Pharmacotherapy最新文献

{"title":"Characterization of lamotrigine disposition changes during and after pregnancy in women with epilepsy.","authors":"Ashwin Karanam, Page B Pennell, Kimford J Meador, Yuhan Long, Angela K Birnbaum","doi":"10.1002/phar.4640","DOIUrl":"10.1002/phar.4640","url":null,"abstract":"<p><strong>Background: </strong>Lamotrigine clearance can change drastically in pregnant women with epilepsy (PWWE) making it difficult to assess the need for dosing adjustments. Our objective was to characterize lamotrigine pharmacokinetics in PWWE during pregnancy and postpartum along with a control group of nonpregnant women with epilepsy (NPWWE).</p><p><strong>Methods: </strong>The Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs (MONEAD) study was a prospective, observational, 20 site, cohort study conducted in the United States (December 2012 and February 2016). Inclusion criteria included patients aged 14-45 years, gestational age <20 weeks at the time of recruitment, IQ >70 points, and receiving lamotrigine. PWWE participated throughout pregnancy and 18 months postpartum with NPWWE having matched visit intervals. Plasma drug and hormone concentrations were measured at each of the seven visits. A population mixed-effects modeling approach was used to describe lamotrigine clearance change.</p><p><strong>Results: </strong>221 (170 PWWE, 51 NPWWE) women were included. Baseline apparent clearance (clearance for NPWWE and when not pregnant for PWWE) was identical between the two groups (2.79 L/hour. with 36% between-subject variability). Two subpopulations were identified in PWWE: ~91% of PWWE had a maximum increase to 275% of baseline clearance with 50% of the maximum increase reached at 12 weeks gestational age and ~9% had no significant change in clearance during gestation. Following delivery, a first-order mono-exponential decline (1.27 weeks^-1) in clearance as a function of postpartum week described a return of clearance to baseline. The use of estrogen-based medication and enzyme-inducing antiseizure medications increased nonpregnant clearance by a further 0.33-fold and 0.84-fold, respectively.</p><p><strong>Discussion: </strong>During pregnancy, 91% of PWWE experience a 275% change from nonpregnant baseline in lamotrigine clearance whereas the remaining PWWE experience little to no change. Nonpregnant baseline lamotrigine clearance was higher in both PWWE and NPWWE with the administration of oral estrogen-containing medications. Our results are of clinical importance as they indicate a subpopulation without the need for substantial dose changes during pregnancy and a source of potential difference across nonpregnant individuals.</p>","PeriodicalId":20013,"journal":{"name":"Pharmacotherapy","volume":"45 1","pages":"33-42"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11755693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to comment on \"Delirium event and associated treatment modifications among older adults with Alzheimer's disease: An interrupted time-series analysis of Medicare data\".","authors":"Rajender R Aparasu, Ashna Talwar","doi":"10.1002/phar.4637","DOIUrl":"https://doi.org/10.1002/phar.4637","url":null,"abstract":"","PeriodicalId":20013,"journal":{"name":"Pharmacotherapy","volume":"45 1","pages":"71"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of atrial fibrillation with lamotrigine: An observational cohort study.","authors":"Sodam Kim, Landon Welch, Bertha De Los Santos, Przemysław B Radwański, Mark A Munger, Kibum Kim","doi":"10.1002/phar.4633","DOIUrl":"10.1002/phar.4633","url":null,"abstract":"<p><strong>Background: </strong>Drug-induced atrial fibrillation (AF) is recognized as an important causal association. Lamotrigine (LTG) is a widely prescribed neurological agent with Class IB antiarrhythmic properties at therapeutically relevant concentrations. The United States Food and Drug Administration has issued a warning for a higher risk of LTG proarrhythmic events in patients with structural heart disease (SHD) and/or myocardial ischemia. This study evaluated the incidence of AF with LTG use.</p><p><strong>Methods: </strong>A retrospective observational study was performed using a large healthcare claims database of adult participants analyzing 2 years AF incidence. The analytic cohort included adult participants with bipolar I disorder (BPD), partial seizures (PSZ), or generalized tonic-clonic seizures (GTSZ). Exposure to LTG was compared with commonly prescribed alternative agents as the control comparators (CTR). Participants were free from supraventricular or ventricular arrhythmias during the 6 months baseline period prior to the index LTG or CTR date. Kaplan-Meier estimator calculated 2 years cumulative AF incidence, with participants censored at last enrollment, treatment switching, or discontinuation. The AF association hazard ratios (HR) for LTG versus CTR were adjusted for baseline characteristics.