and future opportunities that will require the involvement of the clinical pharmacist.</p>\u0000 </div>","PeriodicalId":15381,"journal":{"name":"Journal of Clinical Pharmacy and Therapeutics","volume":"2024 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/2239888","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141165028","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":"Tirofiban on Fully Recanalized Stroke with Thrombectomy: A Propensity Score Matching Analysis","authors":"Wenting Guo,&nbsp;Ning Li,&nbsp;Jiali Xu,&nbsp;Wenbo Hu,&nbsp;Jin Ma,&nbsp;Sijie Li,&nbsp;Changhong Ren,&nbsp;Jian Chen,&nbsp;Jiangang Duan,&nbsp;Qingfeng Ma,&nbsp;Haiqing Song,&nbsp;Wenbo Zhao,&nbsp;Xunming Ji","doi":"10.1155/2024/1171260","DOIUrl":"10.1155/2024/1171260","url":null,"abstract":"<p><i>Background and Objective</i>. Approximately 50% of acute ischemic stroke (AIS) patients who achieve complete recanalization after endovascular therapy (EVT) experience unfavorable outcomes that are potentially partially attributed to incomplete microvascular reperfusion, which can possibly be improved by antiplatelet treatment. This study aimed to evaluate the effect of periprocedural tirofiban on AIS patients who achieved complete recanalization with EVT. <i>Methods</i>. Anterior circulation large-vessel occlusion stroke patients who achieved complete recanalization after EVT were retrospectively analyzed. Patients were dichotomized into tirofiban and nontirofiban groups and compared. Propensity score matching (PSM) was used to balance baseline confounders. 3-month functional independence (modified Rankin scale: 0–2), any intracranial hemorrhage (ICH), symptomatic ICH (sICH), arterial reocclusion, in-hospital mortality, and 3-month mortality were evaluated. <i>Results</i>. This study included 303 patients with 118 and 185 in the nontirofiban and tirofiban groups, respectively. After PSM, 85 couples with balanced baseline characteristics were generated. 49 (57.6%) and 36 patients (42.4%) in the tirofiban and nontirofiban groups achieved functional independence at 3 months with a significant difference (risk ratio: 1.361, 95% confidence interval: 1.001–1.852, <i>P</i> = 0.046). However, there was no significant difference between the tirofiban and nontirofiban groups in terms of the other outcomes (all <i>P</i> &gt; 0.05). <i>Conclusions</i>. In anterior circulation, large-vessel occlusion AIS patients who achieved complete recanalization with EVT, periprocedural tirofiban may improve the functional outcomes and does not appear to increase the rate of ICH and sICH.</p>","PeriodicalId":15381,"journal":{"name":"Journal of Clinical Pharmacy and Therapeutics","volume":"2024 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140489881","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":"Evaluation of Apatinib-Related Hypertension and Identification of Clinical Risk Factors","authors":"Kaidi Le,&nbsp;Min Liu,&nbsp;Yinglin Ma,&nbsp;Jiaqing Yan,&nbsp;Ying Li,&nbsp;Guohui Li","doi":"10.1155/2024/5354295","DOIUrl":"10.1155/2024/5354295","url":null,"abstract":"<p><i>Purpose</i>. Hypertension (HTN) is one of the most common adverse drug reactions to tyrosine kinase inhibitors (TKIs) targeting vascular endothelial growth factor (VEGF), but little is known about its clinical risk factors. The aim of this study was to elucidate the association between baseline clinical characteristics and the occurrence of HTN in advanced gastric cancer (GC) patients prescribed apatinib, a commonly used VEGF-TKI in China, in a real-world setting. <i>Patients and Methods</i>. Fifty-five GC patients treated with apatinib from December 1st, 2016, to December 1st, 2020, were retrospectively included in electronic medical records. Adverse drug reactions were defined according to the National Cancer Institute’s Common Terminology Criteria for Adverse Events (CTCAE) v5.0. Univariate and multivariable logistic regression analyses were used to investigate potential clinical risk factors for apatinib-related HTN. <i>Results</i>. The incidence of apatinib-related HTN of all grades was 45.45%, and grade 3 HTN occurred in 16.36% of patients. The median maximal systolic blood pressure (SBP) during apatinib treatment was 153 mm·Hg, and the median time to event was 25 days. New-onset HTN occurred in 10/33 (30.30%) patients. Preexisting HTN (odds ratio [OR]: 4.155; 95% confidence interval [CI]: 1.252, 13.787; <i>p</i> = 0.020) was the key independent risk factor associated with apatinib-related HTN. <i>Conclusion</i>. The incidence of HTN was high in patients treated with apatinib, and preexisting HTN was an independent risk factor. It is important to provide thorough and close monitoring of patients during treatment with apatinib, especially for those with preexisting HTN. This trial is registered with ChiCTR1900024531.