Annals of Pharmacotherapy最新文献

{"title":"Roflumilast and the Changing Landscape of Seborrheic Dermatitis Treatment.","authors":"Jimmy Dhillon, Aryan Mahajan, Joy Xie, Madeline Tchack, Babar K Rao","doi":"10.1177/10600280251355662","DOIUrl":"https://doi.org/10.1177/10600280251355662","url":null,"abstract":"<p><strong>Objective: </strong>This article reviews clinical trial data that assess the safety, efficacy, and clinical application of roflumilast, a phosphodiesterase-4 inhibitor, for the treatment of seborrheic dermatitis.</p><p><strong>Data sources: </strong>A review of the literature was conducted in MEDLINE (Pubmed) and Clinicaltrials.gov from January 1, 1950 to April 13, 2025 using the search terms: \"Roflumilast\" and \"seborrheic dermatitis.\"</p><p><strong>Study selection and data extraction: </strong>Relevant articles in English relating to the safety, efficacy, pharmacodynamics, and pharmacokinetics were included.</p><p><strong>Data synthesis: </strong>In one phase IIa clinical trial, 73.8% of patients treated with roflumilast achieved Investigator Global Assessment (IGA) success, compared with 40.9% in the vehicle group at 8 weeks (<i>P</i> < 0.001). A phase III trial found 79.5% of patients in the roflumilast group achieved IGA success at week 8, compared with 58.0% in the vehicle group (<i>P</i> < 0.001). Furthermore, there were statistically significant reductions in erythema, scaling, and itch severity in the roflumilast group. Roflumilast was well tolerated, with adverse events comparable with vehicle foam.Relevance to Patient Care and Clinical Practice in Comparison to Existing Drugs:Roflumilast is the first phosphodiesterase-4 inhibitor approved by the Food and Drug Administration for the treatment of seborrheic dermatitis. Based on 2 clinical trials, roflumilast has a positive safety profile, is efficacious, and is easy to apply, highlighting its utility in treating seborrheic dermatitis.</p><p><strong>Conclusion: </strong>Roflumilast is effective in treating seborrheic dermatitis. Future trials should compare its safety and efficacy with other drugs.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"10600280251355662"},"PeriodicalIF":2.3,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599177","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":"Hydrocortisone Dosing Frequency in Intensive Care Unit Patients With Septic Shock: A Comparison of 2 Regimens.","authors":"Abigail Danos, Alyssa Lear, Erin Roach, Nicholas J Quinn","doi":"10.1177/10600280251355619","DOIUrl":"https://doi.org/10.1177/10600280251355619","url":null,"abstract":"<p><strong>Background: </strong>In patients with septic shock, intravenous (IV) hydrocortisone is recommended when there is an ongoing vasopressor requirement. Guidelines recommend IV hydrocortisone 200 mg/day administered as a continuous infusion or 50 mg every 6 hours. To prevent waste during a hydrocortisone shortage and reduce cost, our institution implemented a dosing regimen of 100 mg every 12 hours.</p><p><strong>Objectives: </strong>The primary objective of this study was to compare the impact of hydrocortisone 100 mg IV every 12 hours vs 50 mg IV every 6 hours on clinical outcomes in patients with septic shock.</p><p><strong>Methods: </strong>This was a retrospective, multicenter study that evaluated patients admitted from April 2022 to September 2023 to a Greater Charlotte Atrium Health facility. Adult patients diagnosed via the <i>International Statistical Classification of Diseases and Related Health Problems 10th Revision</i> (ICD-10) codes with sepsis, severe sepsis, or septic shock receiving ≥15 mcg/min of norepinephrine equivalents requiring ≥ 24 hours of hydrocortisone were included. The primary outcome was time to shock reversal. Secondary outcomes included in-hospital mortality, hospital and intensive care unit (ICU) length of stay, and hyperglycemia.</p><p><strong>Results: </strong>Of 446 screened patients, 111 were included. Median Sequential Organ Failure Assessment scores and Charlson Comorbidity Index were similar among groups. The median time to shock reversal was 56 [34-81] hours in the every 12 hours group compared to 65 [39-101] hours in the every 6 hours group (<i>P</i> = 0.21). In-hospital mortality was comparable between the every 6 hours group and the every 12 hours group (51.9% vs 45.6%, <i>P</i> = 0.51). There was no difference in hospital or ICU length of stay nor in incidence of hyperglycemic episodes between groups.</p><p><strong>Conclusion and relevance: </strong>There was no difference in the primary outcome of time to shock reversal or any secondary outcome between hydrocortisone groups. This alternative hydrocortisone dosing strategy may warrant further evaluation in large, prospective studies.