Therapie最新文献

{"title":"Un outil d’adaptation individualisée des posologies de médicaments chez le patient adulte obèse","authors":"Julien Gouju , Charles Jourdan , Samuel Legeay","doi":"10.1016/j.therap.2023.07.004","DOIUrl":"10.1016/j.therap.2023.07.004","url":null,"abstract":"<div><h3>Contexte</h3><p>Entre 1975 et 2014, le nombre de personnes souffrant d’obésité a triplé, jusqu’à atteindre 17 % de la population adulte en France et plus de 35 % aux États-Unis. L’obésité se définit par un indice de masse corporelle (IMC)<!--> <!-->><!--> <!-->30<!--> <!-->kg/m<sup>2</sup> et se caractérise par une accumulation importante de tissu adipeux responsable de l’augmentation du poids. Cette accumulation entraîne des changements physiologiques capables de modifier la pharmacocinétique des médicaments pouvant conduire à l’administration de doses inappropriées. Pour cette raison, certains des ajustements posologiques significatifs sont nécessaires chez le patient obèse. Cependant, les données sur ces adaptations sont peu accessibles et parfois complexes à mettre en œuvre en pratique.</p></div><div><h3>Objectif</h3><p>Proposer un nouvel outil en ligne permettant de calculer un ajustement de la dose d’un médicament à administrer à un patient obèse.</p></div><div><h3>Méthodes</h3><p>(i) réalisation d’une recherche bibliographique extensive selon la méthodologie PRISMA ; et (ii) développement d’un outil en ligne proposant une dose ajustée pour les patients obèses.</p></div><div><h3>Résultats</h3><p>Dans un premier temps, 49 revues de la littérature ont été évaluées concernant l’adaptation de la posologie des médicaments chez les patients obèses puis, dans un deuxième temps, 319 articles ont été sélectionnés. Parmi ces 319 articles, 204 ont été inclus dans la base de données afin de fournir des informations d’adaptation de posologie pour 84 molécules et modalités d’administration incluant des antibiotiques, des antifongiques, des anticoagulants ou encore des cytotoxiques. Cette base de données a été rendue accessible à travers le développement d’un calculateur utilisable sur le site internet Adapt’Obese. Ainsi, grâce au sexe, à la taille et au poids du patient obèse, l’outil propose au praticien une adaptation personnalisée du médicament à administrer au patient obèse.</p></div><div><h3>Perspectives</h3><p>D’autres principes actifs seront ajoutés prochainement, et des améliorations des fonctionnalités sont envisagées dans le but d’adapter les posologies chez le patient obèse, comme cela peut être réalisé chez les patients insuffisants rénaux.</p></div><div><h3>Background</h3><p>Between 1975 and 2014, the number of people suffering from obesity tripled, reaching 17% of the adult population in France and more than 35% in the United States. Obesity is defined by a Body Mass Index (BMI)<!--> <!-->><!--> <!-->30<!--> <!-->kg/m<sup>2</sup> and characterized by a significant accumulation of adipose tissue responsible for the increase in weight. This accumulation leads to physiological changes capable of modifying the pharmacokinetics of drugs, which can lead to the administration of inappropriate doses. For this reason, some significant dosage adjustments are necessary for obese patients. However, data on these adaptations are not easil","PeriodicalId":23147,"journal":{"name":"Therapie","volume":"79 3","pages":"Pages 379-392"},"PeriodicalIF":2.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49682633","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":"Cannabidiol and pharmacokinetics drug-drug interactions: Pharmacological toolbox","authors":"Clémence Lacroix ,&nbsp;Romain Guilhaumou ,&nbsp;Joëlle Micallef ,&nbsp;Olivier Blin","doi":"10.1016/j.therap.2023.05.003","DOIUrl":"10.1016/j.therap.2023.05.003","url":null,"abstract":"<div><p><span>Cannabidiol (CBD) is one of the most important components of the </span><em>Cannabis sativa</em><span> plant with delta9-tetrahydrocannabinol (THC). CBD is used both for medical and recreational purposes. It can be of pharmaceutical grade (Epidyolex®), and also self-service purchased in pharmacy, CBD shops and on the internet (non-pharmaceutical). CBD is almost as widespread as it is poorly understood from a pharmacological point of view and particularly in terms of drug interactions. Drug-drug interactions could lead to clinical complications, and we here gather data currently available on pharmacokinetics (PK) drug-drug interactions with CBD through a narrative review. This review shows that several PK drug-drug interactions exist with different class of medications and aims to help clinicians to better know about CBD for their practice as this product is increasingly used.