Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy最新文献

{"title":"Comparative Effectiveness and Safety of Ticagrelor versus Prasugrel in Patients with Acute Coronary Syndrome: A Retrospective Cohort Analysis","authors":"G. Dawwas, E. Dietrich, D. Winchester, A. Winterstein, R. Segal, Haesuk Park","doi":"10.1002/phar.2311","DOIUrl":"https://doi.org/10.1002/phar.2311","url":null,"abstract":"To compare the effectiveness and safety of ticagrelor versus prasugrel in preventing recurrent cardiovascular disease (CVD) and major bleeding events in patients with acute coronary syndrome (ACS).","PeriodicalId":19812,"journal":{"name":"Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81327763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bevacizumab Use and the Risk of Arterial and Venous Thromboembolism in Patients with High-Grade Gliomas: A Nested Case-Control Study.","authors":"Inyoung Lee, Sruthi Adimadhyam, Edith A Nutescu, Jifang Zhou, Alemseged A Asfaw, Karen I Sweiss, Pritesh R Patel, Gregory S Calip","doi":"10.1002/phar.2310","DOIUrl":"10.1002/phar.2310","url":null,"abstract":"<p><strong>Study objective: </strong>Bevacizumab is used in the treatment of recurrent glioblastoma, but evidence is limited on the incidence of thromboembolic complications regarding the use of this drug in real-world settings. We evaluated the risk of arterial thromboembolism (ATE) and venous thromboembolism (VTE) associated with the use of bevacizumab among adults diagnosed with high-grade gliomas in a commercially insured U.S.</p><p><strong>Population: </strong></p><p><strong>Design: </strong>Nested case-control study.</p><p><strong>Data source: </strong>Truven Health MarketScan Commercial and Medicare Supplemental health claims databases (2009-2015).</p><p><strong>Patients: </strong>A total of 2157 patients with high-grade gliomas who underwent incident (first-time) craniotomy, radiation, and concurrent temozolomide treatment between 2009 and 2015 were identified. Overall, 25 cases of ATE and 99 cases of VTE were each identified in this cohort, and each case was matched to up to 10 controls (170 for ATE and 819 for VTE) based on sex, age, quarter year of index time, and follow-up duration by using incidence density sampling without replacement from the overall cohort. Controls were at risk for the outcome of interest (ATE or VTE) at the time of case occurrence and survived at least as long as their referent case.</p><p><strong>Measurements and main results: </strong>Exposure to bevacizumab was determined during inpatient or outpatient encounters between the index date (date of the incident craniotomy) and the ATE or VTE event or corresponding matched control date. Multivariable conditional logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the risk of ATE and VTE separately. A higher proportion of patients with ATE received bevacizumab compared with controls (28% vs 17%; adjusted OR 1.51, 95% CI 0.54-4.24), but this excess in odds was not statistically significant. Similarly, bevacizumab was not significantly associated with VTE (13% vs 9%; adjusted OR 1.40, 95% CI 0.71-2.75).</p><p><strong>Conclusion: </strong>We found no significant association between the use of bevacizumab and the occurrence of thromboembolic events in patients with high-grade gliomas, although our study was limited by the small number of ATE events. Because the potential for complications from arterial thrombosis cannot be completely ruled out, further research is needed to confirm the thromboembolic safety of bevacizumab in a larger sample of patients with high-grade gliomas.</p>","PeriodicalId":19812,"journal":{"name":"Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7395667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91015494","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":"Calcium Channel Blocker Use and the Risk for Prostate Cancer: A Population‐Based Nested Case‐Control Study","authors":"","doi":"10.1002/phar.2317","DOIUrl":"https://doi.org/10.1002/phar.2317","url":null,"abstract":"In Rotshild et al. some typographical errors were published in “Material and Methods” and “Discussion” sections. Material and Methods section Data Source The word “logistic” in the penultimate sentence should have been “logical”. The correct sentence is: . . . The CHS database system validates the diagnoses of chronic diseases and malignancies by logical checks, such as comparing diagnoses from various providers, and by direct authentication of the diagnoses of primary physicians. . . . Discussion section The word “no” should have been added between “have” and “reason” in the penultimate sentence. The correct sentence is: . . . However, we have no reason to assume the mortality rates would be differential between the exposure groups, as the study population is based on a homogeneous cohort of patients using antihypertensive drugs. We apologize for these errors. Reference 1. Rotshild V, Azoulay L, Feldhamer I, Perlman A, Muszkat M, Matok I. Calcium channel blocker use and the risk for prostate cancer: a population-based nested case-control study. Pharmacotherapy 2019;39(6):690–6. https://doi.org/10.1002/phar.2266","PeriodicalId":19812,"journal":{"name":"Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86821168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transitioning Hospitalized Patients with Opioid Use Disorder from Methadone to Buprenorphine without a Period of Opioid Abstinence Using a Microdosing Protocol","authors":"Dale Terasaki, Christopher Smith, S. Calcaterra","doi":"10.1002/phar.2313","DOIUrl":"https://doi.org/10.1002/phar.2313","url":null,"abstract":"Buprenorphine, a partial μ‐opioid agonist, is an effective treatment for opioid use disorder that conventionally requires symptoms of withdrawal before initiation to avoid precipitating withdrawal. Our institution implemented a microdosing approach to transition patients from full μ‐opioid agonists to buprenorphine without requiring patients to undergo a period of opioid abstinence. Little has been published about this strategy in the inpatient setting in the United States, and even less has been published dealing with the transition from methadone to buprenorphine. Our objective was to demonstrate that a microdosing protocol to transition