Therapie最新文献

{"title":"Indication-related misuse of oral fluoroquinolones in adults by general practitioners in France.","authors":"Lisa Dilange, Karima Hider-Mlynarz, Daniele Saade, Marie-Joëlle Jabagi, Marion Bertrand, Mahmoud Zureik","doi":"10.1016/j.therap.2026.04.001","DOIUrl":"https://doi.org/10.1016/j.therap.2026.04.001","url":null,"abstract":"<p><strong>Background: </strong>Fluoroquinolones (FQ) are broad-spectrum antibiotics effective against various infections. However, their use has been progressively restricted by guidelines due to safety concerns, leading to repeated reassessments of their indication. Despite a marked decline in prescriptions, misuse remains a concern. This study aimed to assess FQ prescribing indications in general practice in France and analyse their evolution between 2014 and 2023 in light of changing guidelines.</p><p><strong>Methods: </strong>We conducted a descriptive observational study using data from the THIN® (The Health Improvement Network) database, managed by CEGEDIM-GERS DATA. This European database collects anonymized electronic health records from private practitioners in seven countries, including France since 2014. In 2023, the French panel included over 3 million patients and approximately 2000 general practitioners (GPs). Available data include administrative and medical information. Oral FQ prescriptions for patients aged≥20years were analyzed in 2014, 2019 and 2023 for compliance with five frameworks: marketing authorization (MA), SPILF 2015 (French Infectious Diseases Society), HAS 2016 (French National Authority of Health) and EMA 2018/2019 (European Medicines Agency). Results were stratified by sex, age, molecule and indication category.</p><p><strong>Results: </strong>FQ prescriptions by GPs declines by 59% between 2014 and 2023. Compliance varied by reference: approximately 75% according to MA and SPILF versus less than 25% with more recent guidelines (HAS 2016 and EMA 2018/2019). Compliance was lower in women and patients aged≥75years. In 2023, the largest misuse was observed for urinary and prostate infections (from approximately 94% to 24%) due to changes affecting uncomplicated urinary tract infections in women. For respiratory or ear nose and throat (ENT) infections, compliance remained low (20-40%) across all references.</p><p><strong>Conclusions: </strong>Despite decreasing FQ use in general practice, many prescriptions remain non-compliant with updated recommendations, highlighting a persistent gap between clinical practices and evolving guidelines.</p>","PeriodicalId":23147,"journal":{"name":"Therapie","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148006233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cyclin-dependent kinase inhibitors and kidney injury: Analysis of the French pharmacovigilance database.","authors":"Laurence Lagarce, Anais Gaiffe, Romane Freppel, Wilhelm Storck, Jean-Luc Cracowski, Marie Briet","doi":"10.1016/j.therap.2026.03.005","DOIUrl":"https://doi.org/10.1016/j.therap.2026.03.005","url":null,"abstract":"<p><strong>Background: </strong>Cyclin-dependent kinase 4/6 (CDK4/6) inhibitors are widely used in the treatment of advanced breast cancer. While a reversible increase in serum creatinine is a recognized class effect, the spectrum and severity of renal adverse events (AE) associated with these agents remain incompletely characterized.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of the French national pharmacovigilance database from 2016 to January 2024 to identify reports of renal AE associated with the CDK4/6 inhibitors, palbociclib, abemaciclib, and ribociclib. Cases were classified as pseudo-renal failure, renal failure in the context of dehydration, or renal failure without dehydration.</p><p><strong>Results: </strong>Among 42 cases of renal AE identified, abemaciclib was implicated in 48%, palbociclib in 33%, and ribociclib in 19%. Pseudo-renal failure, attributed to inhibition of tubular creatinine transporters, was observed in one case. Seventeen cases of renal failure occurred in the context of dehydration, predominantly associated with abemaciclib and gastrointestinal toxicity. Twenty-four cases occurred without dehydration, with some confirmed as acute tubular necrosis (ATN) or tubulo-interstitial nephritis (TIN) on biopsy. Most cases were serious and required hospitalization. Renal replacement therapy was needed in three cases. CDK4/6 inhibitor was discontinued in 85% of the cases with a favorable outcome in the majority of the cases. A positive rechallenge was observed in 4 cases including true acute kidney injury in 2 cases.