Annals of Pharmacotherapy最新文献

{"title":"Orforglipron: An Oral GLP-1 Receptor Agonist for Obesity Treatment.","authors":"Jon P Wietholter, Chris M Terpening","doi":"10.1177/10600280261486055","DOIUrl":"https://doi.org/10.1177/10600280261486055","url":null,"abstract":"<p><strong>Objective: </strong>To describe the properties of a newly approved oral glucagon-like peptide-1 receptor agonist for the treatment of obesity.</p><p><strong>Data sources: </strong>A literature search of MEDLINE and SCOPUS was performed without date range exclusions using the search terms orforglipron and obesity. Additional articles were identified from review of clinical trial bibliographies and product monograph.</p><p><strong>Study selection and data extraction: </strong>Two phase 1 studies in healthy individuals and in patients with type 2 diabetes mellitus and 4 phase 2/3 clinical trials specifically evaluating orforglipron use for obesity were identified for analysis, using no date exclusion criteria.</p><p><strong>Data synthesis: </strong>Orforglipron was evaluated in 4 phase 2/3 trials regarding its efficacy for weight loss. These trials showed a mean 7.1% to 10.6% placebo-adjusted weight reduction with orforglipron. Adverse events seen with its use were primarily gastrointestinal.Relevance to Patient Care and Clinical Practice in Comparison With Existing Drugs:Orforglipron provides an oral weight management option that is potentially more effective than liraglutide, similarly effective compared with semaglutide, and less effective than tirzepatide. As a non-injectable option that does not require strict oral administration parameters, orforglipron has advantages in certain patient populations.</p><p><strong>Conclusions: </strong>Orforglipron is a potentially useful addition for the treatment of obesity, but it still requires additional data on efficacy in treatment of obesity-related comorbidities for full comparison.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"10600280261486055"},"PeriodicalIF":2.5,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001095","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 Fremanezumab in Episodic Migraine: A Systematic Review and Meta-analysis.","authors":"Taha Ibrahim, Muhammad Burhan, Shaheer Bin Shafiq, Ali Wajahat, Owais Sanaullah, Muhammad Hanzalah Atif, Ghulam Taha Khan, Muhammad Anzar, Ammad Uddin, Jawaria Ibrahim, Muhammad Ahmed Zahoor, Ibrahim Nagmeldin Hassan","doi":"10.1177/10600280261480989","DOIUrl":"https://doi.org/10.1177/10600280261480989","url":null,"abstract":"<p><strong>Background: </strong>Fremanezumab, a calcitonin gene-related peptide monoclonal antibody, is approved for migraine prevention, yet evidence specific to episodic migraine remains limited. We synthesized randomized evidence on its efficacy and safety.</p><p><strong>Methods: </strong>Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO CRD420261385104), we systematically searched PubMed, Embase, and Scopus from inception to June 5, 2026, for placebo-controlled randomized controlled trials (RCTs) evaluating fremanezumab for episodic migraine prevention. Primary outcomes were the ≥50% responder rate and change in monthly migraine days. Random-effects meta-analyses were performed, and risk of bias was assessed using the Cochrane RoB 2 tool.</p><p><strong>Results: </strong>Four RCTs including 1764 participants were included. Fremanezumab significantly increased the ≥50% responder rate (risk ratio: 1.81, 95% CI: 1.53-2.15) and reduced monthly migraine days (mean difference: -1.98, 95% CI: -2.93 to -1.03), headache days, acute medication-use days, and migraine-related disability. Overall safety was comparable to placebo, with no significant differences in treatment-emergent adverse events, serious adverse events, or treatment discontinuations; injection-site induration occurred more frequently with fremanezumab.</p><p><strong>Relevance to patient care and clinical practice: </strong>This meta-analysis strengthens the evidence supporting fremanezumab as an effective and generally well-tolerated preventive therapy for episodic migraine. The demonstrated reductions in migraine frequency, disability, and acute medication use, together with flexible monthly and quarterly dosing, support its use in appropriately selected patients and may facilitate individualized treatment decisions by clinicians and pharmacists. Although the inclusion of pediatric data expands the current evidence base, these findings should be interpreted cautiously because they are derived from a single randomized trial.</p><p><strong>Conclusion: </strong>Fremanezumab is an effective and generally well-tolerated preventive treatment for episodic migraine. Evidence is robust in adults, whereas pediatric findings remain preliminary and warrant confirmation in future randomized trials.