</p>","PeriodicalId":15381,"journal":{"name":"Journal of Clinical Pharmacy and Therapeutics","volume":"2024 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139595838","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":"Hydroxychloroquine: Pharmacokinetics and Toxicity","authors":"Philippe Brouqui,&nbsp;Eric Chabrière,&nbsp;Didier Raoult","doi":"10.1155/2024/6500340","DOIUrl":"https://doi.org/10.1155/2024/6500340","url":null,"abstract":"<p><i>Background/Purpose(s)</i>. We have extensively used HCQ at 200 mg three times a day (tid) to treat various infections such as Q fever and Whipple’s disease. Serum levels of between 1 <i>μ</i>g/ml and 2 <i>μ</i>g/ml serum level are recommended to achieve the safety and efficacy of these treatments. Our aim in this paper is to describe our experience regarding the pharmacokinetics and toxicity of HCQ in another infection caused by SARS-CoV-2. <i>Methods</i>. As recommended, we performed electrocardiograms before administering HCQ off-label. The HCQ concentration in the serum was monitored to ensure the effectiveness and safety of the treatment. We retrospectively analysed HCQ serum concentrations measured over time and toxicity data in patients with COVID-19 who were treated with HCQ at the IHU Marseille Infection. We did not treat patients with HCQ contraindications with this medication. <i>Results</i>. We measured HCQ concentrations in 1310 serum samples from 989 patients with COVID-19. The mean ± SD HCQ concentration increased in patients’ sera during treatment from day 1 (0.10 <i>μ</i>g/ml ± 0.08) to day 11 (0.85 <i>μ</i>g/ml ± 0.44), confirming that HCQ accumulates in the body during short-term therapy. However, the observed concentrations did not exceed the therapeutic range for other indications (0.80–1.20 <i>μ</i>g/mL in Q fever patients treated for between 18 and 24 months). In patients treated with HCQ, major side effects included intestinal disorders (nausea, vomiting, and gastric pain) and QT prolongation. No conduction disorders (including torsades de pointes and ventricular arrhythmia), cardiomyopathy, retinopathy, or HCQ-related deaths were observed. <i>Conclusions</i>. In patients treated over a short time period with 200 mg tid of HCQ, therapeutic concentrations in serum were obtained in most patients without significant side effects or complications. Although patients must be carefully evaluated for HCQ contraindications, HCQ 200 mg tid for ten days can be considered an appropriate and safe dosage in patients with COVID-19.</p>","PeriodicalId":15381,"journal":{"name":"Journal of Clinical Pharmacy and Therapeutics","volume":"2024 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141164939","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":"Efficacy and Safety of Pharmacist-Managed NSAIDs Deprescribing: A Jordanian Outpatient Study","authors":"Deema Jaber,&nbsp;Abeer Al Shihab,&nbsp;Lina N. Tamimi","doi":"10.1155/2024/5874686","DOIUrl":"10.1155/2024/5874686","url":null,"abstract":"<p><i>Background</i>. Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to manage pain, including chronic pain conditions. However, their prolonged use is associated with significant risks, particularly gastrointestinal (GI) adverse events. This study aimed to evaluate the effectiveness and safety of a pharmacist-managed deprescribing program for NSAIDs in a Jordanian outpatient population. <i>Methods</i>. A convenience sample of 100 participants who had been using NSAIDs for pain management was recruited. Participants underwent a structured deprescribing intervention in collaboration with physicians. Various effectiveness and safety outcomes were assessed before and after deprescribing. Descriptive statistics and chi-square test were used for data analysis. <i>Results</i>. The majority of participants reported chronic pain conditions, with rheumatoid arthritis (24%) and osteoarthritis (22%) being the most prevalent. Ibuprofen (28%) and diclofenac (22%) were the most commonly used NSAIDs. The deprescribing program was associated with a significant reduction in heartburn, stomach ulcer, kidney problems and fluctuation in blood pressure readings (<i>p</i> &lt; 0.05), and pain exacerbation. Notably, the reduction in pain exacerbation was evident (<i>p</i> = 0.003) in the 4-month follow-up. <i>Conclusion</i>. A pharmacist-managed NSAIDs deprescribing program demonstrated effectiveness in reducing the risk of GI adverse events and fluctuation in blood pressure readings without causing harm during a short-term follow-up. These findings support the feasibility of implementing such programs in outpatient settings. Further long-term investigations are necessary to confirm these results.