Pharmacotherapy最新文献

{"title":"Safety of Tenecteplase in Stroke Mimics Compared With Acute Ischemic Stroke: A Retrospective Cohort Study.","authors":"A Shaun Rowe, Brian Wiseman, Leslie A Hamilton, Sarah Crowell, Lillian McCampbell, Destiny Ford","doi":"10.1002/phar.70112","DOIUrl":"10.1002/phar.70112","url":null,"abstract":"<p><strong>Background: </strong>Acute ischemic stroke (AIS) accounts for 87% of all strokes and is associated with high morbidity and mortality. Stroke mimics, conditions that present with stroke-like symptoms but are not AIS, represent an important proportion of stroke cases. Tenecteplase, an alteplase variant with higher fibrin affinity and a longer half-life, has recently gained approval for the treatment of AIS. Limited evidence exists on the safety of tenecteplase in stroke mimics.</p><p><strong>Objective: </strong>The objective of this study was to determine the incidence of intracranial hemorrhage in patients with stroke-like signs and symptoms who received tenecteplase with and without a confirmed diagnosis of AIS.</p><p><strong>Methods: </strong>This was a single-center, retrospective cohort study conducted at a comprehensive stroke center. Patients who received tenecteplase for stroke-like symptoms from June 2020 to December 2021 were included. Patients were grouped based on AIS diagnosis confirmed by neuroimaging or discharge diagnosis. The primary outcome was the incidence of intracranial hemorrhage, and secondary outcomes included incidence of symptomatic and asymptomatic intracranial hemorrhage, extracranial hemorrhage, hospital length of stay, angioedema development, and discharge disposition.</p><p><strong>Results: </strong>Of 250 patients, 174 were diagnosed with AIS and 76 with stroke mimics. Patients with AIS were older (69 years [SD: 13.8 years] vs. 62.3 years [SD: 16.1 years]; p = 0.0008), had higher hypertension prevalence (132 [75.9%] vs. 44 [57.9%]; p = 0.0042), and lower previous stroke prevalence (9 [5.2%] vs. 11 [14.5%]; p = 0.0126) compared with stroke-mimic patients, respectively. Patients with AIS had shorter median tenecteplase door-to-needle times (38.5 min [IQR: 30 min, 53 min] vs. 46.5 min [IQR: 34.5 min, 64.5 min]; p = 0.0154) compared with stroke mimics. Intracranial hemorrhage occurred in 11.5% of patients with AIS and none in stroke mimics (p = 0.0021). Symptomatic hemorrhage rates were similar between groups. Patients with AIS had longer median hospital stays (3 days [IQR: 2 days, 6 days] vs. 2 days [IQR: 2 days, 4 days]; p = 0.0018). Discharge dispositions and cases of angioedema were similar between groups.</p><p><strong>Conclusion: </strong>Tenecteplase appears safe for stroke mimics, with no disproportionate harm compared to patients with AIS. This study further supports the safety of tenecteplase in stroke mimics, aiding rapid treatment decisions in stroke-like presentations.</p>","PeriodicalId":20013,"journal":{"name":"Pharmacotherapy","volume":"46 1","pages":"e70112"},"PeriodicalIF":4.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146019009","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":"External Validation of the Fraser Equation for Estimation of Free Valproate Concentrations in Critically Ill Adults.","authors":"Andrew J Webb, Caitlin S Brown, JiTong Liu, Richard R Riker, Natasha D Lopez, Eric S Rosenthal, Sahar F Zafar, David J Gagnon","doi":"10.1002/phar.70079","DOIUrl":"10.1002/phar.70079","url":null,"abstract":"<p><strong>Background: </strong>Critically ill patients may be overexposed to valproate because altered protein binding leads to a disproportionate free valproate fraction. The Fraser equation was derived and internally validated to estimate critically ill patients' free valproate concentrations, but it requires external validation.</p><p><strong>Methods: </strong>Adult intensive care unit (ICU) patients at two academic centers with concurrently measured free and total valproate concentrations were included. Free valproate concentrations were estimated using the Fraser equation which includes total valproate, albumin and BUN concentration, and whether the patient received propofol or aspirin. The primary outcome was Fraser equation performance, assessed using Bland-Altman methods. Comparative performance against estimates from the Doré equation (an alternative predictive equation), therapeutic concordance using a target free valproate range of 5-15 mg/L, and equation improvements were explored.