patients from methadone to buprenorphine can be feasibly implemented in a U.S. hospital setting.","PeriodicalId":19812,"journal":{"name":"Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79441530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alternative Viewpoint of “Alteplase Therapy for Acute Ischemic Stroke in Pregnancy: Two Case Reports and a Systematic Review of the Literature”","authors":"B. Gilbert, J. Dingman, Jacob A. Reeder, Amy L. Kiskaddon","doi":"10.1002/phar.2304","DOIUrl":"https://doi.org/10.1002/phar.2304","url":null,"abstract":"We read with great enthusiasm the article by Ryman et al and wish to highlight a few key concepts not mentioned in their article. Although a large proportion of data for alteplase in acute ischemic stroke (AIS) remains controversial, we propose that the hemostatic variances seen during pregnancy make the women in this patient population ideal candidates for thrombolysis. Pregnancy is associated with a hypercoagulable state secondary to increased clotting factor production, decreased protein C and S activity, and decreased natural thrombolytic activity. It would be expected that clots formed during pregnancy would be fibrin rich, presenting an ideal therapeutic target for alteplase. This is in contrast to the typically more calcified composition of cardioembolic strokes, offering a theoretical explanation for the varied responses to alteplase seen in patients with this type of stroke. Also, although actual body weight has been the only dosing strategy evaluated for AIS during pregnancy in the literature thus far, lower dosing strategies were evaluated in select cohorts that have largely shown success. 5 Given the variances during pregnancy in volume of distribution, cardiac output, plasminogen activator inhibitor concentration, and hepatic clearance, it is reasonable to expect altered serum alteplase concentrations that may affect drug concentration and delivery to affected vessels. Therefore, optimal dosing strategies throughout each trimester should continue to be an area of active research. Given that the fatal bleed risk extends beyond just intracranial hemorrhages for pregnant patients, a question remains as to whether those at high risk for uterine hemorrhage or with mild stroke severity should bypass alteplase administration in favor of thrombectomy or antiplatelet therapies. Lastly, with increasing use of tenecteplase for ischemic stroke, it will be important to consider if alteplase alone or fibrinolytics as a class are safe and effective in pregnancy.","PeriodicalId":19812,"journal":{"name":"Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86779428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drs. Ryman et al. reply to Drs. Gilbert et al. and Drs. Guner et al.","authors":"Klayton M Ryman, Wilson D Pace, Shawn Smith, Gabriel V Fontaine","doi":"10.1002/phar.2302","DOIUrl":"10.1002/phar.2302","url":null,"abstract":"","PeriodicalId":19812,"journal":{"name":"Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87283381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Critique of “Alteplase Therapy for Acute Ischemic Stroke in Pregnancy: Two Case Reports and a Systematic Review of the Literature”","authors":"A. Guner, M. Kalçık, M. Özkan","doi":"10.1002/phar.2303","DOIUrl":"https://doi.org/10.1002/phar.2303","url":null,"abstract":"We recently read with great interest the article by Ryman et al entitled “Alteplase Therapy for Acute Ischemic Stroke in Pregnancy: Two Case Reports and a Systematic Review of the Literature.” We would like to congratulate the authors for achieving a successful outcome in such a high-risk patient for acute ischemic stroke (AIS) during pregnancy, and we want to share our experience in pregnant women with prosthetic valve thrombosis (PVT) who underwent AIS during thrombolytic therapy (TT). A prosthetic heart valve is highly thrombogenic and increases the risk of thrombosis up to 10% (especially a mechanical prosthetic valve) with the procoagulant condition of pregnancy. We previously reported that a low-dose slow infusion of tissue-type plasminogen activator (tPA [alteplase]) with repeated doses as needed is an effective therapy with an excellent thrombolytic success rate for the treatment of PVT in pregnant women and that TT should be considered firstline therapy in pregnant patients with PVT. The most feared complication is the risk of cerebral embolism that can be up to 5–6% for left-sided PVT. The first 6 hours after cerebral thromboembolism are crucial, and early diagnosis and exclusion of hemorrhage by multidetector computed tomography is very important. Although the recommended dose of alteplase according to the stroke guideline is 0.9 mg/kg (maximum dose 90 mg) for 60 minutes for AIS according to current guidelines, with 10% of the dose given as a bolus for 1 minute, we used lower doses for safety concerns. Our success reported in our case reports may have been due to the early diagnosis and fresh nature of the thrombus. 4 Faster TT regimens may induce new thromboembolisms in patients with concomitant PVT. In conclusion, low-dose and slow-infusion TT is effective and safe in AIS during PVT treatment.","PeriodicalId":19812,"journal":{"name":"Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79420617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2018 ACCP Updates in Therapeutics","authors":"","doi":"10.1002/phar.2122","DOIUrl":"https://doi.org/10.1002/phar.2122","url":null,"abstract":"","PeriodicalId":19812,"journal":{"name":"Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85285404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ACCP Updates in Therapeutics® 2018 May 23–24, 2018 UT Clinical Pharmacy Forum","authors":"","doi":"10.1002/phar.2101","DOIUrl":"https://doi.org/10.1002/phar.2101","url":null,"abstract":"","PeriodicalId":19812,"journal":{"name":"Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83363400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ACCP Virtual Poster Symposium","authors":"Pouran Manzouri","doi":"10.1002/phar.1964","DOIUrl":"https://doi.org/10.1002/phar.1964","url":null,"abstract":"","PeriodicalId":19812,"journal":{"name":"Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85019908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}