</p><p><strong>Results: </strong>The analytic cohort with BPD, PSZ, and GTSZ consisted, respectively, of 150,470 LTG versus 204,704 CTR, 9565 LTG versus 21,595 CTR, and 5505 LTG versus 15,513 CTR patients. In a predominantly middle-aged female population at baseline, the prevalence of cardiovascular conditions was low. The 12 months cumulative incidence of AF for LTG versus CTR was 0.764% versus 0.642% among BPD, 0.833% versus 0.646% among PSZ, and 0.585% versus 0.338% among GTSZ, respectively. The adjusted 365-day HR [95% confidence interval CI] of AF for LTG versus CTR in the BPD, PSZ, and CTSZ groups was 1.257 [1.088-1.453], 1.651 [1.104-2.468], and 1.451 [0.770-2.734], respectively.</p><p><strong>Conclusions: </strong>In adult AF-naïve participants, LTG has a strong association with increased AF risk compared with commonly prescribed alternatives.</p>","PeriodicalId":20013,"journal":{"name":"Pharmacotherapy","volume":" ","pages":"20-32"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"Delirium event and associated treatment modifications among older adults with Alzheimer's disease: An interrupted time-series analysis of Medicare data\".","authors":"Shih-Jie Wang, Lien-Chung Wei, Hsien-Jane Chiu","doi":"10.1002/phar.4636","DOIUrl":"https://doi.org/10.1002/phar.4636","url":null,"abstract":"","PeriodicalId":20013,"journal":{"name":"Pharmacotherapy","volume":"45 1","pages":"70"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacokinetics of cefiderocol in a patient with carbapenem-resistant Acinetobacter baumannii ventriculitis: A case report.","authors":"Natalie A Finch, Alejandro Granillo, Nazanin Pouya, Adarsh Bhimraj, William R Miller, Vincent H Tam","doi":"10.1002/phar.4632","DOIUrl":"10.1002/phar.4632","url":null,"abstract":"<p><strong>Objective: </strong>Cefiderocol is a novel antibiotic used to treat multidrug-resistant bacterial infections. However, there is limited data on its effectiveness for ventriculitis. The objective of this study was to evaluate cefiderocol concentrations in both serum and cerebrospinal fluid (CSF) during the treatment of ventriculitis.</p><p><strong>Method: </strong>A 54-year-old patient with carbapenem-resistant Acinetobacter baumannii ventriculitis was given cefiderocol intravenously 2 g every 6 h (each dose administered over 3 h). Serial samples were obtained over a dosing interval at steady state, and cefiderocol concentrations in serum and CSF were assayed by liquid chromatography-tandem mass spectrometry (LC-MS/MS). Cefiderocol serum concentration-time profile was characterized by a one-compartment model with zero-order input. Penetration into CSF was estimated as the CSF AUC/unbound serum AUC ratio.</p><p><strong>Results: </strong>Observed total serum concentrations ranged between 24.6 and 76.7 mg/L, while CSF concentrations were approximately 10.0 mg/L. The AUC_0-6 of the free drug in serum and CSF were 181.6 and 60.2 mg h/L, respectively.</p><p><strong>Conclusion: </strong>We observed minimal fluctuation of cefiderocol concentrations in CSF, questioning the conventional reliance on CSF/serum area under the curve (AUC) ratio as a measure of CNS penetration. Our experience suggests that a single CSF concentration (random or trough) could be directly compared to the minimum inhibitory concentration, offering a potentially simpler approach to evaluate dosing adequacy.</p>","PeriodicalId":20013,"journal":{"name":"Pharmacotherapy","volume":" ","pages":"66-69"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11757030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current and emerging PCSK9-directed therapies to reduce LDL-C and ASCVD risk: A state-of-the-art review.","authors":"Candice L Garwood, Katherine P Cabral, Roy Brown, Dave L Dixon","doi":"10.1002/phar.4635","DOIUrl":"10.1002/phar.4635","url":null,"abstract":"<p><p>Atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of death worldwide. Lowering low-density lipoprotein cholesterol (LDL-C) levels is a primary strategy to reduce ASCVD risk. Although statin therapy remains the initial therapy of choice to reduce LDL-C and ASCVD risk, statin intolerance and suboptimal LDL-C lowering response prompts the need for additional non-statin therapies. Ezetimibe and bempedoic acid are reasonable options but they modestly reduce LDL-C levels (15% to 25%). Therapies directed at the proprotein convertase subtilisin/kexin type 9 (PCSK9) enzyme, however, reduce LDL-C levels by 50%-60% when added to background statin therapy. PCSK9 is an enzyme synthesized by the liver that facilitates the degradation of LDL receptors and prevents their recycling to the hepatocyte surface to remove LDL-C from circulation. Approaches to inhibit this effect have centered on monoclonal antibodies (mAbs) (alirocumab, evolocumab) targeting PCSK9 functionality and small interfering RNA (siRNA) therapies (inclisiran) targeting the hepatic synthesis of PCSK9. Randomized controlled trials have demonstrated beneficial cardiovascular outcomes of PCSK9 mAbs, but such evidence is not yet available for inclisiran. Current clinical practice guidelines generally recommend PCSK9-directed therapies for higher-risk patients with established ASCVD and those with familial hypercholesterolemia. This approach is, in part, due to their cost and uncertain economic value, but also because these therapies require subcutaneous administration, which is not preferred by some patients. Oral therapies targeting PCSK9 are, however, in development. This scoping review covers the development of current and emerging PCSK9-directed therapies, their efficacy, safety, and role in clinical practice.