</p>","PeriodicalId":15381,"journal":{"name":"Journal of Clinical Pharmacy and Therapeutics","volume":"2024 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139616029","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":"Investigation of the Potential Targets and Mechanism Actions of Berberine in the Treatment of Pulpitis Based on Bioinformatics Analysis","authors":"Bingchang Xin,&nbsp;Jia Song,&nbsp;Juan Zhou,&nbsp;Ran Li,&nbsp;Ke Sun,&nbsp;Jin Zhang,&nbsp;Jiaying Wang","doi":"10.1155/2024/1595240","DOIUrl":"10.1155/2024/1595240","url":null,"abstract":"<p>Berberine, an active compound extracted from the Chinese herb, was reported to have an antibacterial effect and an anti-inflammatory effect and promote osteogenic differentiation of human dental pulp stem cells. However, the underlying therapeutic mechanism of berberine in pulpitis is still unknown. Here, bioinformatics analysis was performed to investigate the potential mechanism of berberine against pulpitis. First, we identified the collective targets of berberine and pulpitis from several databases using a Venny online tool. The pattern of interaction between berberine and the targeted protein was visualized by molecular docking. Moreover, we performed GSEA, Gene Ontology (GO), and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses to obtain potential pathways. Cell experiments were performed to validate the bioinformatics analysis results. Prostaglandin-endoperoxide synthase 2 (PTGS2) was identified as the crucial antipulpitis target of berberine via the CytoHubba plugin. Docking analysis indicated that berberine could fit in the binding pocket of the PTGS2 protein. Additionally, berberine exerted its therapeutic effects against pulpitis via multiple pathways. Overall, berberine possessed therapeutic effects against pulpitis through the inactivation of toll-like receptor and NOD-like receptor signaling pathways. The present research proposes a novel approach to explore the therapeutic mechanism of natural products.</p>","PeriodicalId":15381,"journal":{"name":"Journal of Clinical Pharmacy and Therapeutics","volume":"2024 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139616541","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":"Efficacy and Safety of Hetrombopag for Thrombocytopenia in Patients with Advanced Solid Tumors: A Retrospective Study","authors":"Haonan Liu, Xiao Ma, Di Pan, Menghan Cao, Zhengxiang Han, Hongmei Wang","doi":"10.1155/2023/2859670","DOIUrl":"https://doi.org/10.1155/2023/2859670","url":null,"abstract":"Objective. To analyze and evaluate the clinical value of hetrombopag in cancer therapy-induced thrombocytopenia (CTIT) caused by antitumor therapy for malignant tumors and to provide scientific evidence support for clinical application in the real-world setting. Methods. The clinical data of CTIT patients with advanced solid tumors who received hetrombopag were analyzed retrospectively. The proportion of patients with different characteristics who recovered platelet count to ≥75 × 109/L at day 14 and the effective rate of platelet elevation was compared by the χ2 test or Fisher exact probability method. P<0.05 was considered statistically significant. Results. A total of 60 CTIT patients who received hetrombopag at our site from July 2021 to October 2022 were finally included in this study. The proportion of patients who achieved therapeutic effect within (7 ± 2) days after treatment was 26.7% (16/60), among which 20.0% (12/60) patients had platelet count recovered to ≥100 × 109/L, and 25.0% (15/60) patients had platelet count increase from baseline ≥50 × 109/L. Within (14 ± 2) days of treatment with hetrombopag, 66.7% (40/60) of patients achieved treatment response, of whom 56.7% (34/60) had platelet counts ≥100 × 109/L and 53.3% (32/60) had platelet counts ≥50 × 109/L increase from baseline. In addition, no treatment-related adverse events occurred during the treatment period. Conclusion. This retrospective study provides preliminary evidence that hetrombopag increases platelets in CTIT patients receiving antitumor therapy for advanced solid tumors.","PeriodicalId":15381,"journal":{"name":"Journal of Clinical Pharmacy and Therapeutics","volume":" 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139138811","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":"Efficacy and Safety of Trastuzumab Combined with Pertuzumab for Human Epidermal Growth Factor Receptor-2-Positive Breast Cancer: A Meta-Analysis Study of Randomized Control Trials","authors":"Qingdong Gao, Xufang Duan","doi":"10.1155/2023/2274965","DOIUrl":"https://doi.org/10.1155/2023/2274965","url":null,"abstract":"Objective. This systematic review was aimed to evaluate the efficacy and safety of trastuzumab in combination with pertuzumab for human epidermal growth factor receptor-2 (HER2)-positive breast cancer (BC). Methods. A comprehensive search of PubMed, Web of Science, Embase, China National Knowledge Internet, and Wanfang databases was conducted. All randomized controlled trials on trastuzumab in combination