Journal of Pharmacy Technology最新文献

{"title":"Doxycycline for <i>Legionella</i> Pneumonia: Expanding Treatment Horizons Through a Case Series and Narrative Review.","authors":"M Gabriela Cabanilla, Aileen C Scheibner, Jorge R Mera","doi":"10.1177/87551225251366324","DOIUrl":"10.1177/87551225251366324","url":null,"abstract":"<p><p><b>Background:</b> <i>Legionella</i> pneumonia is a significant cause of community-acquired pneumonia that often requires timely and effective treatment. While fluoroquinolones and macrolides are the recommended first-line therapies, doxycycline offers an alternative with favorable pharmacokinetics, safety, and minimal drug-drug interactions. <b>Methods:</b> We describe three hospitalized patients with <i>Legionella</i> pneumonia who received doxycycline monotherapy.Clinical outcomes, including symptom resolution and survival, were assessed at 60 days. A literature review was also performed for studies published between 1980 and 2025 that evaluated doxycycline for Legionella infection. <b>Results:</b> All three patients achieved clinical improvement with doxycycline monotherapy, with resolution of presenting symptoms and survival at 60 days post-hospitalization. The literature review identified limited clinical data on doxycycline for Legionella pneumonia. In vitro data suggested that doxycycline may have lower bactericidal activity than fluoroquinolones, although its pharmacological profile and tolerability support its consideration in select cases. <b>Conclusion</b>: Doxycycline monotherapy was associated with favorable outcomes in three cases of Legionella pneumonia. Although the evidence remains sparse, doxycycline may represent a viable alternative when first-line therapy is contraindicated. Further research is required to define its role in the treatment of <i>Legionella</i> pneumonia.</p>","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":" ","pages":"30-37"},"PeriodicalIF":1.5,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12399582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144992864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proton Pump Inhibitor Use in Patients With Cirrhosis and Its Association With Spontaneous Bacterial Peritonitis.","authors":"Morgan Thomas, Cameron Lanier, Kelly Covert","doi":"10.1177/87551225251364516","DOIUrl":"10.1177/87551225251364516","url":null,"abstract":"<p><p><b>Background:</b> Cirrhosis is a major cause of morbidity and mortality in the United States, with spontaneous bacterial peritonitis (SBP) being a serious complication. Established SBP risk factors include gastrointestinal bleeding and low ascitic protein, but the role of proton pump inhibitors (PPIs) remains unclear. <b>Objective:</b> This study evaluated the impact of PPI use on primary SBP development in hospitalized patients with cirrhosis. Additional objectives included reviewing PPI prescribing patterns and associated clinical outcomes. <b>Methods:</b> An institutional review board-approved, retrospective chart review was conducted on adults (≥18 years) with cirrhosis admitted for presumed SBP between June 1, 2022, and June 30, 2024. Exclusion criteria included pregnancy, incarceration, and recent or current upper gastrointestinal bleeding. Patients were grouped by PPI exposure, defined as PPI use prior to admission. The primary outcome was SBP incidence; secondary outcomes included mortality and hepatic decompensation events. <b>Results:</b> Eighty-one patients were included: 42 reported home PPI therapy, and 39 did not. SBP incidence was 33.3% in the PPI group versus 20.5% in the no PPI group (χ² = 0.249, <i>P</i> = 0.618). Worsening ascites occurred in 99%, encephalopathy in 42%, varices in 11%, and suspected hepatorenal syndrome in 21%. In-hospital mortality was 9.9%. PPI indications were often undocumented. <b>Conclusion and Relevance:</b> Although no significant association was found between home PPI use and SBP, frequent undocumented use and potential overuse of PPIs underscore the need for targeted intervention. Pharmacists are well-positioned to lead stewardship efforts by reviewing indications and minimizing unnecessary therapy to enhance safety and outcomes.