</p>","PeriodicalId":20013,"journal":{"name":"Pharmacotherapy","volume":" ","pages":"54-65"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11755694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilization and associated factors of TPMT testing among Australian adults receiving thiopurines: A national retrospective data-linkage study.","authors":"Chin Hang Yiu, Bella D Ianni, Kenji Fujita, Edwin C K Tan, Sarah N Hilmer, Christine Y Lu","doi":"10.1002/phar.4631","DOIUrl":"10.1002/phar.4631","url":null,"abstract":"<p><strong>Introduction: </strong>Thiopurine drugs are metabolized by thiopurine methyltransferase (TPMT) and low TPMT activity can result in severe adverse drug reactions. Therefore, TPMT testing is recommended for individuals receiving thiopurines to reduce the risk of toxicity.</p><p><strong>Objectives: </strong>The objectives of this study were to assess the rate of TPMT testing among individuals receiving thiopurines and explore factors associated with undergoing TPMT testing in Australia.</p><p><strong>Methods: </strong>This retrospective cohort study utilized administrative data from the Pharmaceutical Benefits Scheme (PBS), Medicare Benefits Schedule (MBS), and the 2021 Census, accessed via the Person Level Integrated Data Asset (PLIDA) at the Australian Bureau of Statistics (ABS) DataLab. Individuals receiving thiopurines aged 18 years or above were identified using PBS data and exposure to TPMT testing was determined using MBS data. Multivariate logistic regression was performed to identify factors associated with TPMT testing.</p><p><strong>Results: </strong>A total of 62,574 prevalent thiopurine users were identified between 2020 and 2022. Of these, 20,327 (32.5%) underwent TPMT testing (2011-2022). The most significant factor associated with TPMT testing was having at least one thiopurine medication prescribed by a medical specialist (adjusted odds ratio [aOR] 2.12, 95% confidence interval [CI] 2.02-2.22), compared to having medication solely prescribed by primary care physicians (PCPs). Other significant factors associated with TPMT testing included speaking a non-English language at home (aOR 1.29, 95% CI 1.22-1.36), having no chronic health conditions (aOR 1.18, 95% CI 1.13-1.24), not requiring assistance with core activities (aOR 1.16, 95% CI 1.08-1.23), and having a higher educational attainment (aOR 1.11, 95% CI 1.06-1.11). Compared to living in major cities, individuals living in remote areas were significantly less likely to undergo testing (aOR 0.49, 95% CI 0.39-0.60).</p><p><strong>Conclusion: </strong>Our study highlights the low utilization of TPMT testing in Australia and suggests the need for targeted interventions to address disparities and improve TPMT testing.</p>","PeriodicalId":20013,"journal":{"name":"Pharmacotherapy","volume":" ","pages":"12-19"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between mineralocorticoid receptor antagonists and kidney harm: A systematic review and meta-analysis of randomized controlled trials.","authors":"Satoru Mitsuboshi, Makoto Morizumi, Shungo Imai, Satoko Hori, Kazumasa Kotake","doi":"10.1002/phar.4618","DOIUrl":"10.1002/phar.4618","url":null,"abstract":"<p><p>Conflicting data have been reported on the association between mineralocorticoid receptor antagonists (MRAs) and acute kidney injury (AKI). This systematic review and meta-analysis aimed to evaluate whether MRAs affect the risk of AKI. MEDLINE via PubMed, the Cochrane Central Register of Controlled Trials, and the ClinicalTrials.gov website were comprehensively searched to extract all relevant studies. Randomized controlled trials (RCTs) were selected that compared MRA versus placebo or no treatment and had study populations consisting of patients with heart or kidney disease. The primary outcome was AKI. The secondary outcome was kidney injury, including AKI and non-AKI. Thirty-three studies were included in the meta-analysis. MRAs were not associated with an increased risk of AKI (risk ratio [RR] 1.13, 95% confidence interval [CI] 0.88-1.46, p = 0.29, I² = 15%, 18,065 patients, 13 RCTs, moderate certainty). For the secondary outcome, MRAs were associated with an increased risk of kidney injury (RR 1.52, 95% CI 1.24-1.87, p < 0.01, I² = 48%, 27,492 patients, 33 RCTs, low certainty). In particular, only canrenone (RR 5.39, 95% CI 2.17-13.37, p < 0.01) and spironolactone (RR 1.78, 95% CI 1.48-2.14, p < 0.01) were associated with an increased risk of kidney injury. However, eplerenone and finerenone seem not to increase the risk of kidney injury in patients with heart or kidney disease. The selection of MRAs might influence the risk of kidney-associated events. Further studies focusing on individual MRAs may be needed to clarify these differences.