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"10600280261480989"},"PeriodicalIF":2.5,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148910836","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 Baxdrostat in Hypertension: A GRADE-Assessed Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Muhammad Burhan, Zain Ul Abideen Shahid, Muhammad Abdullah Naveed, Nitin Wathore, Ziyan Ansari, Taha Ibrahim, Syed Huzaifa Alam Raza, Malika Abidi, Ayesha Irshad, Shiva Kumar, Saad Ashraf, Zoya Ansari, Mudassir Shahnawaz, Urooj Sheraz, Muhammad Salaar Riaz, Maham Abbasi","doi":"10.1177/10600280261480672","DOIUrl":"https://doi.org/10.1177/10600280261480672","url":null,"abstract":"<p><strong>Background: </strong>Baxdrostat, a selective aldosterone synthase inhibitor, has emerged as a novel therapy for uncontrolled or resistant hypertension; however, randomized controlled trials (RCTs) have shown variable results.</p><p><strong>Objective: </strong>To evaluate the efficacy and safety of baxdrostat compared with placebo or standard care in patients with uncontrolled or resistant hypertension.</p><p><strong>Methods: </strong>We conducted a Preferred Reporting Items for Systematic Reviews and Meta-analyses-compliant systematic review and meta-analysis of RCTs. PubMed, Embase, Scopus, Cochrane Library, and ClinicalTrials.gov were searched from inception to March 2026. Random-effects models were used to pool standardized mean differences (SMDs) and risk ratios (RRs). Certainty of evidence was assessed using Grading of Recommendations Assessment, Development, and Evaluation (GRADE).</p><p><strong>Results: </strong>Five RCTs (n = 1724) were included. Baxdrostat significantly reduced systolic blood pressure (SMD = -0.40; 95% CI = -0.59 to -0.22; <i>P</i> < .001) and diastolic blood pressure (SMD = -0.29; 95% CI = -0.47 to -0.11; <i>P</i> <i>=</i> .001), and increased achievement of blood pressure control <130 mm Hg (RR = 2.08; 95% CI = 1.18-3.68; <i>P</i> < .001). It reduced serum sodium (SMD = -0.63; 95% CI = -0.80 to -0.47) but increased serum potassium (SMD = 0.91; 95% CI = 0.77-1.05), hyperkalemia (RR = 10.22; 95% CI = 4.22-24.73), and hyponatremia (RR = 2.90; 95% CI = 1.82-4.61). A modest decline in eGFR was observed (SMD = -0.49; 95% CI = -0.65 to -0.34). Serious adverse events and mortality were not significantly different. Evidence certainty was moderate to high.</p><p><strong>Conclusion and relevance: </strong>Baxdrostat significantly improves blood pressure control in patients with uncontrolled or resistant hypertension but increases the risk of hyperkalemia and other electrolyte disturbances. These findings strengthen the evidence for selective aldosterone synthase inhibition as a therapeutic approach for aldosterone-mediated hypertension and suggest that baxdrostat may provide an additional treatment option, particularly for patients who remain uncontrolled or cannot tolerate mineralocorticoid receptor antagonists. However, the increased risk of hyperkalemia and the limited duration of available trials highlight the need for careful electrolyte and renal monitoring and further studies evaluating long-term cardiovascular outcomes and comparisons with established therapies.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"10600280261480672"},"PeriodicalIF":2.5,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900092","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 Linaclotide in Pediatric Patients of Functional Constipation: A Meta-analysis of Randomized Controlled Trials.","authors":"Muhammad Saad Khan, Humayou Ahmed, Erum Siddiqui, Maliha Khalid, Devya Khaim Chandani, Hafiz Waqas Naseer, Muhammad Tarish Abro","doi":"10.1177/10600280261479335","DOIUrl":"https://doi.org/10.1177/10600280261479335","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy and safety of linaclotide in children with functional constipation (FC) by synthesizing evidence from randomized controlled trials (RCTs).</p><p><strong>Data sources: </strong>A systematic search of PubMed, Scopus, Cochrane Central Register of Controlled Trials, and Google Scholar was conducted from inception through December 2024. The protocol was registered in PROSPERO (CRD420251018285), and the review was performed according to PRISMA guidelines.</p><p><strong>Study selection and data extraction: </strong>RCTs comparing linaclotide with placebo in children (<18 years) with FC were included. Two reviewers independently screened studies, extracted data, and assessed risk of bias using the Cochrane RoB 2 tool. Certainty of evidence was evaluated using the GRADE framework.</p><p><strong>Data synthesis: </strong>Three RCTs involving 309 pediatric patients were included. Random-effects models demonstrated significant improvements with linaclotide in stool consistency (MD = 0.56, 95% CI, 0.27-0.86; <i>P</i> = .0001) and reduction in straining (MD = -0.26, 95% CI, -0.42 to -0.10; <i>P</i> = .001). No significant effects were observed for spontaneous bowel movement frequency, complete spontaneous bowel movement frequency, or abdominal pain. Treatment-related adverse events were more frequent with linaclotide (relative risk [RR] = 2.93, 95% CI, 1.27-6.77), mainly due to increased diarrhea (RR = 3.81, 95% CI, 1.48-9.82).</p><p><strong>Relevance to patient care and clinical practice: </strong>Linaclotide may provide symptom relief for selected children with FC, particularly those with hard stools and straining despite conventional therapy. Clinicians should counsel families regarding diarrhea risk and monitor tolerability, while recognizing the limited long-term pediatric evidence.