</p>","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":" ","pages":"283-290"},"PeriodicalIF":1.5,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12373648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Intravenous Electrolyte Supplementation on Refeeding Syndrome for Patients Initiated on Parenteral Nutrition.","authors":"Makayla F Hoke, Katelyn A Butler, Marcos J Ortiz-Uriarte, Andrew J Franck","doi":"10.1177/87551225251363426","DOIUrl":"10.1177/87551225251363426","url":null,"abstract":"<p><p><b>Background:</b> Refeeding syndrome (RS) is a potentially life-threatening condition, marked by decreases in serum phosphorus, potassium, or magnesium, that commonly occurs in patients who receive parenteral nutrition (PN) after a period of inadequate caloric intake. <b>Objective:</b> To compare the occurrence and severity of RS in hospitalized patients who received intravenous (IV) electrolyte supplementation versus those who did not receive IV electrolyte supplementation prior to initiation of PN. <b>Methods:</b> This single-center, retrospective cohort study included adult patients hospitalized over a 10-year period who received PN. The primary outcome was the occurrence of RS in each group (decrease in serum phosphorus, potassium, or magnesium of 10% or more from baseline within 5 days of PN initiation). <b>Results:</b> A total of 124 patients were included in the study, with 62 patients in each group. Fifty-two patients (83.9%) in the IV electrolyte supplementation group developed RS of any severity compared to 48 patients (77.4%) in the no IV electrolyte supplementation group (odds ratio [OR] = 1.52, 95% confidence interval [CI] = 0.62 to 3.74, <i>P</i> = 0.4). The IV electrolyte supplementation group developed more mild cases of RS (OR = 2.48, 95% CI = 1.14 to 5.40, <i>P</i> = 0.02), had a lower median decrease in serum phosphorus (median difference [MD] = -6.0, 95% CI = 10.9 to <-0.1, <i>P</i> = 0.03), and had lower in-hospital mortality (OR = 0.25, 95% CI = 0.09 to 0.74, <i>P</i> = 0.008). There were no significant differences for other secondary outcomes. <b>Conclusion:</b> Overall occurrence of RS was not significantly different between groups. However, some findings were suggestive of benefit associated with IV electrolyte supplementation.</p>","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":" ","pages":"276-282"},"PeriodicalIF":1.5,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Retrospective Within-Subjects Analysis of Vancomycin Bayesian Modeling With Pre-steady-State vs Steady-State Concentrations.","authors":"Elizabeth W Covington, Jihyun L Chae, Sarah Grace Gunter","doi":"10.1177/87551225251362731","DOIUrl":"10.1177/87551225251362731","url":null,"abstract":"<p><p><b>Background:</b> Bayesian modeling of vancomycin can estimate 24-hour area under the curve (AUC₂₄) using pre-steady-state concentrations. Limited literature exists comparing Bayesian AUC₂₄ calculations derived from steady-state versus pre-steady-state concentrations. <b>Objective:</b> To assess the agreement between vancomycin AUC₂₄ calculations using pre-steady-state versus steady-state concentrations, employing Bayesian modeling. <b>Methods:</b> This retrospective within-subjects cohort study included patients with at least 1 pre-steady-state and 1 steady-state vancomycin concentration. Patients with age >100 years, weight <40 kg, height <60 inches, or renal dysfunction were excluded. The steady-state AUC₂₄ from dosing software was documented with and without hiding steady-state levels from calculations. The primary outcome was agreement between AUC₂₄ without levels hidden compared with AUC₂₄ with steady-state levels hidden from analysis. Secondary outcomes included the agreement between AUC₂₄ with pre-steady-state levels hidden and the percentage of patients with matching AUC₂₄ categories. The AUC₂₄ agreement was evaluated via Bland-Altman plot and bias via linear regression. Statistical tests were performed using SPSS statistics software (IBM Corp). <b>Results:</b> A total of 93 patients were included. The mean difference in AUC₂₄ compared to AUC₂₄ with steady-state levels hidden was 8.8 mg*h/L, and with pre-steady-state levels hidden, it was -3.7 mg*h/L. Linear regression analysis indicated a proportional bias when steady-state levels were hidden (β = 0.22; <i>P</i> = 0.038) but not when pre-steady-state levels were hidden. Category mismatch occurred more often when steady-state levels were hidden vs when pre-steady-state levels were hidden (26% vs 8%; <i>P</i> < 0.001). <b>Conclusion and Relevance:</b> The study demonstrated overall agreement between AUC₂₄ compared to AUC₂₄ with steady-state levels hidden. The mean differences in AUC₂₄ estimates were small, no matter which level was hidden, although tighter limits of agreement were observed when steady-state levels were utilized in Bayesian calculations. Further research with larger sample sizes is necessary.