</p><p><strong>Results: </strong>Overall, 315 patients and 556 free-total valproate concentration pairs were included. The mean (±SD) age was 58 (±17) years and 90 (29%) patients were on valproate prior to hospital admission. The Fraser equation estimated free valproate concentrations were correlated with measured concentrations (r = 0.728) with a negative bias (mean bias -2.77 mg/L, 95% LOA -18.9, 13.4). The Fraser equation increasingly underestimated measured concentrations as measured concentrations increased. 71% of Fraser equation estimates were therapeutically concordant (e.g., estimate and measured both within reference range) compared to 61.9% of Doré estimates (p = 0.001). Fraser equation modifications led to minor performance improvements but did not overcome worsening underestimation with higher measured free valproate concentrations.</p><p><strong>Conclusion: </strong>The Fraser equation was moderately accurate and corresponded with an appropriate interpretation for 71% of free valproate concentrations. Worse underestimation with higher measured free valproate concentrations suggests direct measurement of free valproate concentrations is warranted. While the Fraser equation could complement therapeutic decision making at centers where direct free valproate measurements are unavailable or slow to return, its accuracy is currently insufficient to replace direct measurement.</p>","PeriodicalId":20013,"journal":{"name":"Pharmacotherapy","volume":" ","pages":"831-839"},"PeriodicalIF":4.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12668601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145541828","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":"Correlation Between Analgesic and Sedative Drug Withdrawal and Salivary Cortisol Levels in Children in PICUs: A Prospective Cohort Study.","authors":"Yaping Zhan, Shu Lin, Lingjie Lin, Min Lin, Yi Wang, Shihui Bao","doi":"10.1002/phar.70082","DOIUrl":"10.1002/phar.70082","url":null,"abstract":"<p><strong>Background and objective: </strong>Opioids and benzodiazepines are the most widely utilized sedative-analgesic agents in pediatric intensive care units (PICUs). However, prolonged exposure to these drugs may lead to drug tolerance and dependence, whereas abrupt discontinuation or rapid dose reduction can precipitate withdrawal symptoms, which increase the risk of complications such as medical device dislodgement, exacerbated patient discomfort, and prolonged mechanical ventilation dependency and hospital stays. Studies have revealed that up to 94% of children in PICUs develop iatrogenic withdrawal syndrome (IWS), but there is currently no gold standard for a definitive diagnosis of IWS. This study aims to explore the correlation between salivary cortisol levels, sedation-analgesia status, and the occurrence of IWS in critically ill children.</p><p><strong>Methods: </strong>A total of 118 critically ill children who were exposed to sedative and/or analgesic drugs for a continuous period of ≥ 5 days at Yuying Children's Hospital, Affiliated Second Hospital of Wenzhou Medical University, from October 2022 to September 2024, were screened, and 106 patients were included in the study. Based on the Sofia observation withdrawal symptoms scale (SOS) score, 42 patients were divided into the IWS group (SOS ≥ 4) and 64 patients into the non-IWS group (SOS < 4). The usage of sedative and analgesic drugs was compared between the two groups, as well as the salivary cortisol concentrations at 24, 48, and 72 h after drug withdrawal. The influencing factors of IWS occurrence and the predictive value of related indicators were analyzed.</p><p><strong>Results: </strong>The cumulative doses of sedative and analgesic drugs administered in the IWS group were statistically significantly higher than those in the non-IWS group (p < 0.05). The median salivary cortisol concentration in the IWS group was significantly higher at 24 h after drug discontinuation compared with the non-IWS group. Logistic results of binary regression analysis showed that a higher level of salivary cortisol at 24 h after discontinuation was an independent predictor for the occurrence of IWS (p < 0.05). Receiver operating characteristic (ROC) curve analysis indicated an area under the curve of 0.857 (95% confidence interval (CI): 0.782-0.932) with sensitivity and specificity of 88.1% and 84.4%, respectively.