Annals of Pharmacotherapy最新文献

{"title":"Reply: Safety and Efficacy of the Prescribing Practices of Ketamine for Pain and Agitation in the Medical Intensive Care Unit.","authors":"Shaelyn Cooper, Rebecca Nashett Wren, MaryEllen Antkowiak, Derek Devine","doi":"10.1177/10600280261423816","DOIUrl":"10.1177/10600280261423816","url":null,"abstract":"","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"1028-1029"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147343468","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":"Biologic Treatments in Adolescents With Moderate-to-Severe Atopic Dermatitis: A Systematic Literature Review and Network Meta-analysis.","authors":"Kevin H Li, Emily K Duffy, Jonathan Luong, Beth Devine","doi":"10.1177/10600280251415369","DOIUrl":"10.1177/10600280251415369","url":null,"abstract":"<p><strong>Background: </strong>Novel interventions, particularly biologic therapies, have been shown to be efficacious and safe in treating atopic dermatitis (AD) in adolescents. However, the comparative efficacy and safety of biologic interventions in adolescents with moderate-to-severe AD have not been explored.</p><p><strong>Objective: </strong>To compare efficacy and safety measures in clinical trials of biologic interventions in adolescents aged 12 to 17 with moderate-to-severe AD.</p><p><strong>Methods: </strong>MEDLINE, Embase, and trial registries were searched for double-blind, randomized placebo-controlled clinical trials assessing the efficacy of biologic therapies in adolescents with moderate-to-severe AD. Arm-level Bayesian network meta-analyses (NMAs) were performed and certainty of evidence was assessed through the Confidence in Network Meta-Analysis grading tool. Primary outcomes included the proportion of participants who achieved 75% improvement in Eczema Area and Severity Index score (EASI-75) and the proportion of participants who achieved 0 (clear) or 1 (almost clear) value on the Investigators' Global Assessment (IGA 0/1) at week 16.</p><p><strong>Results: </strong>Four trials evaluating 3 drugs, dupilumab, lebrikizumab, and tralokinumab, representing 642 study participants were analyzed. Two dosing options were assessed for dupilumab and tralokinumab. Compared with placebo, the greatest effect was observed with dupilumab 200/300 mg every 2 weeks in both EASI-75 (risk ratio [RR]: 5.2; 95% credible interval [CrI]: 2.6, 12.0) and IGA 0/1 (RR: 12.0; 95% CrI: 3.3, 78.0). No differences were found between treatments. Certainty of the evidence was low.</p><p><strong>Conclusion and relevance: </strong>Although there is some evidence that dupilumab may be more efficacious than lebrikizumab or tralokinumab, our findings suggest that there is no strong evidence of superiority of one treatment over another.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"970-978"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146111885","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":"Corrigendum to \"Efficacy of Oxycodone Combined With Thoracic Paravertebral Nerve Block for Postoperative Analgesia in Esophageal Cancer Surgery: A Retrospective Study\".","authors":"","doi":"10.1177/10600280261425822","DOIUrl":"10.1177/10600280261425822","url":null,"abstract":"","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"1030"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147343432","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":"The 2025 CAP Controversy: Why Guideline Methodology Matters for Clinical Decision-Making.","authors":"Brittany Bissell Turpin, Barbara E Jones, Brian L Erstad, Kevin Wilson","doi":"10.1177/10600280261422237","DOIUrl":"10.1177/10600280261422237","url":null,"abstract":"<p><p>The 2025 update to the community-acquired pneumonia guideline illustrates the complex balance between evidence, methodology, and clinical priorities. Discussion among key stakeholders highlights that guidelines are not merely neutral summaries of evidence, but rather structured tools that shape bedside care in numerous ways. Rigorous methodology and transparent consideration of value judgments support recommendations even when evidence is limited or conflicting. Conditional guidance reflects deliberate judgment in areas of uncertainty. Differences between societies often arise from competing priorities, such as balancing antimicrobial stewardship with the risk of undertreatment, rather than from flaws in methodology. For clinicians, understanding how and why recommendations are made is crucial for the safe and evidence-informed application of these guidelines. The 2025 CAP guideline experience offers a practical case study in navigating uncertainty, interpreting conditional guidance, and integrating structured judgment into clinical decision-making.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"1019-1022"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146225207","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":"Real-World Postdischarge P2Y12 Inhibitor Use After Ischemic Stroke and Transient Ischemic Attack, 2020 to 2024.","authors":"Adnan I Qureshi, Hassan Raza, Hatem Tolba, Gunjanpreet Kaur, Kimberley Pfeiffer, Thomas Sandifer, Chun Shing Kwok, Camilo R Gomez, M Fareed K Suri","doi":"10.1177/10600280261487728","DOIUrl":"https://doi.org/10.1177/10600280261487728","url":null,"abstract":"<p><strong>Background: </strong>P2Y12 inhibitor acquisition and continuation after ischemic stroke or transient ischemic attack (TIA) are incompletely characterized.