</p><p><strong>Conclusions: </strong>CDK4/6 inhibitors may cause functional and true renal impairment, ranging from mild, reversible creatinine increases to severe acute kidney injury. When performed, renal biopsy showed ATN and TIN. Close monitoring of renal function including cystatine-C based GFR evaluation and characterization of renal injury are essential to optimize patient safety.</p>","PeriodicalId":23147,"journal":{"name":"Therapie","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Systematic review of the literature and evaluation of the effectiveness of muscle relaxants in acute low back pain according to REB method].","authors":"Hélène Langelier, Julio Pires, Rémy Boussageon","doi":"10.1016/j.therap.2026.03.004","DOIUrl":"https://doi.org/10.1016/j.therap.2026.03.004","url":null,"abstract":"<p><strong>Introduction: </strong>Acute low back pain (LBP), with or without radiculopathy, is a common condition in primary care. In practice, muscle relaxants are widely used, although their effectiveness remains controversial. A 2021 meta-analysis of randomized controlled trials (RCTs) suggested possible efficacy but with a low level of evidence.</p><p><strong>Objectives: </strong>The aim of this study is to evaluate the effectiveness of three muscle relaxants (thiocolchicoside, methocarbamol, and diazepam) commonly used in practice for improving pain and functionality in acute low back pain with or without radiculopathy through a systematic review of RCTs, with assessment of the level of evidence according to the REB (Rebuild the Evidence Base) method.</p><p><strong>Methods: </strong>A systematic search was conducted in three databases (Medline, Cochrane, and Embase) and the ClinicalTrials.gov registry up to March 31, 2024. The risk of bias was assessed using the RoB2 tool. The primary outcomes were pain improvement and functional recovery. The REB method was applied to evaluate the global level of evidence for the effectiveness of each molecule. PROSPERO Protocol: CRD42024564738.</p><p><strong>Results: </strong>Eight trials were included: thiocolchicoside (4 RCTs, 604 patients), methocarbamol (2 RCTs, 223 patients), diazepam (2 RCTs, 164 patients). The RCTs evaluating the effectiveness of thiocolchicoside were all at high risk of bias. For methocarbamol, one RCT had a low risk of bias and showed a functional improvement of 2.8 points in favor of the placebo (95% CI: 0.0 to 5.7), which was not statistically significant. For diazepam, one RCT with a low risk of bias reported a functional improvement of +0.3 points in favor of the placebo (95% CI: -2.8 to 3.5), which was also not statistically significant.</p><p><strong>Conclusion: </strong>According to the REB method, none of the three molecules demonstrated efficacy in acute low back pain with or without radiculopathy.</p>","PeriodicalId":23147,"journal":{"name":"Therapie","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lercanidipine-associated peripheral oedema after pristinamycin introduction: A pharmacokinetic interaction hypothesis.","authors":"Hélène Geniaux, Jérémie Bordes, Marie-Laure Laroche","doi":"10.1016/j.therap.2026.03.003","DOIUrl":"https://doi.org/10.1016/j.therap.2026.03.003","url":null,"abstract":"","PeriodicalId":23147,"journal":{"name":"Therapie","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147717901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serious respiratory distress associated with bosentan administration in chronic thromboembolic pulmonary hypertension: A case report.","authors":"Justine Perino, Philémon Bassan, Francesco Salvo, Ghada Miremont-Salamé, Arnaud Maurac, Gaël Dournes, Pierre-Olivier Girodet","doi":"10.1016/j.therap.2026.03.002","DOIUrl":"https://doi.org/10.1016/j.therap.2026.03.002","url":null,"abstract":"","PeriodicalId":23147,"journal":{"name":"Therapie","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147699776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Descriptive study of the effects of treprostinil and/or epoprostenol in newborn infants with inhaled NO refractory persistent pulmonary hypertension of the newborn (PPHN).","authors":"Charlotte Mazepa, Sébastien Mur, Géraldine Gascoin, Laurent Storme, Nicolas Joram, Caroline Viard, Yves Dulac, Marine Butin, Sophie Breinig","doi":"10.1016/j.therap.2026.03.001","DOIUrl":"https://doi.org/10.1016/j.therap.2026.03.001","url":null,"abstract":"<p><strong>Background: </strong>Epoprostenol and treprostinil, prostacyclin analogues, are used in some neonatal intensive care units (NICU) in the treatment of persistent pulmonary hypertension of the newborn (PPHN) refractory to inhaled nitric oxide (iNO). The aim of this retrospective multicentric descriptive study was to assess the profile and evolution of these newborns.