</span></p></div>","PeriodicalId":23147,"journal":{"name":"Therapie","volume":"79 3","pages":"Pages 351-363"},"PeriodicalIF":2.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9592999","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":"Prescription-free consultation: A cross-sectional study in general practice","authors":"Amélie Richard ,&nbsp;Élodie Charuel ,&nbsp;Sébastien Cambier ,&nbsp;Manon Turpin ,&nbsp;Bruno Baudin ,&nbsp;José-Philippe Moreno ,&nbsp;Hélène Vaillant-Roussel","doi":"10.1016/j.therap.2023.07.003","DOIUrl":"10.1016/j.therap.2023.07.003","url":null,"abstract":"<div><h3>Purpose</h3><p>In 2005, 10% of consultations in France ended without a prescription. In 2019, a review of the literature found 30 to 70% of prescription-free consultations in Northern Europe and 10 to 22% in Southern Europe and underlined the scarcity of quantitative data. Different factors contribute to this heterogeneity, such as product availability and status, modes of management, distribution channels, clinical practice recommendations, public policies targeting certain classes, etc. The main objective of our study was to quantify the rate of prescription-free consultations in general practice in France in 2021. The secondary objective was to characterize prescription-free consultations and analyze their determinants.</p></div><div><h3>Methods</h3><p>This was a quantitative observational study conducted using self-questionnaires among patients in medical practices in Auvergne.</p></div><div><h3>Results</h3><p>Out of 540 questionnaires, the rate of prescription-free consultations was 24% (95% CI [20.11–27.41]). Prescription-free consultations were for prevention, administrative problems, and gestures. The limiting factors are “feeling a need for a medication” (OR<!--> <!-->=<!--> <!-->0,006), “not knowing if a medication is needed” (OR<!--> <!-->=<!--> <!-->0.11) and “consultations for acute reasons” (OR<!--> <!-->=<!--> <!-->0.33).</p></div><div><h3>Conclusion</h3><p>Acute consultations limit prescription-free consultations. General practitioners (GPs) probably overestimate patients’ expectation of drug prescription. The French GP must be supported in their decision to not prescribe drugs. This is a long-term investment of time, to educate patients and avoid new consultations for acute reasons. A tool to help doctors manage non-prescription during acute consultations will be created in a future study in France.</p></div>","PeriodicalId":23147,"journal":{"name":"Therapie","volume":"79 3","pages":"Pages 319-326"},"PeriodicalIF":2.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S004059572300104X/pdfft?md5=f2b8af16cae065d0d1d5837deedecdfb&pid=1-s2.0-S004059572300104X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10073292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drug-related hypophosphatemia: Descriptive study and case/non-case analysis of the French national pharmacovigilance database","authors":"Eve-Marie Thillard ,&nbsp;Paula Sade ,&nbsp;Joelle Michot ,&nbsp;Virginie Bres ,&nbsp;Annie-Pierre Jonville-Bera","doi":"10.1016/j.therap.2023.07.007","DOIUrl":"10.1016/j.therap.2023.07.007","url":null,"abstract":"<div><p><span><span>Phosphorus is an essential element for all living organisms and is involved in various biological pathways. A severe hypophosphatemia can lead to serious complications (acute heart or respiratory failure, </span>rhabdomyolysis<span>, hemolysis…) and increases mortality in patients at risk. Various drugs are known to induce hypophosphatemia through various mechanisms. The aim of this study was to highlight the main drugs associated with hypophosphatemia and to deduce the underlying mechanisms based on a descriptive analysis and a case/non-case analysis using the cases of drug-induced hypophosphatemia reported to the French Pharmacovigilance Network. A total of 368 cases of hypophosphatemia were included in the study. Patients’ mean age was 52</span></span> <!