</p>","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":" ","pages":"268-275"},"PeriodicalIF":1.5,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Effectiveness of a Pharmacist-Driven Warfarin Consult Service Versus Physician Management in a Tertiary Community Hospital.","authors":"Erik Wasowski, Anne Harris, Taylor Elias","doi":"10.1177/87551225251363438","DOIUrl":"10.1177/87551225251363438","url":null,"abstract":"<p><p><b>Background:</b> The use of warfarin is complicated by a narrow therapeutic window, requiring close monitoring to prevent serious adverse events. Literature has shown that pharmacist-led warfarin management improves patient outcomes and decreases hospitalization length of stay. This study assessed the impact of the recently implemented pharmacist-driven warfarin consult service at 3 hospitals within the Cleveland Clinic Health System. <b>Methods:</b> This was a retrospective, multi-centered study which included 64 adult patients admitted to Cleveland Clinic Hospitals between June 1, 2023, and July 31, 2024 who received at least 3 doses of warfarin. Exclusion criteria included an elevated international normalized ratio (INR) upon admission, argatroban use, active cancer, or warfarin ordered by both managing services. <b>Results:</b> The primary outcome, rate of supratherapeutic INR values, did not significantly differ between groups (<i>P</i> = .84). In addition, the secondary outcomes including rate of subtherapeutic INRs, INR ≥0.7 within 24 hours, therapeutic INR at discharge, and major bleeding showed no significant difference. However, pharmacists were twice as likely to order an initial starting dose of <5 mg compared to physicians (62.5% vs 31.3%). In addition, physician-managed patients were observed more frequently for the INR ≥0.7 within 24 hours (11 vs 4 events). <b>Conclusion:</b> Overall, there was not a significant difference found in patient outcomes when comparing pharmacist versus physician warfarin management. Future studies with a larger sample size are needed to explore the potential differences in dosing regimens and its effect on the rate of significant INR elevations.</p>","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":" ","pages":"262-267"},"PeriodicalIF":1.5,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12343540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Methicillin-Resistant <i>Staphylococcus aureus</i> Nasal PCR Versus Culture on Vancomycin Utilization in Pneumonia Management.","authors":"Surafel G Mulugeta, Shivani Kantharia, Michael P Veve, Shaina Vincent, Amy Beaulac, Nisha Patel","doi":"10.1177/87551225251359508","DOIUrl":"10.1177/87551225251359508","url":null,"abstract":"<p><p><b>Introduction:</b> Methicillin-resistant <i>Staphylococcus aureus</i> pneumonia (PNA) can be ruled out via methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) culture and polymerase chain reaction (PCR) nasal screening, facilitating the de-escalation of empiric anti-MRSA agents like intravenous vancomycin. This study evaluated the impact of transitioning from culture to PCR-based MRSA nasal screening in patients with PNA. <b>Methods:</b> This Institutional Review Board (IRB)-approved retrospective quasi-experimental study was conducted at a 5-hospital system and included adult, nonpregnant hospitalized patients from September to December 2021 (\"culture group\") and September to December 2022 (\"PCR group\") and diagnosed with PNA. Exclusion criteria were ventilator-acquired PNA or positive MRSA respiratory culture. The primary endpoint was the number of vancomycin levels obtained. Secondary endpoints were vancomycin duration as well as acute kidney injury (AKI) and all-cause 30-day readmission rates. <b>Results:</b> Two-hundred patients were included: 100 in each group. Baseline characteristics were similar. There were 117 vancomycin levels obtained: 67 (67) and 50 (50) in the culture and PCR group, respectively (<i>P</i> = .021). Median vancomycin duration was 50% shorter in the PCR group: 2 days (1-3) versus 3 days (2-4), <i>P</i> < .001. After adjusting for confounders, the culture group was more likely to have vancomycin levels obtained compared to the PCR group: adjusted odd ratio (aOR) (95% confidence interval [CI])] = 1.833 (1.016-3.309). Long-term obstructive pulmonary disease was associated with reduced risk of ordering vancomycin levels: aOR [95% CI] = 0.426 (0.218-0.831). Readmission and AKI rates were comparable. <b>Conclusion:</b> Transitioning from culture to PCR-based MRSA nasal screening significantly reduced vancomycin levels obtained from patients and shortened vancomycin duration without negatively impacting patient outcome.