Annals of Pharmacotherapy最新文献

{"title":"Sugammadex Use Outside of the Postoperative Setting.","authors":"Hayley T Gartner, Megan A Rech","doi":"10.1177/10600280241232660","DOIUrl":"10.1177/10600280241232660","url":null,"abstract":"<p><strong>Background: </strong>Sugammadex rapidly reverses the nondepolarizing neuromuscular blocking agents (NMBAs) rocuronium and vecuronium. The role of sugammadex is not well-defined outside of the postoperative setting.</p><p><strong>Objective: </strong>This study aims to describe sugammadex use outside the postoperative setting for the reversal of nondepolarizing NMBAs.</p><p><strong>Methods: </strong>This was a single-center, retrospective cohort study conducted in patients who received sugammadex outside of the postoperative setting at an academic medical center between June 2016 and November 2022. The primary outcome was the effect of sugammadex use for rocuronium reversal, defined as any increase in train-of-four (TOF) after sugammadex administration and/or progress note documentation if TOF was unavailable. Secondary outcomes included adverse events and documentation of contraceptive counseling in patients taking hormonal contraceptives with child-bearing ability.</p><p><strong>Results: </strong>A total of 14 383 patients received sugammadex during the study period. Of those patients, 39 (0.3%) were outside of the postoperative setting for the reversal of rocuronium and included in the study. Twenty-nine (74%) patients had an increase in TOF after sugammadex administration and/or progress note documentation if TOF was unavailable. Ten (26%) patients lacked documentation regarding the effect of sugammadex. No adverse reactions were reported. Three (8%) patients included in the study were of child-bearing ability, and 1 of the 3 patients was counseled on using an alternative method of contraception following sugammadex administration.</p><p><strong>Conclusion and relevance: </strong>There is a paucity of literature for the use of sugammadex outside of the postoperative setting. This study found that while the use of sugammadex was rare, overall, it was safe and well-tolerated.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"1117-1121"},"PeriodicalIF":2.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139929653","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":"Cytomegalovirus Treatment in Solid Organ Transplantation: An Update on Current Approaches.","authors":"Karen L Hardinger, Daniel C Brennan","doi":"10.1177/10600280241237534","DOIUrl":"10.1177/10600280241237534","url":null,"abstract":"<p><strong>Objective: </strong>The article reviews the safety and efficacy of treatments for cytomegalovirus (CMV) in solid organ transplantation.</p><p><strong>Data sources: </strong>A literature review was conducted in PubMed, MEDLINE, and Clinicaltrials.gov from database inception through January 2024, using terms CMV, therapy, and solid organ transplantation.</p><p><strong>Study selection and data extraction: </strong>Clinical trials, meta-analyses, cohort studies, case reports, and guidelines were included. Letters to the editor, reviews, and commentaries were excluded.</p><p><strong>Data synthesis: </strong>After abstract screening and full-text review of 728 citations for eligibility, 53 were included. Valganciclovir and intravenous ganciclovir are drugs of choice for CMV management and, until recently, the availability of alternative options has been restricted due to toxicity. For instance, foscarnet and cidofovir serve as second-line agents due to potential bone marrow and renal toxicity. In patients with refractory or resistant CMV, maribavir, a novel oral agent, has proven efficacy and a lower adverse effect profile. However, in refractory or resistant CMV, foscarnet and cidofovir are preferred in invasive disease (CMV gastritis, CMV retinitis, and CMV encephalitis), high viral loads, and inability to tolerate oral preparations.</p><p><strong>Relevance to patient care and clinical practice: </strong>Consensus guidelines have not been revised since approval of novel antivirals in solid organ transplantation. Valganciclovir and ganciclovir remain drugs of choice for initial CMV therapy. Foscarnet, cidofovir, and maribavir are treatments for refractory or resistant-CMV.</p><p><strong>Conclusions: </strong>Selection of CMV antiviral treatment should be determined by patient-specific factors, including severity of illness, resistant or refractory disease, dose-limiting adverse effects, and the preferred route of administration.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"1122-1133"},"PeriodicalIF":2.