-->±<!--> <!-->18 years. One hundred and ninety-one cases (52%) were serious including 131 (36%) hospitalizations. The median value of serum phosphorus level was 0.54<!--> <!-->mmol/L [0.40–0.66] (<em>n</em> <!-->=<!--> <span>309). Those 368 cases corresponded to 185 different suspected substances among which the most frequent drugs were tenofovir disoproxil (</span><em>n</em> <!-->=<!--> <span>175; 48%), ferric carboxymaltose (</span><em>n</em> <!-->=<!--> <span>29; 8%), denosumab (</span><em>n</em> <!-->=<!--> <span>16; 4%), zoledronic acid (</span><em>n</em> <!-->=<!--> <span>14; 4%) and hydrochlorothiazide (</span><em>n</em> <!-->=<!--> <span><span>10; 3%). For these five drugs, a significant disproportionality was found. Tenofovir-disoproxil related hypophosphatemia occurred more than one year after its introduction, and a renal tubulopathy<span> (Fanconi's syndrome) was reported in 44 cases (25%). Hypophosphatemia related to iron carboxymaltose occurred within a median of 20 days after injection and was mostly severe. Mechanism included the fibroblast growth factor 23 which can be measured to confirm drug origin. Concerning anti-osteoporosis treatments, hypophosphatemia could be explained by their mechanism of action (abrupt increase of </span></span>parathormone<span> induced by hypocalcemia) but the patient history (malignancy condition) was a major bias. For hydrochlorothiazide, hyphosphatemia was often moderate, associated with other electrolytic disturbances and occurred during a long-term treatment. Awareness of healthcare professionals is essential to detect as soon as possible hypophosphatemia and its complications related to these drugs.</span></span></p></div>","PeriodicalId":23147,"journal":{"name":"Therapie","volume":"79 3","pages":"Pages 371-378"},"PeriodicalIF":2.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10081816","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":"Carbamazepine-induced drug reaction with eosinophilia and systemic symptoms (DRESS): Interest of skin tests in cross-reactivity to phenobarbital","authors":"Jawhar Rebai ,&nbsp;Haifa Ben Romdhane ,&nbsp;Khadija Mansour ,&nbsp;Najah Ben Fadhel ,&nbsp;Ines Lahouel ,&nbsp;Zohra Chadly ,&nbsp;Amel Chaabane ,&nbsp;Nadia Ben Fredj ,&nbsp;Karim Aouam","doi":"10.1016/j.therap.2023.06.005","DOIUrl":"10.1016/j.therap.2023.06.005","url":null,"abstract":"","PeriodicalId":23147,"journal":{"name":"Therapie","volume":"79 3","pages":"Pages 398-401"},"PeriodicalIF":2.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9746361","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":"GPs' practices when prescribing buprenorphine in primary care: A survey among the Sentinelles network.","authors":"Barbara Lépine, Marion Debin, Lise Dassieu, Laetitia Gimenez, Aurore Palmaro, Camille Ponté, Morgane Swital, Maryse Lapeyre-Mestre, Thierry Blanchon, Julie Dupouy","doi":"10.1016/j.therap.2024.04.002","DOIUrl":"https://doi.org/10.1016/j.therap.2024.04.002","url":null,"abstract":"<p><strong>Introduction: </strong>France is a leading country for opioid agonist treatment providing, with a predominance of buprenorphine. General practitioners (GPs) are the main prescribers of buprenorphine, but they seem to be less involved over the last 10 years. This work is the second part of a larger study analysing buprenorphine prescribing among French GPs working in primary care, and aims to describe GPs' practices when prescribing buprenorphine.