</p>","PeriodicalId":20013,"journal":{"name":"Pharmacotherapy","volume":" ","pages":"43-53"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Precision medicine to identify, prevent, and treat pediatric obesity.","authors":"Emma M Tillman, Selsbiel Mertami","doi":"10.1002/phar.4626","DOIUrl":"10.1002/phar.4626","url":null,"abstract":"<p><p>Pediatric obesity is a growing health concern that has many secondary adverse health implications. Personalized medicine is a tool that can be used to optimize diagnosis and treatments of many diseases. In this review, we will focus on three areas related to the genetics of pediatric obesity: (i) genetic causes predisposing to pediatric obesity, (ii) pharmacogenomics that may predict weight gain associated with pharmacotherapy, and (iii) pharmacogenomics of anti-obesity pharmacotherapy. This narrative review evaluates genetic cause of pediatric obesity and how genetic findings can be used to optimize pharmacotherapy to minimize weight gain and optimize obesity treatment in pediatric patients. Pediatric obesity has many genetic causes including genomic obesity syndromes and monogenic obesity disorders. Several genetic etiologies of obesity have current or emerging targeted genetic therapies. Pharmacogenomic (PGx) targets associated with pharmacotherapy-induced weight gain have been identified for antipsychotic, antiepileptic, antidepressant therapies, and steroids, yet to date no clinical guidelines exist for application use of PGx to tailor pharmacotherapy to avoid weight gain. As legislation evolves for genetic testing coverage and technology advances, this will decrease cost and expand access to genetic testing. This will result in identification of potential genetic causes of obesity and genes that predispose to pharmacotherapy-induced weight gain. Advances in precision medicine can ultimately lead to development of clinical practice guidelines on how to apply genetic findings to optimize pharmacotherapy to treat genetic targets of obesity and avoid weight gain as an adverse event associated with pharmacotherapy.</p>","PeriodicalId":20013,"journal":{"name":"Pharmacotherapy","volume":" ","pages":"939-947"},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11687202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aztreonam-avibactam: The dynamic duo against multidrug-resistant gram-negative pathogens.","authors":"Mohammed Al Musawa, Callan R Bleick, Shelbye R Herbin, Kaylee E Caniff, Sean R Van Helden, Michael J Rybak","doi":"10.1002/phar.4629","DOIUrl":"10.1002/phar.4629","url":null,"abstract":"<p><p>Antimicrobial resistance poses a significant public health challenge, particularly with the rise of gram-negative hospital-acquired infections resistant to carbapenems. Aztreonam-avibactam (ATM-AVI) is a promising new combination therapy designed to combat multidrug-resistant (MDR) gram-negative bacteria, including those producing metallo-β-lactamases (MBLs). Aztreonam, a monobactam antibiotic, is resistant to hydrolysis by MBLs but can be degraded by other β-lactamases. Avibactam, a novel non-β-lactam β-lactamase inhibitor, effectively neutralizes extended-spectrum β-lactamases (ESBLs) and AmpC β-lactamases, restoring aztreonam's efficacy against resistant pathogens. This review covers the chemistry, mechanisms of action, spectrum of activity, pharmacokinetics, pharmacodynamics, and clinical efficacy of ATM-AVI. ATM-AVI combination has shown efficacy against a wide range of resistant Enterobacterales and other gram-negative bacteria in both in vitro and clinical studies. Pharmacokinetic and pharmacodynamic analyses demonstrate that ATM-AVI maintains effective drug concentrations in the body, with dose adjustments recommended for patients with renal impairment. Clinical trials, including the REVISIT and ASSEMBLE studies, have demonstrated the safety and efficacy of ATM-AVI in treating complicated intra-abdominal infections (cIAI), urinary tract infections (UTIs), and hospital-acquired pneumonia (HAP) caused by MDR gram-negative pathogens. The European Medicines Agency (EMA) has approved ATM-AVI for these indications, and further research is ongoing to optimize dosing regimens and expand its clinical use. This combination represents a critical advancement in the fight against antimicrobial resistance, offering a new therapeutic option for treating severe infections caused by MDR gram-negative, including MBL-producing, bacteria.</p>","PeriodicalId":20013,"journal":{"name":"Pharmacotherapy","volume":" ","pages":"927-938"},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11687205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142731826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}