</p><p><strong>Conclusions: </strong>A statistically significant correlation was observed between salivary cortisol levels, the cumulative dosage of sedative-analgesic drugs, and the occurrence of IWS. Higher levels of salivary cortisol are a predictor of IWS occurrence. Detecting salivary cortisol levels has clinical application for early diagnosis of IWS and judgment of withdrawal severity in critically ill children.</p>","PeriodicalId":20013,"journal":{"name":"Pharmacotherapy","volume":" ","pages":"801-808"},"PeriodicalIF":3.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145541822","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":"Terlipressin Administration Strategies in Hepatorenal Syndrome-Acute Kidney Injury: A Narrative Review of Continuous Infusion and Intermittent Bolus Approaches.","authors":"Tien Q Pham, Stephanie N Bass, Jason R Yerke","doi":"10.1002/phar.70084","DOIUrl":"10.1002/phar.70084","url":null,"abstract":"<p><p>Hepatorenal syndrome-acute kidney injury (HRS-AKI) is a life-threatening complication of cirrhosis, marked by profound splanchnic vasodilation leading to renal hypoperfusion. Guidelines throughout the years have refined the definitions, classifications, and diagnostic criteria of HRS-AKI to promote earlier recognition and intervention. Vasoconstrictor therapy remains the cornerstone of the management of HRS-AKI. Among the available agents, terlipressin is the most well-studied and has been endorsed by multiple international guidelines as first-line therapy for HRS-AKI. Although approved by the United States Food and Drug Administration for use in HRS-AKI with an intermittent intravenous bolus dosing strategy, recent consensus guidance recommends continuous infusion as the preferred route of administration. This narrative review summarizes current evidence from clinical trials and comparative studies evaluating terlipressin continuous infusion versus intermittent bolus dosing strategies, with a focus on efficacy, safety, and operational considerations. Clinical trials comparing the two strategies have shown that the continuous infusion strategy provides comparable, and possibly superior, efficacy in HRS reversal compared to intermittent bolus dosing, while also demonstrating a lower incidence of adverse effects. Operational feasibility is supported by physical and chemical stability in various diluents over 24-h infusion periods; however, implementation challenges remain, including limited line compatibility data and line access issues in patients with cirrhosis. In conclusion, the terlipressin continuous infusion strategy appears to be an efficacious, safe, and operationally plausible alternative to intermittent bolus dosing and may be considered for routine use in clinical practice.</p>","PeriodicalId":20013,"journal":{"name":"Pharmacotherapy","volume":" ","pages":"852-861"},"PeriodicalIF":3.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145637555","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":"Real-World Use of Letermovir and Maribavir for CMV Prophylaxis and Treatment in Solid Organ Transplant Recipients: Clinical Outcomes and Resistance Patterns From a Dual-Center Cohort.","authors":"Man Ting Xu, Alissa Wright, Allison Mah, Nancy Matic, Christopher Lowe, Casara Hong, Sara Belga, Wan-Yun Polinna Tsai","doi":"10.1002/phar.70086","DOIUrl":"10.1002/phar.70086","url":null,"abstract":"<p><strong>Background: </strong>Cytomegalovirus (CMV) is a major opportunistic infection in solid organ transplant (SOT) recipients. Although valganciclovir is first-line for CMV treatment, its use may be limited by resistance and myelotoxicity. Letermovir (LET) and maribavir (MBV) are increasingly used as alternative therapies, though real-world outcomes remain incompletely defined. This study evaluated real-world outcomes of LET and MBV in SOT recipients for whom standard CMV therapy was inadequate or not feasible. Viral clearance, breakthrough infection, refractory infection, and resistance emergence were assessed.