</p><p><strong>Objective: </strong>To describe postdischarge clopidogrel and ticagrelor uptake, persistence, switching, bleeding diagnoses, and trends.</p><p><strong>Methods: </strong>This retrospective descriptive cohort study used US claims (2020-2025). Adults with a first qualifying inpatient ischemic stroke or inpatient/emergency-department TIA from July 2020 through December 2024 were included. Fills were assessed through 90 days. Persistence and 1-year bleeding diagnoses were evaluated among continuously enrolled initiators; switching was assessed through follow-up of 365 days.</p><p><strong>Results: </strong>Among 45 763 patients, 8667 (18.9%) filled a P2Y12 inhibitor within 30 days: 8226 clopidogrel (94.9% of initiators) and 441 ticagrelor (5.1%). Among 5641 continuously enrolled initiators, clopidogrel versus ticagrelor persistence was 66.3% versus 78.3% at day 90 and 50.5% versus 59.6% at day 180; it was low for both at day 365. Switching occurred in 2.9%; 23.8% of ticagrelor initiators later filled clopidogrel versus 1.7% in the reverse direction. Crude 1-year intracerebral hemorrhage and gastrointestinal bleeding diagnosis rates were 2.6% and 5.8%. Overall uptake rose from 18.3% in July to December 2020 to 20.9% in 2024. Claims did not reliably capture over-the-counter aspirin, clinical eligibility, ingestion, or reasons for changes.</p><p><strong>Conclusion and relevance: </strong>Fewer than 1 in 5 adults with coded ischemic stroke or TIA filled a P2Y12 inhibitor within 30 days. These data benchmark outpatient acquisition and persistence, not guideline adherence or comparative effectiveness.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"10600280261487728"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103197","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":"Cancer-Related Malnutrition: The Hospital Pharmacist's Role in Early Detection and Pharmacotherapeutic Optimization.","authors":"Sandra Caíña López, Claudia Barca Díez","doi":"10.1177/10600280261433204","DOIUrl":"10.1177/10600280261433204","url":null,"abstract":"","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"1023-1025"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147490340","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":"Prognostic Value of Mean Platelet Volume-To-Monocyte Ratio and Ferritin in NSTEMI: Independent Impact of Angiotensin-Converting Enzyme Inhibitor Therapy.","authors":"Emir Bećirović, Minela Bećirović, Amir Bećirović, Kenana Ljuca, Admir Abdić, Nadina Ljuca, Emir Begagić, Salih Hammami","doi":"10.1177/10600280261422203","DOIUrl":"10.1177/10600280261422203","url":null,"abstract":"<p><strong>Background: </strong>Inflammation-driven mechanisms play a central role in adverse outcomes after non-ST-elevation myocardial infarction (NSTEMI), yet simple, widely available biomarkers for early risk stratification remain insufficiently defined. Hemogram-derived indices and iron-related inflammatory markers may provide complementary prognostic information.</p><p><strong>Objective: </strong>To evaluate the prognostic significance of the mean platelet volume-to-monocyte ratio (MMR) and serum ferritin in predicting major adverse cardiovascular events (MACE) in patients with NSTEMI, and to assess the association of angiotensin-converting enzyme (ACE) inhibitor therapy with clinical outcomes.</p><p><strong>Methods: </strong>This prospective cohort study included 170 consecutive NSTEMI patients admitted to the University Clinical Center Tuzla between February 2022 and January 2023. All patients received dual antiplatelet therapy and high-intensity statins. The baseline evaluation included a complete blood count, serum ferritin, and C-reactive protein. MMR was calculated as the ratio of mean platelet volume to absolute monocyte count. Patients were followed for 12 months for the occurrence of MACE, defined as cardiovascular death, non-fatal myocardial infarction, urgent revascularization, stroke, or hospitalization for heart failure.</p><p><strong>Results: </strong>During follow-up, 103 patients (60.6%) experienced MACE. Admission MMR (18.1 ± 11.7 vs 13.2 ± 5.5; <i>P</i> = 0.003) and ferritin levels (284 ± 396 vs 152 ± 109 µg/L; <i>P</i> = 0.001) were significantly higher in patients with events. In multivariable analysis, both MMR (odds ratio [OR] 1.06, 95% confidence interval [CI] 1.02-1.11; <i>P</i> = 0.008) and ferritin (OR 1.28 per 100 µg/L, 95% CI 1.10-1.55; <i>P</i> = 0.003) independently predicted MACE, while ACE inhibitor therapy was associated with a lower risk (OR 0.24, 95% CI 0.08-0.70; <i>P</i> = 0.01). The combined model demonstrated good discriminative performance (AUC 0.72; 95% CI 0.64-0.80).</p><p><strong>Conclusion and relevance: </strong>Elevated admission MMR and ferritin were independently associated with a higher 1-year risk of MACE in patients with NSTEMI. ACE inhibitor therapy was associated with improved outcomes, although causality cannot be inferred. These findings suggest that readily available inflammatory biomarkers may complement established clinical parameters for early risk stratification and support continued guideline-directed pharmacotherapy in NSTEMI.