</p>","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":" ","pages":"255-261"},"PeriodicalIF":1.5,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12328358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of Acute Kidney Injury in Critically Ill Patients Receiving Vancomycin With Concomitant Piperacillin-Tazobactam Versus Other Beta-Lactams: A Systematic Review and Meta-Analysis.","authors":"Ranyi Li, Yanli Li, Chenqi Xu, Ziyan Shen, Xialian Xu, Xiaoqiang Ding, Xiaoyu Li, Qianzhou Lv, Kunming Pan","doi":"10.1177/87551225251350894","DOIUrl":"10.1177/87551225251350894","url":null,"abstract":"<p><p><b>Objectives</b>: To explore whether vancomycin (VAN) plus piperacillin-tazobactam (PTZ) was associated with an increased risk of acute kidney injury (AKI) compared with VAN plus other beta-lactams (BLs) or monotherapy in critically ill patients, where the evidence remains controversial. <b>Data sources:</b> PubMed, Cochrane, Web of Science, and Embase were searched from inception to June 2024. <b>Study selection:</b> Studies comparing the risk of AKI with one group receiving VAN+PTZ, and other groups receiving VAN plus other BLs, or monotherapy in critically ill. <b>Data synthesis:</b> This analysis included 20 articles with 28 243 participants. The majority of included studies were retrospective (95%, 19/20) and had moderate risks of bias (80.0%, 16/20). The results indicated VAN+PTZ was associated with a significantly higher risk of AKI compared with VAN plus other BLs (OR = 1.66, 95% CI = 1.42-1.94, <i>P</i> < 0.001). Subgroup analyses showed that compared with adults, children were associated with a higher risk of AKI when receiving VAN+PTZ (OR = 3.16 vs 1.59). Also, VAN+PTZ was associated with a significantly higher risk of severe stage 2 to 3 AKI than VAN plus other BLs (OR = 1.63, 95% CI = 1.28-2.06, <i>P</i> < 0.001). No significant difference was identified in mortality, dialysis, time to AKI, and length of stay between patients receiving VAN plus PTZ and other combinations. <b>Conclusions</b>: In critically ill, VAN plus PTZ was associated with an increased risk of AKI and severe stage 2 to 3 AKI compared with VAN plus other BLs, especially in children. However, more high-quality multicenter, prospective cohort studies, and randomized controlled studies are needed.</p>","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":" ","pages":"291-302"},"PeriodicalIF":1.5,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12301226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Effect of Concomitant Azoles on Anticoagulant Prescribing Practices in Transplant Patients: A National Survey of Clinicians.","authors":"Kristina M Burroughs, Alicia B Lichvar, Lara M Groetzinger, Edward Horn, Carlo J Iasella, Cody A Moore, Dana R Pierce, Lauren M Sacha, Ryan M Rivosecchi","doi":"10.1177/87551225251348830","DOIUrl":"10.1177/87551225251348830","url":null,"abstract":"<p><p><b>Background:</b> Patients undergoing transplantation experience higher rates of venous thromboembolism and non-valvular atrial fibrillation (NVAF) compared with the general population. Anticoagulation decisions in this patient population are complex. A national survey on direct-acting oral anticoagulant practices demonstrated significant heterogeneity, in the setting of drug-drug interactions. <b>Objective:</b> The aim of this study was to evaluate the anticoagulation practices of clinicians caring for solid organ transplant patients. <b>Methods:</b> A 15-question survey consisting of 7 demographic questions and 8 unique patient cases was distributed via email Listserv of several professional transplantation organizations. Each case question asked the participant to select an anticoagulant regimen depending on: (1) indication for anticoagulation, (2) renal function, and (3) drug-drug interactions. Participants selected one of the following options: apixaban, dabigatran, enoxaparin, rivaroxaban, warfarin, or write in an alternative option. Descriptive statistics were used to analyze survey results. <b>Results:</b> Fifty participants completed 4 or more (≥50%) of the case-based survey questions and were included in the analysis. Ninety-four percent of participants were pharmacists, representing 43 transplant centers. Fifty-one percent of responders preferred warfarin for the indication of NVAF. Apixaban was preferred in patients with new or previous deep vein thrombosis/pulmonary embolism (51%). Fifty-four percent of respondents preferred warfarin in questions in renal dysfunction. In scenarios involving a mild-moderate CYP3A4 inhibitor azole antifungal, 61% of respondents preferred apixaban, with 64% of those selecting a standard dose regimen (vs a reduced dose regimen). Participants preferred warfarin (57%) in scenarios with a strong CYP3A4 inhibitor. <b>Conclusion and Relevance:</b> The results of our survey demonstrated a high degree of variation when selecting anticoagulation strategies in complex clinical scenarios involving transplant patients.