</p><p><strong>Methods: </strong>We conducted a retrospective cohort analysis of adult SOT patients receiving LET (2018-2025) and/or MBV (2019-2025) at two transplant centers. Primary outcomes included CMV breakthrough (≥ 500 IU/mL) during LET prophylaxis and CMV clearance (< 200 IU/mL) at the end of MBV treatment. Secondary outcomes included resistant, refractory, and recurrent CMV infection within 3 months post-therapy.</p><p><strong>Results: </strong>Among 47 LET courses (41 patients), breakthrough CMV occurred in 14/32 (44%) secondary prophylaxis (SP) courses (median viral load [VL]: 1037 IU/mL, interquartile range [IQR] 673-3427) but in none of the 15 primary prophylaxis (PP) courses. No resistance to LET was detected during or after prophylaxis. MBV was administered in 21 courses (17 patients); MBV-refractory/resistant (R/R) infection occurred in 8 courses (38%), and 11 (52%) courses achieved CMV clearance. Within 3 months post-MBV, 14 (67%) courses had CMV VL ≥ 1000 IU/mL, and two (10%) courses experienced recurrence. MBV resistance emerged in 6/17 (35%) patients during or after treatment.</p><p><strong>Conclusions: </strong>LET was effective for PP but associated with frequent breakthroughs in SP patients. MBV was limited by incomplete viral suppression and emergent resistance. These findings highlight the variable effectiveness of LET and MBV in clinical practice and support the need for further research to define optimal antiviral use in SP and refractory CMV treatment.</p>","PeriodicalId":20013,"journal":{"name":"Pharmacotherapy","volume":"45 12","pages":"815-824"},"PeriodicalIF":3.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12728795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145820450","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":"Intravenous Push Levetiracetam Administration Compared With Intravenous Piggyback on Benzodiazepine Use for Acute Seizure Treatment.","authors":"Sarah C Markovich, Justin Miller, Rebecca Lucarelli, Benjamin A Wilkinson, Haley L Kavelak","doi":"10.1002/phar.70078","DOIUrl":"10.1002/phar.70078","url":null,"abstract":"<p><strong>Introduction: </strong>Levetiracetam (LEV) is indicated for benzodiazepine (BZD) refractory status epilepticus (SE) and is traditionally administered as an intravenous piggyback (IVPB) infused over 15 min, although rapid intravenous push (IVP) administration over 2 to 5 min has gained popularity. Current literature surrounding IVP LEV administration supports increased efficiency and equal safety of IVP compared with IVPB, though efficacy comparisons, such as seizure duration, are limited. The objective of this study was to assess the impact of IVP LEV on seizure duration and BZD requirements.</p><p><strong>Methods: </strong>This retrospective cohort study assessed adult patients who received IVP or IVPB LEV following a BZD for an acute or suspected seizure. The primary outcome was the number of patients who required additional BZD doses between LEV order and administration. Secondary outcomes included additional BZD requirement within 6 h after LEV administration, time from LEV order to administration, need for intubation, and intensive care unit (ICU) admission. Safety outcomes assessed included bradycardia, hypotension, and infusion site reactions.</p><p><strong>Results: </strong>A total of 299 patients were included, 144 in the IVP group and 155 in the IVPB group. Fewer patients required additional BZD doses between LEV order and administration in the IVP group than the IVPB group (8 patients [5.6%] vs. 27 patients [17.4%]; p = 0.002). Additionally, the median time from LEV order to administration was shorter in the IVP group than in the IVPB group (14.5 min vs. 29.0 min; p < 0.001). Bradycardia occurred more frequently in the IVPB group compared with the IVP group (8.8% vs. 2.3%; p = 0.03).</p><p><strong>Conclusion: </strong>IVP LEV was associated with less frequent requirement of additional BZD doses for treatment of acute or suspected seizures compared with IVPB, as well as a faster time to medication administration and potentially a lower risk of bradycardia.</p>","PeriodicalId":20013,"journal":{"name":"Pharmacotherapy","volume":" ","pages":"809-814"},"PeriodicalIF":3.