</p><p><strong>Methods: </strong>This is a cross-sectional study conducted in France from March to July 2021 among a sample of GPs in the Sentinelles network, a national epidemiologic surveillance system. Data about the last situations of initiation and renewal of buprenorphine were collected.</p><p><strong>Results: </strong>Among the 237 participants (34.3% response rate), 156 responded to the questionnaire about the last situation of renewal and 41 about the last situation of initiation. The last initiation occurred more than 12 months earlier for 46.3% of respondents, whereas the last renewal occurred less than 1 month ago for 68.6%. There was an over-representation of the male gender among the patients who were consulting (initiation 70.7%, renewal 68.6%). A majority of patients had an illicit opioid use disorder (initiation 78.0%, renewal 82.7%). Overall, GPs were involved in the general care of patients with opioids use disorder and in opioids harm reduction (initiation 87.8% and 82.9%, renewal 88.5% and 51.9%).</p><p><strong>Conclusion: </strong>Among buprenorphine prescribers, initiations were infrequent unlike renewals and involved mainly illicit opioid users.</p>","PeriodicalId":23147,"journal":{"name":"Therapie","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140903509","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":"Drug-induced psychiatric disorders: A pharmacovigilance update","authors":"François Montastruc ,&nbsp;Tanguy Taillefer de Laportaliere","doi":"10.1016/j.therap.2023.09.007","DOIUrl":"10.1016/j.therap.2023.09.007","url":null,"abstract":"<div><p>The psychiatric risks associated with drugs are sometimes one of the few restrictions on the use of certain drug classes, such as corticosteroids in patients with a history of severe psychotic episodes associated with this drug class. In this non-exhaustive review, we propose to deal with the most recent issues concerning psychiatric disorders induced by drugs and encountered in doctors’ clinical practice. Firstly, we look at depressive disorders and suicide risks, secondly at psychotic and manic disorders<span> and thirdly at anxiety and sleep disorders. While lot of drugs are associated with psychiatric disorders, the confounding by indication represents an important methodological gap since information on the psychiatric profile of patients is not always available. This is particularly the case for serotonin reuptake inhibitors<span><span> and esketamine<span> used as antidepressants. Recent pharmacovigilance concerns of psychiatric disorders emerged with montelukast, </span></span>orexin receptor antagonists<span> or cystic fibrosis transmembrane regulator (CFTR) modulators.</span></span></span></p></div>","PeriodicalId":23147,"journal":{"name":"Therapie","volume":"79 2","pages":"Pages 173-179"},"PeriodicalIF":2.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92156838","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":"Drug-induced diseases: A worrying, neglected, preventable, serious and costly epidemic","authors":"Jean-Louis Montastruc","doi":"10.1016/j.therap.2023.10.007","DOIUrl":"10.1016/j.therap.2023.10.007","url":null,"abstract":"","PeriodicalId":23147,"journal":{"name":"Therapie","volume":"79 2","pages":"Pages 151-154"},"PeriodicalIF":2.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136128255","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":"Antibiotic-induced neurological adverse drug reactions","authors":"Clémence Lacroix,&nbsp;Tessa Pietri,&nbsp;Vincent Montero,&nbsp;Thomas Soeiro,&nbsp;Frank Rouby,&nbsp;Olivier Blin,&nbsp;Romain Guilhaumou,&nbsp;Joëlle Micallef","doi":"10.1016/j.therap.2023.09.008","DOIUrl":"10.1016/j.therap.2023.09.008","url":null,"abstract":"<div><p>Antibiotics are drugs widely used all around the world. Central nervous system adverse drug reactions<span><span> (CNS ADRs) are mostly under-suspected with antibiotics. Nevertheless, these ADRs could lead to severe complications such as encephalopathy. To illustrate the clinical patterns of these off-target ADRs, we here present data from pharmacovigilance system, through different populations and points of view (worldwide, French population, vulnerable