</p><p><strong>Methods: </strong>Inclusion of neonates born ≥ 34 weeks of gestational age (WGA) and aged ≤ 28 days of life, presenting clinical signs of PPHN (respiratory and/or hemodynamic lability), and at least one echocardiographic sign of pulmonary hypertension. We collected data on the use of prostacyclin analogues, their tolerance, and their efficacy, by collecting clinical, biological, and echocardiographic data of these newborns.</p><p><strong>Results: </strong>Seventy patients were included from 4 French NICU. It appears that there may be an improvement in pulmonary hypertension (PH) at the initiation of prostacyclin analogues, showing by an increase in post-ductal SpO₂, a decrease in FiO₂ and an improvement in PH'level on echocardiography. Only four patients needed a treatment discontinuation due to poor hemodynamic tolerance.</p><p><strong>Conclusion: </strong>Our study highlighted the safety of the use of epoprostenol and treprostinil in neonates suffering from iNO refractory PPHN, without significant adverse effect. It appears to be necessary to carry out further study to establish recommendations for the management of PPHN, and also to define more precisely the place of treprostinil and epoprostenol in this pathology.</p>","PeriodicalId":23147,"journal":{"name":"Therapie","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147933805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the hype: The multifaceted reality of artificial intelligence in pharmacology","authors":"Jean-Baptiste Woillard","doi":"10.1016/j.therap.2025.12.002","DOIUrl":"10.1016/j.therap.2025.12.002","url":null,"abstract":"","PeriodicalId":23147,"journal":{"name":"Therapie","volume":"81 2","pages":"Pages 130-131"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145985733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence for precision medicine","authors":"Marie-Elise Martel ,&nbsp;Adan José-Garcia ,&nbsp;Celine Vens ,&nbsp;Maarten De Vos ,&nbsp;Vincent Sobanski","doi":"10.1016/j.therap.2025.10.003","DOIUrl":"10.1016/j.therap.2025.10.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Precision medicine aims to tailor healthcare decisions and interventions to the unique biological and clinical characteristics of each patient. The recent convergence of artificial intelligence (AI) with advances in digital health, omics, and big data analytics has accelerated progress toward this goal. AI technologies – particularly machine learning, deep learning, natural language processing and generative large language models – enable the rapid and meaningful analysis of complex biomedical datasets, supporting more individualized care.</div></div><div><h3>Purpose of review</h3><div>In this narrative review, we provide an accessible overview of the core principles of AI for healthcare professionals and explore its practical applications across the spectrum of precision medicine. Real-world examples highlight how AI is being used to enhance early diagnosis, guide treatment selection, support disease prevention, and even contribute directly to therapeutic interventions. Alongside these advances, we discuss critical limitations and challenges, including ethical considerations, algorithmic bias, data privacy concerns, environmental impact, and practical barriers to clinical implementation.</div></div><div><h3>Conclusion</h3><div>This review offers both an introduction to AI and a practical overview of how it is being used, and where its limitations lie, in precision medicine, with the goal of helping healthcare professionals understand these evolving tools and use them efficiently and responsibly in clinical practice.</div></div>","PeriodicalId":23147,"journal":{"name":"Therapie","volume":"81 2","pages":"Pages 171-186"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145410136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Being 80 years old in a rapidly changing world…","authors":"Dominique Deplanque","doi":"10.1016/j.therap.2026.01.001","DOIUrl":"10.1016/j.therap.2026.01.001","url":null,"abstract":"","PeriodicalId":23147,"journal":{"name":"Therapie","volume":"81 2","pages":"Pages 127-129"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146182713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing AI through the lens of planetary health","authors":"Nicolas Faure","doi":"10.1016/j.therap.2026.01.002","DOIUrl":"10.1016/j.therap.2026.01.002","url":null,"abstract":"","PeriodicalId":23147,"journal":{"name":"Therapie","volume":"81 2","pages":"Pages 187-188"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146228497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}