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145605241","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":"Intravenous Regular Insulin for Treatment of Hyperkalemia in Overweight Patients.","authors":"Denise Kelley, Sarah Piccuirro, Prakruti Gandhi, Hannah Kim","doi":"10.1002/phar.70080","DOIUrl":"10.1002/phar.70080","url":null,"abstract":"<p><strong>Introduction: </strong>Intravenous regular insulin is often used for the management of hyperkalemia due to its rapid onset of action and predictable potassium-lowering effects. Various studies have been conducted to determine optimal insulin dosing strategies that reduce serum potassium levels without increasing hypoglycemia risk. As data shifts towards lower or fixed insulin doses, validating the appropriateness of these dosing regimens for the management of hyperkalemia in overweight patients is warranted. The purpose of this study was to evaluate the serum potassium-lowering effects of 5 units versus 10 units of intravenous regular insulin in hyperkalemic patients with a body mass index (BMI) ≥ 25 kg/m².</p><p><strong>Methods: </strong>A multicenter, retrospective study was performed in adult patients with BMI ≥ 25 kg/m² who received 5 or 10 units of intravenous regular insulin for the treatment of hyperkalemia. The primary outcome was the potassium-lowering effects of 5 units versus 10 units of intravenous regular insulin. Secondary outcomes include the incidence of hypoglycemic episodes within 6 h of insulin administration, hospital length of stay (LOS), and treatment failure.</p><p><strong>Results: </strong>Of 699 patients screened, 81 patients received 5 units and 81 patients received 10 units. There was no difference in the serum potassium-lowering effects of 5 units versus 10 units of intravenous regular insulin (0.5 (0.1-1.1) mmol/L vs. 0.5 (0.2-1) mmol/L; p = 0.65). No significant differences were observed for any secondary outcomes. Subgroup analyses revealed no significant differences for BMI; the number of concomitant acute potassium-lowering therapies received; or the degree of renal impairment, aside from a significantly larger potassium-lowering effect with 10 units of intravenous regular insulin observed in the subgroup receiving no concomitant acute potassium-lowering therapies as well as the subgroup with a creatinine clearance of 30-60 mL/min.</p><p><strong>Conclusion: </strong>In this small, retrospective cohort study, treatment with 5 units of intravenous regular insulin did not compromise the serum potassium-lowering effect when compared to 10 units in overweight patients with hyperkalemia. Further controlled studies are warranted to confirm these findings.</p>","PeriodicalId":20013,"journal":{"name":"Pharmacotherapy","volume":" ","pages":"794-800"},"PeriodicalIF":3.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12728786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145550227","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":"Prescription Sequence Symmetry Analysis for Detection of Chronic Opioid Use Adverse Event Signals Using Administrative Claims Data.","authors":"Efstathia Polychronopoulou, Mukaila A Raji, Yong-Fang Kuo","doi":"10.1002/phar.70081","DOIUrl":"10.1002/phar.70081","url":null,"abstract":"<p><strong>Introduction: </strong>Opioids are commonly used to manage chronic pain in older adults, despite their well-documented adverse events (AEs) and the potential for additional less well-known risks. Post-marketing surveillance methods applied in real-world settings are essential to monitor AEs. Prescription Sequence Symmetry Analysis (PSSA) is a method that compares medication initiation patterns within individuals and can detect signals of prescribing cascades and drug AEs. This study applied PSSA to Medicare claims data to explore potential AEs following the initiation of long-term opioid therapy (LOT).</p><p><strong>Methods: </strong>We used Texas-Medicare data to identify adults who initiated LOT (≥ 90 consecutive days) in 2016-2019. Prescription sequence symmetry analysis (PSSA) was performed to explore associations between opioids and related adverse events treated by marker drugs. The observation period for sequences of incident marker drug prescriptions was limited to 12 months before and after opioid initiation. Marker drugs were categorized based on the Anatomical Therapeutic Chemical (ATC) Classification System. Adjusted sequence symmetry ratios (aSSR) and 95% confidence intervals were calculated to account for prescribing trend changes.