population and individual). These data could help clinicians to better know about CNS ADRs with antibiotics, to better identify risk factors and vulnerable patients and to highlight the importance to set up the right diagnostic explorations in the best timing to avoid complications. Clinicians should request a pharmacological opinion from pharmacologist (biologists and pharmacovigilance clinicians) in front of vulnerable population before or during antibiotics. Pharmacovigilance advice could help clinicians in the diagnosis and the management of an ADR. </span>Therapeutic drug monitoring is particularly contributive to adjust doses of antibiotics administered in vulnerable patients. Pharmacovigilance advice and TDM are essential to perform personalized medicine, and contribute to the proper use of drugs.</span></p></div>","PeriodicalId":23147,"journal":{"name":"Therapie","volume":"79 2","pages":"Pages 181-188"},"PeriodicalIF":2.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92156834","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":"Drug-induced hyperglycemia and diabetes","authors":"Marie-Anne Heurtebize ,&nbsp;Jean-Luc Faillie","doi":"10.1016/j.therap.2023.09.010","DOIUrl":"10.1016/j.therap.2023.09.010","url":null,"abstract":"<div><h3>Background</h3><p>Drug-induced hyperglycemia and diabetes have negative and potentially serious health consequences but can often be unnoticed.</p></div><div><h3>Methods</h3><p>We reviewed the literature searching Medline database for articles addressing drug-induced hyperglycemia and diabetes up to January 31, 2023. We also selected drugs that could induce hyperglycemia or diabetes according official data from drug information databases Thériaque and Micromedex. For each selected drug or pharmacotherapeutic class, the mechanisms of action potentially involved were investigated. For drugs considered to be at risk of hyperglycemia or diabetes, disproportionality analyses were performed using data from the international pharmacovigilance database VigiBase. In order to detect new pharmacovigilance signals, additional disproportionality analyses were carried out for drug classes with more than 100 cases reported in VigiBase, but not found in the literature or official documents.</p></div><div><h3>Results</h3><p><span><span>The main drug classes found to cause hyperglycemia are glucocorticoids<span>, HMG-coA reductase<span><span> inhibitors, thiazide diuretics, beta-blockers, </span>antipsychotics<span>, fluoroquinolones, antiretrovirals, </span></span></span></span>antineoplastic agents<span><span><span><span> and immunosuppressants. The main mechanisms involved are alterations in insulin secretion and sensitivity, direct cytotoxic effects on pancreatic cells and increases in glucose production. Pharmacovigilance signal were found for a majority of drugs or pharmacological classes identified as being at risk of diabetes or hyperglycemia. We identified new pharmacovigilance signals with drugs not known to be at risk according to the literature or official data: </span>phosphodiesterase type 5 inhibitors, </span>endothelin receptor antagonists, </span>sodium oxybate<span>, biphosphonates including </span></span></span>alendronic acid<span><span><span>, digoxin, </span>sartans, linosipril, </span>diltiazem<span><span>, verapamil, and </span>darbepoetin alpha. Further studies will be needed to confirm these signals.</span></span></p></div><div><h3>Conclusions</h3><p>The risks of induced hyperglycemia vary from one drug to another, and the underlying mechanisms are multiple and potentially complex. Clinicians need to be vigilant when using at-risk drugs in order to detect and manage these adverse drug reactions. However, it is to emphasize that the benefits of appropriately prescribed treatments most often outweigh their metabolic risks.</p></div>","PeriodicalId":23147,"journal":{"name":"Therapie","volume":"79 2","pages":"Pages 221-238"},"PeriodicalIF":2.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136128418","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}