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"10600280251355619"},"PeriodicalIF":2.3,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567003","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":"Reply: Impact of Remdesivir on Heart Rate and Bradycardia Incidence Among Hospitalized Adults With COVID-19.","authors":"Wesley D Kufel, Robert W Seabury, Sarah A Spinler","doi":"10.1177/10600280251354862","DOIUrl":"https://doi.org/10.1177/10600280251354862","url":null,"abstract":"","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"10600280251354862"},"PeriodicalIF":2.3,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567004","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":"Comment: Impact of Remdesivir on Heart Rate and Bradycardia Incidence Among Hospitalized Adults With COVID-19.","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.1177/10600280251354855","DOIUrl":"https://doi.org/10.1177/10600280251354855","url":null,"abstract":"","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"10600280251354855"},"PeriodicalIF":2.3,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567001","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":"Comment: Safety of Phenobarbital Versus Benzodiazepines for Alcohol Withdrawal in Critically Ill Patients with Primary Neurologic Injuries.","authors":"Travis Hanson, Frank Paloucek, Abigail Elmes-Patel","doi":"10.1177/10600280251351934","DOIUrl":"https://doi.org/10.1177/10600280251351934","url":null,"abstract":"","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"10600280251351934"},"PeriodicalIF":2.3,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567002","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":"Reply: FDA Approved mRESVIA: Embracing the New Era of RSV Prevention With Advanced mRNA Technology.","authors":"Daniel Wroblewski, Lindsay A Brust-Sisti, Matthew Bridgeman, Mary Barna Bridgeman","doi":"10.1177/10600280241301430","DOIUrl":"10.1177/10600280241301430","url":null,"abstract":"","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"678-679"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799122","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":"Philosophical and Ethical Underpinnings of the Medical Decision-Making Process: A Focus on Patient Values and Preferences.","authors":"Brian L Erstad","doi":"10.1177/10600280241289133","DOIUrl":"10.1177/10600280241289133","url":null,"abstract":"<p><p>Current clinical practice is based on the principles of evidence-based medicine (EBM) with clinical practice guidelines (CPGs) often serving as a source of information for the medical decision-making process. There are philosophical and ethical tenets underlying this process including those pertaining to patient values and preferences. Despite their importance, these tenets may receive less attention than the empirically derived recommendations in CPGs based on the principles of EBM. The purpose of this article is to provide an overview of the philosophical and ethical underpinnings of the medical decision-making process with a focus on patient values and preferences so pharmacists and other clinicians can appreciate the interplay between science, philosophy and ethics when providing patient- or person-centered care. Appreciation of these discussions should help practitioners to recognize the limitations and challenges when attempting to incorporate population-based evidence into a patient-specific medical decision-making process that often necessitates reconciliation and negotiation between the clinician and patient when striving to provide optimal care.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"666-670"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142612184","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":"FDA Approves mRESVIA: Embracing the New Era of RSV Prevention With Advanced mRNA Technology.","authors":"Zainab Anfaal, Zmarak Ahmed Khan, Muhammad Ammar Aslam","doi":"10.1177/10600280241301432","DOIUrl":"10.1177/10600280241301432","url":null,"abstract":"","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"676-677"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799121","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":"Safety of Intermittent Parenteral Midazolam Injection in Hospitalized Patients Admitted to Non-Intensive Care Nursing Units: A Retrospective Matched-Cohort Study.","authors":"Melanie Mills, Haley Torr, Nicolette Centanni, Richard R Riker, David Gagnon, Ashley Gale","doi":"10.1177/10600280241299059","DOIUrl":"https://doi.org/10.1177/10600280241299059","url":null,"abstract":"<p><strong>Background: </strong>The prescribing information for parenteral midazolam contains a Boxed Warning stating its use may precipitate respiratory arrest, and its safety in non-intensive care unit (ICU) nursing units has been understudied.