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140157432","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":"Evaluation of Short Versus Long Courses of Antibiotics in Critically Ill Patients With Gram-Negative Bloodstream Infections.","authors":"Daniel T Anderson, Divisha Sharma, Aaron M Chase, Zoheb Irshad Sulaiman, August H Anderson, Ashley L Huggett, Joshua Eudy","doi":"10.1177/10600280241231611","DOIUrl":"10.1177/10600280241231611","url":null,"abstract":"<p><strong>Background: </strong>Short courses of antibiotics (7-10 days) are effective for uncomplicated gram-negative bloodstream infections (GN-BSI). However, prior studies have been limited to small cohorts of critically ill patients.</p><p><strong>Objective: </strong>The objective of this study was to evaluate the safety and efficacy of short courses of therapy compared with longer courses in patients admitted to the intensive care unit (ICU) with GN-BSI.</p><p><strong>Methods: </strong>Propensity-matched, retrospective cohort study of critically ill patients with GN-BSI. The primary outcome was a composite of 30-day mortality or 60-day relapse. Secondary endpoints were components of the composite, 30-day relapse, cure with or without adverse drug events (ADE), and ADEs. Regression analysis was performed to identify factors predictive of the composite outcome.</p><p><strong>Results: </strong>225 patients were included in the propensity analysis, 145 in the long cohort and 80 in the short cohort. The primary outcome occurred in 3.8% of patients in the short group and 9.0% of patients in the long group (<i>P</i> = 0.24). There was no difference in 30-day mortality (3.8% vs 5.5%, <i>P</i> = 0.79), 60-day relapse (0% vs 3.4%, <i>P</i> = 0.23), or 30-day readmission (20% vs 22.8%, <i>P</i> = 0.76). ADEs were more common in the long group (47.2% vs 34.1%, OR 1.7, 95% CI 1.04-2.9), primarily attributable to diarrhea.</p><p><strong>Conclusion and relevance: </strong>In critically ill patients with GN-BSI, there were no efficacy outcome differences in patients treated with a short course of antibiotics compared with longer. However, patients in the short group were less likely to experience ADE. These findings suggest that short courses of antibiotics are effective for GN-BSI in critically ill patients.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"1081-1088"},"PeriodicalIF":2.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11317549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139721307","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":"Influence of the Type of Antiretroviral Treatment on the Time to Reach High Pharmacotherapy Complexity in People Living With HIV.","authors":"Enrique Contreras Macías, María de Las Aguas Robustillo Cortés, José Ramón Blanco Ramos, Ramón Morillo Verdugo","doi":"10.1177/10600280241291738","DOIUrl":"https://doi.org/10.1177/10600280241291738","url":null,"abstract":"<p><strong>Background: </strong>The introduction of antiretroviral therapy (ARV) has significantly improved the survival of people living with HIV (PLWH), increasing the proportion of individuals over 50 years old. This aging trend poses challenges, such as the development of age-related comorbidities and a higher prevalence of polypharmacy. The pharmacotherapeutic complexity, assessed using the Medication Regimen Complexity Index (MRCI), is crucial for identifying and optimizing treatment, especially in elderly and polymedicated patients.</p><p><strong>Objective: </strong>The main objective was to assess the association between different ARV regimens and the time required to reach a high level of pharmacotherapeutic complexity in PLWH.</p><p><strong>Methods: </strong>A single-center observational analytical research study was conducted, including adult PLWH on active ARV from January 2010 to December 2021 with follow-up until December 2023. An analysis of the time to reach MRCI ≥11.25 was performed, followed by a Cox regression model to determine the influence of ARV on high MRCI.</p><p><strong>Results: </strong>A total of 789 PLWH were included, median age of 52 years (interquartile range: 45-58). Overall, 195 patients had an MRCI value ≥11.25 with a mean time to reach it of 181.86 months (95% confidence interval [CI]: 176.24 to 187.49). Significant differences were observed in sex, advanced age, AIDS stage, presence of comorbidities, polypharmacy, and ARV-related variables. A multivariate Cox proportional hazards model showed an association between integrase inhibitor (INSTI)-containing regimens (hazard ratio [HR]: 1.83; 95% CI: 1.08 to 3.10) and non-nucleoside reverse transcriptase inhibitor (NNRTI)-based regimens (HR: 0.72; 95% CI: 0.52 to 0.98) with the time to reach high MRCI.