</p>","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":" ","pages":"217-225"},"PeriodicalIF":1.5,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12209238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ensifentrine: A Novel Option for Maintenance of Chronic Obstructive Pulmonary Disease.","authors":"Emily M Hitt, Alexa J Powell","doi":"10.1177/87551225251350899","DOIUrl":"10.1177/87551225251350899","url":null,"abstract":"<p><p><b>Objective:</b> The goals of this article are reviewing the clinical aspects of ensifentrine, results from the clinical trials that led to its approval and examining its potential impact on patient care to aid therapeutic decision-making. <b>Data Sources:</b> A literature search of studies took place between October 2024 and December 2024 on PubMed using the terms <i>ensifentrine, roflumilast, Ohtuvayre™</i> and <i>ensifentrine</i> chronic obstructive pulmonary disease (COPD). <b>Study selection/data extraction:</b> Phase II and III randomized controlled trials were eligible for inclusion. Pertinent clinical trials included those focusing on the use of ensifentrine in the treatment of COPD. Meeting abstracts, systematic reviews and meta-analyses were excluded from this article. <b>Data synthesis:</b> Food and Drug Administration approval for ensifentrine is based off the phase III ENHANCE clinical trials in patients with COPD. Ensifentrine demonstrated improvement in lung function and a reduction in symptoms in clinical studies with a tolerable safety profile. <b>Conclusion:</b> The development and approval of ensifentrine for the maintenance of COPD demonstrates an advancement in patient care for a disease with significant morbidity and mortality. Ensifentrine could be a viable option as adjunct therapy for patients still experiencing symptoms despite treatment with currently recommended therapies.</p>","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":" ","pages":"242-248"},"PeriodicalIF":1.5,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12187689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144506041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vamorolone Versus Traditional Glucocorticoids in Duchenne Muscular Dystrophy: A Review and Meta-Analysis of Efficacy and Safety.","authors":"Dawood Javed, Abdullah Javed, Faran Ahmed Jajja, Ahmed Jahanzeb","doi":"10.1177/87551225251349402","DOIUrl":"10.1177/87551225251349402","url":null,"abstract":"<p><p><b>Objective:</b> This meta-analysis evaluates the efficacy and safety of vamorolone, a dissociative glucocorticoid, compared with traditional glucocorticoids in treating Duchenne muscular dystrophy (DMD), aiming to assess its potential as a safer alternative with comparable therapeutic benefits. <b>Data Sources:</b> A systematic search was conducted in PubMed (MEDLINE), Embase, and Web of Science from inception till June 2024. Search terms included (Vamorolone) AND (Corticosteroids OR Glucocorticoids OR Prednisone) AND (Duchenne Muscular Dystrophy OR related terms). Only randomized controlled trials (RCTs) and observational studies were included, with no language restrictions. <b>Study Selection and Data Extraction:</b> From 276 identified reports, 135 were screened after duplicate removal, and 30 underwent full-text review. Five studies (2 RCTs, 2 observational, 1 nonrandomized trial) involving 370 patients were included. Two reviewers independently extracted data on efficacy (TTSTAND, TTRW, TTCLIMB velocities) and safety (height percentile, body mass index-z score, osteocalcin, P1NP) using Microsoft Excel, resolving discrepancies through consensus. <b>Data Synthesis:</b> Vamorolone significantly improved TTSTAND (MD = -0.03, 95% confidence interval [CI] = -0.06 to -0.004, <i>P</i> = .02), TTRW (MD = -0.11, 95% CI = -0.22 to -0.01, <i>P</i> = .04), and TTCLIMB velocities (MD = -0.04, 95% CI = -0.08 to -0.003, <i>P</i> = .03). Safety outcomes showed enhanced height percentile (MD = 16.28, 95% CI = 6.31-26.25, <i>P</i> = .001) and bone biomarkers (osteocalcin: MD = 15.68, <i>P</i> < .00001; P1NP: MD = 158.34, <i>P</i> < .00001), with no significant body mass index-z score difference. <b>Conclusions:</b> Vamorolone offers comparable efficacy with traditional glucocorticoids in DMD, with improved motor function and safer profiles in growth and bone health, suggesting its potential to transform DMD management.</p>","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":" ","pages":"233-241"},"PeriodicalIF":1.5,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12187702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144506042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}