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"933-941"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146225184","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":"Albumin Versus Crystalloids in Postcardiac Surgery Fluid Resuscitation: A Cost and Safety Analysis.","authors":"Eisa Azhar, Corianne Thackrey, Taylor Menderski, Keith Hecht, Brandon Mullins","doi":"10.1177/10600280251393677","DOIUrl":"10.1177/10600280251393677","url":null,"abstract":"<p><strong>Background: </strong>Intravenous fluids are commonly used in postcardiac surgery to maintain or increase intravascular volume. While volume expansion after cardiac surgery is often necessary, the optimal fluid type to use is not established.</p><p><strong>Objective: </strong>The objective of the study is to evaluate cost-savings and clinical outcomes of an albumin minimization protocol for postcardiac surgery fluid resuscitation at a surgical intensive care unit in a community teaching hospital.</p><p><strong>Methods: </strong>This was a single-center retrospective cohort study of patients who received fluid resuscitation after open heart coronary artery bypass surgery or valvular surgery while on cardiopulmonary bypass at a community teaching hospital between February 2021 and May 2022. Cohorts were split up prior to the implementation of an albumin minimization protocol that was implemented in September 2021. The primary outcome was the amount of albumin or crystalloid fluids received after surgery, and the overall cost of intravenous fluids after surgery. Secondary outcomes included 30-day mortality, acute kidney injury, hours on oxygen support, hours on vasopressors, multiple vasopressors used, perioperative blood product transfusions, and 72-hour surgery take back.</p><p><strong>Results: </strong>Of 434 total patients evaluated, 400 patients met criteria for inclusion. Baseline characteristics were balanced between the 2 groups. Average surgical time was shorter in the postprotocol arm. Per patient use of albumin decreased by 27.1 g (22.8-31.4) while crystalloid fluid use increased by 1 L (0.9-1.2) after implementation of the albumin minimization protocol. Average cost savings were approximately $178 per surgery. No statistically significant difference was seen in any of the secondary safety and efficacy outcomes.</p><p><strong>Conclusion and relevance: </strong>This study adds to the body of literature suggesting that the use of an albumin minimization protocol after open heart cardiac surgery was safe and effective. A significant reduction in cost and utilization of albumin was seen in the study without affecting patient outcomes.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"986-990"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146058265","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":"Rasburicase Real-World Usage for the Prevention and Treatment of Tumor Lysis Syndrome in Adults and Children.","authors":"Sandra Labonté, Émilie Bergeron, Isabelle Laverdière, Julien Valois-Demers, Louis-Philippe Grenier","doi":"10.1177/10600280251391871","DOIUrl":"10.1177/10600280251391871","url":null,"abstract":"<p><strong>Background: </strong>Rasburicase is used to prevent and treat tumor lysis syndrome (TLS) by breaking down uric acid. Administration methods vary, including fixed, weight-based (0.15-0.2 mg/kg), single and multiple doses. Our primary objective is to describe rasburicase use in both adults and children for TLS prevention and treatment. Secondary objectives are to describe the efficacy and safety of different regimens inventoried. Exploratory objective is to estimate savings associated with use of a single fixed dose.</p><p><strong>Methods: </strong>Retrospective descriptive study conducted among patients who received rasburicase for TLS prevention or treatment between January 2014 and April 2024 in 3 oncology services of the Hospital Center.</p><p><strong>Results: </strong>A total of 133 adults and 60 children were included, of which 42.9% and 5.0%, respectively, presented biochemical TLS pre-rasburicase. A single 6 mg dose was administered in 86.5% of adults and 21.7% of children. Multiple daily doses were used in 24.8% of adults and 76.7% of children. Few adults (1.5%) received weight-based doses, contrary to children (76.7%). Normalized uric acid (< 476 μmol/L) was observed in 97.9% of patients 24 hours after a first dose, with no serious adverse events. Estimated savings were 86 542.92 CA$ if all patients included (n = 193) received a single 0.15 mg/kg dose, capped at 6 mg.</p><p><strong>Conclusion and relevance: </strong>In the adult and pediatric population, a single rasburicase dose of 0.15 to 0.2 mg/kg, capped at 6 mg, represents an effective, safe, and more cost-effective option for both the prevention and treatment of TLS. Further studies are warranted to compare single versus multiple dosing in pediatric populations and to identify potential risk factors for nonresponders.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"950-961"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145740710","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":"Comment on \"Safety and Efficacy of the Prescribing Practices of Ketamine for Pain and Agitation in the Medical Intensive Care Unit\".","authors":"Kishankumar Mahida, Snehal Rajendra Jagtap","doi":"10.1177/10600280261423585","DOIUrl":"10.1177/10600280261423585","url":null,"abstract":"","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"1026-1027"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147343348","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}