</p><p><strong>Conclusions and relevance: </strong>In summary, NNRTI-based regimens were associated with a lower likelihood of developing high MRCI compared to INSTI-based regimens, which was associated with a higher likelihood. These conclusions are based on a profile of PLWH that included advanced age and a high prevalence of comorbidities and polypharmacy. Identifying high MRCI may help us implement pharmacotherapeutic optimization strategies to improve health outcomes.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"10600280241291738"},"PeriodicalIF":2.3,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142493078","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":"Efficacy and Safety of Mifepristone and Misoprostol Compared to Misoprostol Alone for the Resolution of Miscarriage and Intrauterine Fetal Death: A Systematic Review and Meta-Analysis.","authors":"Rachael G Pirrami, Justin P Reinert","doi":"10.1177/10600280241289968","DOIUrl":"https://doi.org/10.1177/10600280241289968","url":null,"abstract":"<p><strong>Objective: </strong>To determine the efficacy and safety of mifepristone and misoprostol together (intervention) compared to misoprostol alone (comparator) for the resolution of miscarriage and intrauterine fetal death.</p><p><strong>Data sources: </strong>A systematic review and meta-analysis were conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) methodology through July 2024 that evaluated the efficacy and safety of mifepristone and misoprostol together compared to misoprostol alone for the resolution of miscarriage and intrauterine fetal death through July 2024.</p><p><strong>Study selection and data extraction: </strong>Primary endpoints were overall delivery success, 24-hour delivery success, and incidence of safety outcomes. A <i>P</i>-value of <0.05 was considered statistically significant, and heterogeneity was reported as the I² value.</p><p><strong>Data synthesis: </strong>Twelve randomized controlled trials (RCTs) were included. Overall delivery success was higher in the intervention group (0.73 [CI 0.64-0.82], <i>P</i> < 0.01). Twenty-four-hour delivery rate was higher (1.54 [CI 1.32-1.77], <i>P</i> = 0.06), and a shorter time to delivery interval (9.22-18.78 vs 15.47-37.1 hours) was observed in the intervention group. Gastrointestinal adverse effects were more frequent in the intervention group (0.04 [CI -0.03 to 0.12], <i>P</i> < 0.01).</p><p><strong>Relevance to patient care and clinical practice: </strong>Mifepristone and misoprostol together demonstrated higher delivery success rates and comparable safety outcomes to misoprostol alone, demonstrating the potential of improving patient care and positively impacting the time to successful delivery for patients at the bedside.</p><p><strong>Conclusions: </strong>The use of mifepristone and misoprostol together for the resolution of miscarriage and intrauterine fetal death is warranted over the use of misoprostol alone.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"10600280241289968"},"PeriodicalIF":2.3,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142493077","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":"Bimekizumab-bkzx for the Treatment of Plaque Psoriasis: A Drug Review.","authors":"Margaret E Greer, Shannon K Moran, Steven R Feldman","doi":"10.1177/10600280241288553","DOIUrl":"https://doi.org/10.1177/10600280241288553","url":null,"abstract":"<p><strong>Background: </strong>Bimekizumab is a biologic targeting interleukin (IL)-17A/17F, approved by the Food and Drug Administration (FDA) for moderate-to-severe plaque psoriasis in 2023.</p><p><strong>Data sources: </strong>A PubMed search was performed using the keywords \"bimekizumab,\" \"plaque psoriasis,\" and \"bimekizumab clinical trials,\" from origin to August 1, 2024. We included phase I to III trials of bimekizumab for plaque psoriasis, studies published post-FDA approval, and information from the package insert.</p><p><strong>Study selection, data extraction: </strong>We summarized 1 phase I, 4 phase II, and 4 phase III trials, and 3 real-world studies published post-FDA approval.</p><p><strong>Data synthesis: </strong>Bimekizumab was effective; >85% and 70% of patients achieved PASI90 and PASI100, respectively, in phase III trials. Head-to-head, 85% of bimekizumab patients achieved PASI90 versus 50% of ustekinumab patients. The most frequent adverse event was oral candidiasis (4%-10%); serious adverse events were rare (<1%). Long-term studies confirmed sustained efficacy and consistent safety profile.</p><p><strong>Relevance to patient care and clinical practice in comparison to existing drugs: </strong>Bimekizumab was more efficacious than other IL-17 inhibitors, ustekinumab, and adalimumab. Real-world data corroborate bimekizumab's efficacy. Bimekizumab had a safety profile like other IL-17 inhibitors, with higher rates of mucocutaneous candidiasis.