with pertuzumab for HER2-positive BC from the time of database construction to October 2022 were included. A meta-analysis of the included literature was performed using STATA 17.0 software. Results. A total of 8 studies were included, involving a total of 7628 patients, including 3814 patients in the treatment group and 3814 patients in the control groups. The results of the meta-analysis showed that the median progression-free survival was much shorter in the treatment group (trastuzumab combined with pertuzumab) than in the control group (placebo) (OR = 0.656, 95% CI (0.581, 0.741), \u0000 \u0000 P\u0000 \u0000  < 0.001) and that patients in the treatment group experienced significantly more cases of diarrhea than those in the control group (OR = 2.429, 95% CI (2.065, 2.856), \u0000 \u0000 P\u0000 \u0000  < 0.001) while experiencing significantly less cases of constipation (OR = 0.641, 95% CI (0.473, 0.869), \u0000 \u0000 P\u0000 \u0000  = 0.004). Notably, the incidence of nausea and vomiting did not differ significantly between the two groups. In addition, there was no significant difference between the two groups in the incidence of systemic adverse effects such as neutropenia, fatigue, myalgia, and cardiac disease (\u0000 \u0000 P\u0000 \u0000  > 0.05). However, the treatment group had a much higher incidence of rash than the control group (OR = 1.915, 95% CI (1.505, 2.437), \u0000 \u0000 P\u0000 \u0000  < 0.001). The risk of serious adverse reactions was markedly higher in patients in the treatment group than that in the control group (OR = 1.342, 95% CI (1.206, 1.494), \u0000 \u0000 P\u0000 \u0000  < 0.001). Conclusion. The combination of trastuzumab and pertuzumab was not effective in improving the intermediate progression-free survival of patients. However, adverse effects, including diarrhea and rash, are the limiting factors for the current promotion of this combination method.","PeriodicalId":15381,"journal":{"name":"Journal of Clinical Pharmacy and Therapeutics","volume":"5 11","pages":""},"PeriodicalIF":2.0,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139006705","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":"A Meta-Analysis for Comparing the Effects of Febuxostat and Allopurinol on Kidney Function in Hyperuricemia Patients Complicated with Chronic Kidney Disease","authors":"Yu Wang, Kai Chen, Su-ya Zhou, Zi-xuan Qiao, Xiao-rong Bao","doi":"10.1155/2023/9946667","DOIUrl":"https://doi.org/10.1155/2023/9946667","url":null,"abstract":"Background. This study was designed to assess the effects of febuxostat on the uric acid level and kidney function of hyperuricemia (HUA) patients complicated with chronic kidney disease (CKD). Methods. A computer-based search was conducted on the China National Knowledge Infrastructure (CNKI), Wanfang, PubMed, and Web of Science databases from the inception of the databases to April 2023 to identify clinical randomized controlled trials on HUA and CKD, with comparisons between febuxostat and allopurinol as variables of interest. The meta-analysis was conducted using Stata v17.0. Results. Eighteen studies were included in this meta-analysis, encompassing a total of 1877 patients. These patients were segregated into a control group (treated with allopurinol or placebo) consisting of 1039 individuals and an experimental group (treated with febuxostat alone or a combination of febuxostat with other therapies) comprising 838 patients. The meta-analysis revealed that patients in the experimental group, treated with febuxostat, exhibited a significantly higher estimated glomerular filtration rate (eGFR) than those in the control group treated with allopurinol (weighted mean difference (WMD): 2.897, 95% CI: 1.336 to 4.458, \u0000 \u0000 P\u0000 \u0000  < 0.001). In addition, the experimental group demonstrated significantly lower levels of serum creatinine (WMD: −17.810, 95% CI: −24.147 to −11.474, \u0000 \u0000 P\u0000 \u0000  < 0.001), serum uric acid (WMD: −91.891, 95% CI: −117.609 to −66.173, \u0000 \u0000 P\u0000 \u0000  < 0.001), and blood urea nitrogen (WMD: −1.284, 95% CI: −1.837 to −0.731, \u0000 \u0000 P\u0000 \u0000  < 0.001). However, there was no significant difference in 24-hour urinary protein quantity (WMD: −0.198, 95% CI: −0.413 to 0.016, \u0000 \u0000 P\u0000 \u0000  = 0.070) between the two groups. Conclusion. These findings suggest that febuxostat may offer a more beneficial therapeutic option for managing CKD in hyperuricemic patients. However, the observed heterogeneity and the limited diversity of the study population warrant cautious interpretation of these results.","PeriodicalId":15381,"journal":{"name":"Journal of Clinical Pharmacy and Therapeutics","volume":"9 20","pages":""},"PeriodicalIF":2.0,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138977119","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}