</p><p><strong>Results: </strong>Among 11,233 incident opioid users, we identified incident marker drugs belonging to 145 distinct ATC classes, 36 of which had statistically significant aSSRs. We found signals of increased post-opioid prescriptions related to known opioid AEs (e.g., propulsives, antiemetics, laxatives, naltrexone) and less well-documented associations (antimicrobials, hormones, antiarrhythmics, and antipsychotics).</p><p><strong>Conclusions: </strong>PSSA applied to administrative claims data effectively identified both expected and potentially underrecognized adverse effects of long-term opioid use. This approach can enhance post-marketing surveillance by uncovering real-world prescribing cascades in older adults.</p>","PeriodicalId":20013,"journal":{"name":"Pharmacotherapy","volume":" ","pages":"825-830"},"PeriodicalIF":3.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12826115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145541839","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":"Correction to Chloride Dipstick to Rapidly Estimate Urine Sodium During Diuresis in Acute Heart Failure.","authors":"","doi":"10.1002/phar.70052","DOIUrl":"10.1002/phar.70052","url":null,"abstract":"<p><p>V. Shah, D. Cordwin, S. L. Hummel, M. P. Dorsch, \"Chloride Dipstick to Rapidly Estimate Urine Sodium During Diuresis in Acute Heart Failure.\" Pharmacotherapy. 45, (2025): 352-355. https://doi.org/10.1002/phar.70026. The author's name, V Shah, was corrected to Vacha Shah in the online version. We apologize for this error.</p>","PeriodicalId":20013,"journal":{"name":"Pharmacotherapy","volume":" ","pages":"862"},"PeriodicalIF":3.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12862685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144848261","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":"Therapeutic Modulation of IL-6/STAT-3 and Nitric Oxide by Fenofibrate in Patients With Ulcerative Colitis: A Randomized Controlled Pilot Study.","authors":"Khlood Mohammad Aldossary, Mahmoud S Abdallah, Noha Kamal, Mounir M Bahgat, Sarah Alrubia, Amsha S Alsegiani, Mostafa M Bahaa, Ahmed S Hassan, Eman El-Khateeb","doi":"10.1002/phar.70088","DOIUrl":"10.1002/phar.70088","url":null,"abstract":"<p><strong>Background: </strong>Peroxisome proliferator-activated receptor α (PPARα) has been reported to exert protective roles in immune-mediated intestinal diseases through inhibition of interleukin-6 (IL-6)-induced signal transducer and activator of transcription factor 3 (STAT3) activation.</p><p><strong>Aim: </strong>To investigate the potential anti-inflammatory effect of fenofibrate, as an add-on therapy to mesalamine, on IL-6/STAT3 and nitric oxide (NO) in patients with ulcerative colitis (UC).</p><p><strong>Methods: </strong>This pilot, double-blind, randomized, controlled trial included 60 patients diagnosed with mild-to-moderate UC. Patients were randomly allocated into two groups. The placebo group (n = 30) received placebo plus mesalamine 1 g three times daily, and the fenofibrate group (n = 30) received mesalamine 1 g three times daily and fenofibrate 160 mg once daily. The study duration was 6 months. The severity of UC was evaluated using the Disease Activity Index (DAI), and quality of life (QoL) was assessed using the Short Form-36 questionnaire (SF-36). Serum levels of IL-6, NO, C-reactive protein (CRP), and STAT3 were measured for all patients.</p><p><strong>Results: </strong>After treatment, both groups showed a significant reduction in DAI, IL-6, STAT3, NO, and CRP, along with an increase in SF-36 scores. Furthermore, the fenofibrate group demonstrated a significantly greater decrease in DAI (p = 0.0002), IL-6 (p = 0.04), STAT3 (p = 0.004), NO (p = 0.013), and CRP (p = 0.034), as well as a greater increase in SF-36 (p = 0.04) compared with the placebo group.</p><p><strong>Conclusion: </strong>Fenofibrate may represent a promising add-on therapy in patients with mild-to-moderate UC by modulating inflammation and improving QoL.</p><p><strong>Trial registration: </strong>NCT05753267.</p>","PeriodicalId":20013,"journal":{"name":"Pharmacotherapy","volume":" ","pages":"840-851"},"PeriodicalIF":3.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145661679","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}