</p><p><strong>Conclusion: </strong>Many patients who failed other IL-17 inhibitors and switched to bimekizumab experienced clearance. The efficacy of bimekizumab in patients who failed other IL-17 blockers may be attributable to bimekizumab's ability to block multiple IL-17 isoforms. Bimekizumab also outperformed tumor necrosis factor (TNF)-alpha inhibitors. There may be patients who fail previously available drugs, for reasons including nonadherence, antidrug antibodies, or adverse effects; bimekizumab, which targets additional cytokines, may bridge that gap.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"10600280241288553"},"PeriodicalIF":2.3,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456325","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":"Icodec: A Novel Once-Weekly Basal Insulin for Diabetes Management.","authors":"Jennifer Goldman, Curtis Triplitt, Diana Isaacs","doi":"10.1177/10600280241287790","DOIUrl":"https://doi.org/10.1177/10600280241287790","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy, safety, and clinical implications of insulin icodec, a novel once-weekly basal insulin for the treatment of type 1 diabetes (T1D) and type 2 diabetes (T2D), with an emphasis on its advantages and challenges in comparison with existing daily basal insulins.</p><p><strong>Data sources: </strong>A literature search was performed using PubMed, Google Scholar, Embase, and ClinicalTrials.gov up to August 26, 2024, using the search terms <i>icodec</i> and <i>ONWARDS trial</i>. Studies involving patients living with T1D or T2D on once-weekly insulin icodec compared with once-daily insulins glargine U100, glargine U300, and degludec were considered for this review.</p><p><strong>Study selection and data extraction: </strong>Relevant English-language studies and those conducted in humans were considered.</p><p><strong>Data synthesis: </strong>Insulin icodec offers reduced dosing frequency and potentially superior glycemic management with a safety profile comparable to existing basal insulins.</p><p><strong>Relevance to patient care and clinical practice: </strong>Insulin icodec once-weekly dosing could significantly improve convenience and efficacy over daily basal insulins, representing a significant innovation in insulin therapy.</p><p><strong>Conclusions: </strong>Insulin icodec emerges as a promising option for diabetes management, potentially improving treatment adherence and quality of life.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"10600280241287790"},"PeriodicalIF":2.3,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456327","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":"Olanzapine Versus Quetiapine: Corrected QT Changes in Critically Ill Patients.","authors":"Kaden Shen, Kevin M Dube, Jeremy R DeGrado, Paul M Szumita, Kenneth E Lupi","doi":"10.1177/10600280241290254","DOIUrl":"https://doi.org/10.1177/10600280241290254","url":null,"abstract":"<p><strong>Background: </strong>Olanzapine and quetiapine are frequently administered atypical antipsychotic medications and their effects on the corrected QT (QTc) in the critically ill population remain understudied.</p><p><strong>Objective: </strong>The objective of this study was to compare the impact of olanzapine and quetiapine on QTc changes in critically ill patients.</p><p><strong>Methods: </strong>This was a single-center, retrospective analysis. Adult patients admitted to the intensive care unit (ICU) from January 2023 through July 2023 were included if they received ≥2 doses of either olanzapine or quetiapine within a 48-hour period and had one QTc evaluated within 48 hours of antipsychotic initiation. The major endpoint was a composite of the incidence of QTc prolongation (defined as QTc > 500 ms or QTc > 60 ms above baseline) following antipsychotic initiation. Univariable and multivariable analyses were performed to identify risk factors for QTc prolongation.</p><p><strong>Results: </strong>There was no statistical difference in the major composite endpoint between patients in the olanzapine and quetiapine groups (8/83 [9.6%] vs 19/129 [14.7%]; <i>P</i> = .28). The incidence of QTc > 500 ms (7/244 [2.9%] vs 20/427 [4.7%]; <i>P</i> = .25) and change from baseline >60 ms (5/244 [2.0%] vs 17/427 [4.0%]; <i>P</i> = .26) were not statistically different between the olanzapine and quetiapine groups, respectively. There were no occurrences of Torsades de Pointes or extrapyramidal symptoms in either group.</p><p><strong>Conclusion and relevance: </strong>The results of this study suggest olanzapine and quetiapine may have similar impact on QTc prolongation in critically ill patients. These findings could contribute to safer prescribing practices in the ICU.