</p><p><strong>Objective: </strong>To characterize the safety of intermittent midazolam injections in patients admitted to non-ICU nursing units relative to lorazepam injections.</p><p><strong>Methods: </strong>This single-center, retrospective, matched-cohort study included patients ≥18 years of age who received intermittent midazolam in non-ICU nursing units. Midazolam administrations were matched 1:1 to lorazepam administrations. Safety outcomes included hypotension, bradycardia, bradypnea, and escalation in level of nursing unit care or oxygen requirement.</p><p><strong>Results: </strong>A total of 94 midazolam administrations were matched to lorazepam administrations. Demographic data were similar between groups. Midazolam was more commonly given intravenously (95.7% vs 85.1%, <i>P</i> = 0.02) and in an intermediate care nursing unit (31.9% vs 14.9%, <i>P</i> = 0.009). The lorazepam cohort had significantly fewer concomitant respiratory depressants administered, and there were no differences in the use of beta-blockers or antihypertensives. There were no differences in the incidence of hypotension (1.1% vs 2.1%, <i>P</i> = 1), bradycardia (5.3% vs 2.1%, <i>P</i> = 0.44), bradypnea (1.1% vs 0%, <i>P</i> = 1), escalation in level of care (2.1% vs 2.1%, <i>P</i> = 1), or escalation in oxygen requirement (5.3% vs 3.2%, <i>P</i> = 0.72).</p><p><strong>Conclusion and relevance: </strong>The administration of parenteral midazolam in non-ICU nursing units resulted in a similar incidence of hypotension, bradycardia, bradypnea, escalation in oxygen requirement, and escalation in level of care compared with lorazepam. These results suggest that midazolam may have a similar safety profile to lorazepam, supporting its use in non-ICU nursing units.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":"59 7","pages":"620-627"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141165","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":"Ceftobiprole Medocaril: A New Fifth-Generation Cephalosporin.","authors":"Justin Zimmerman, Christopher Giuliano, Pramodini B Kale-Pradhan","doi":"10.1177/10600280241293773","DOIUrl":"10.1177/10600280241293773","url":null,"abstract":"<p><strong>Objective: </strong>The objective was to review the pharmacology, efficacy, and safety of intravenous ceftobiprole in the treatment of bloodstream infections, acute bacterial skin and skin structure infections (ABSSSIs), community-acquired pneumonia (CAP), and hospital-acquired pneumonia (HAP), or ventilator-associated pneumonia (VAP).</p><p><strong>Data sources: </strong>PubMed and ClinicalTrials.gov were searched using the following terms: ceftobiprole, ceftobiprole medocaril, ceftobiprole medocaril sodium, Zevtera, and BAL5788.</p><p><strong>Study selection and data extraction: </strong>Articles published in English between January 1985 and August 15, 2024, related to pharmacology, safety, efficacy, and clinical trials were reviewed.</p><p><strong>Data synthesis: </strong>Ceftobiprole has shown similar efficacy to comparator antibiotics in CAP, ABSSSIs, and bloodstream infections. Overall treatment success in patients with bacteremia was 69.8% and 68.7%; 91.3% and 88.1% with ABSSSIs and 86.6% and 87.4% with CAP in ceftobiprole and comparator groups, respectively. Finally, in the management of HAP and VAP, ceftobiprole was inferior in the VAP population. Ceftobiprole had a favorable safety profile with gastrointestinal adverse effects occurring more frequently than comparators.Relevance to Patient Care and Clinical Practice in Comparison to Existing Drugs:Clinicians have limited options to treat multidrug-resistant infections. Ceftobiprole has demonstrated efficacy against causative pathogens in specific infections including methicillin-resistant <i>Staphylococcus aureus</i> bacteremia (SAB), ABSSSI, and CAP and may be considered a viable alternative. However, ceftobiprole's impact on HAP, VAP, and febrile neutropenia needs to be further delineated.</p><p><strong>Conclusion: </strong>Ceftobiprole's broad-spectrum activity makes it a viable option for treating patients hospitalized with CAP, ABSSSI, and SAB. Further studies are needed in severely ill HAP or VAP, febrile neutropenia, and pediatric patients.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"657-665"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791023","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}