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"10600280241290254"},"PeriodicalIF":2.3,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456328","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 Peripherally Infused Sympathomimetic Vasopressors in the Intensive Care Unit and Emergency Department.","authors":"Albert Zichichi, Ryan Wallace, Jessica Daniell, Ginger Rouse, Paul Ahearn, Mahmoud Ammar","doi":"10.1177/10600280241284796","DOIUrl":"https://doi.org/10.1177/10600280241284796","url":null,"abstract":"<p><strong>Background: </strong>Sympathomimetic vasopressors may be administered through a peripheral catheter, but there are limited data available on the safety of peripheral use.</p><p><strong>Objective: </strong>The purpose of this study was to analyze the safety of peripherally infused sympathomimetic vasopressors.</p><p><strong>Methods: </strong>A multicenter, retrospective observational study was conducted to evaluate patients who received peripheral vasopressors. The study's primary outcome was to assess the incidence of extravasation during the administration of peripheral vasopressors. Secondary outcomes include avoidance of central venous catheter (CVC) placement and institution protocol deviations.</p><p><strong>Results: </strong>There were 198 patients included in the study, of which 142 patients received norepinephrine, 48 patients received phenylephrine, and 8 patients received epinephrine peripherally. Extravasation events occurred in 11 (5.6%) patients. Seven patients required a pharmacologic antidote and 10 patients required a warm compress. No significant differences were seen in characteristics of patients who extravasated compared with those who did not. Protocol deviations identified during the study included 24 (12.1%) patients receiving doses above the protocol maximum, 19 (9.6%) with a body mass index above the protocol maximum, and 45 (22.7%) patients receiving peripheral vasopressor over 24 hours. The majority of patients were able to avoid CVC placement (59.1%).</p><p><strong>Conclusion and relevance: </strong>Peripherally infused sympathomimetic vasopressors are safe to administer up to 24 hours with a low incidence of extravasation events while avoiding CVC placement in the majority of patients.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"10600280241284796"},"PeriodicalIF":2.3,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456329","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":"Engaging a New Treatment Paradigm: Elranatamab in Relapsed/Refractory Multiple Myeloma.","authors":"George Saied, Zachery Halford","doi":"10.1177/10600280241281742","DOIUrl":"https://doi.org/10.1177/10600280241281742","url":null,"abstract":"<p><strong>Objective: </strong>To review the therapeutic profile of elranatamab, a novel bispecific T-cell-redirecting therapy, in treating relapsed or refractory (R/R) multiple myeloma (MM).</p><p><strong>Data sources: </strong>A PubMed search was conducted for English-language articles published from January 2000 through June 2024, using the search terms: <i>PF-06863135, elranatamab, Elrexfio</i>, and \"<i>Multiple Myeloma.</i>\" Additional data were obtained from ClinicalTrials.gov and other pertinent publications and meeting abstracts.</p><p><strong>Study selection and data extraction: </strong>Clinical trials, guidelines, and prescribing information pertaining to elranatamab were included.</p><p><strong>Data synthesis: </strong>The phase II MagentisMM-3 trial demonstrated an overall response rate of 61.0% (95% confidence interval, 51.8-69.6) in patients naïve to B-cell maturation antigen targeting therapy (cohort A, n = 123), establishing elranatamab monotherapy as a viable treatment option for patients with R/R MM who have received at least 4 prior lines of therapy. The duration of response and progression-free survival at 12 months were 75.3% and 56.6%, respectively.</p><p><strong>Relevance to patient care and clinical practice in comparison with existing drugs: </strong>Despite the promising activity of elranatamab in R/R MM, the significant treatment-related adverse effects (AEs) associated with this therapy necessitate careful monitoring and expert management. Common AEs include cytokine release syndrome, neurotoxicity, hematologic toxicity, and infectious complications. The cost-effectiveness of elranatamab has yet to be evaluated.</p><p><strong>Conclusions: </strong>Elranatamab is approved by the Food and Drug Administration as a treatment option for patients with heavily pretreated R/R MM. Further studies are warranted to identify the optimal treatment strategy for elranatamab and other bispecific antibodies in the management of R/R MM.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"10600280241281742"},"PeriodicalIF":2.3,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456326","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}