</p><p><strong>Conclusions: </strong>Linaclotide improves stool consistency and reduces straining in pediatric FC but does not consistently improve bowel frequency or global symptom resolution. Its safety profile is generally acceptable, although diarrhea is a notable adverse effect. Further long-term, independently funded trials are needed to define its optimal role in clinical practice.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"10600280261479335"},"PeriodicalIF":2.5,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148890686","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":"Estimating GFR Using Creatinine, Cystatin C, or Both and the Impact on Predicted Vancomycin Half-Life.","authors":"Amanda Dobson, Robert MacLaren, Shelby Pons, Michelle Krey","doi":"10.1177/10600280251378502","DOIUrl":"10.1177/10600280251378502","url":null,"abstract":"<p><strong>Background: </strong>Glomerular filtration rate (GFR) is commonly estimated with equations using creatinine, cystatin C, or a combination of both. Drug dosages may differ depending on the which equation.</p><p><strong>Objectives: </strong>This study determined estimated GFRs from 4 common equations, their correlations, and the subsequent variations of predicted vancomycin half-life (t_1/2).</p><p><strong>Methods: </strong>Retrospective cohort study of critically ill adults with GFR estimations based on Cockcroft-Gault (CrCl_CG), 2021 CKD-EPI Creatinine (eGFR_cr), 2012 CKD-EPI Cystatin C (eGFR_cys), and 2021 CKD-EPI Creatinine-Cystatin (eGFR_cr-cys). Patients were excluded if pregnant, dialysis dependent prior to admission, or sampling occurred within 24 hours of renal replacement therapy. Statistical analyses used MANOVA and Pearson correlation coefficient (<i>r</i>²). Bayesian modeling population estimates predicted vancomycin t_1/2.</p><p><strong>Results: </strong>Sixty-three patients with 104 GFR estimates were assessed. Mean age was 58.5 ± 15.2 years. Mean creatinine and cystatin C were 1.78 ± 2.1 mg/dL and 2.28 ± 1.2 mg/L, respectively. Mean estimated GFRs were 76.6 ± 59.2 mL/min, 72 ± 41.4 mL/min, 38 ± 27.5 mL/min, and 47.3 ± 32.7 mL/min for CrCl_CG, eGFR_cr, eGFR_cys, and eGFR_cr-cys, respectively (<i>P</i> < 0.0001). <i>r</i>² (all <i>P</i> < 0.0001) were 0.82 for CrCl_CG versus eGFR_cr, 0.54 for CrCl_CG versus eGFR_cys, 0.72 for CrCl_CG versus eGFR_cr-cys, 0.57 for eGFR_cr versus eGFR_cys, 0.77 for eGFR_cr versus eGFR_cr-cys, and 0.92 for eGFR_cys versus eGFR_cr-cys. Mean creatinine and cystatin C for vancomycin half-life estimations were 2.72 ± 3.48 mg/dL and 2.76 ± 1.1 mg/L, respectively. Mean predicted t_1/2 values from 17 patients with vancomycin monitoring were 33.3 ± 22.7 hours, 35.7 ± 27.5 hours, 43.2 ± 40.9 hours, and 38.7 ± 37.3 hours, respectively (<i>P</i> = 0.85).</p><p><strong>Conclusions and relevance: </strong>GFR estimations varied substantially with creatinine-based equations resulting in higher values. Correlation analyses revealed moderate to strong associations between equations. Discrepancies between GFR estimations were more apparent at higher GFRs. The variable GFR estimations led to substantial differences in predicted vancomycin t_1/2. Clinicians must be aware that dosing disparities may occur based on the GFR estimation used.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"866-871"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145848813","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":"Comparing Vasopressin and Hydrocortisone as Adjunctive Measures in Septic Shock.","authors":"Hannah F Wang, Beena Cheriyan, Marianne Huebner, Sichao Wang, David M Sudekum","doi":"10.1177/10600280251406750","DOIUrl":"10.1177/10600280251406750","url":null,"abstract":"<p><strong>Background: </strong>Norepinephrine has been widely established as the first-line agent for hemodynamic support in septic shock. The timing and order of initiation of vasopressin and hydrocortisone as adjunctive agents remains highly debated, with recent literature suggesting lower mortality with early hydrocortisone initiation.</p><p><strong>Objective: </strong>The aim of the study was to evaluate the effectiveness and safety of vasopressin compared to hydrocortisone as adjuncts to norepinephrine in septic shock.</p><p><strong>Methods: </strong>This was a multicenter, retrospective, observational study conducted in adult patients with septic shock admitted to the intensive care unit (ICU) between February 2020 and July 2023. Patients were divided into 2 cohorts based on the initial adjunctive agent administered following norepinephrine initiation: vasopressin (0.03-0.04 units/min) or hydrocortisone (200-300 mg/day). Individuals who received both study drugs within 6 hours of each other were excluded. The primary outcome was in-hospital mortality. Secondary outcomes included ICU length of stay (LOS), hospital LOS, time to vasopressor discontinuation, renal replacement therapy (RRT) initiation, and safety outcomes.</p><p><strong>Results: </strong>A total of 628 patients were included: 193 patients (30.7%) received hydrocortisone, and 435 patients (69.3%) received vasopressin. Hydrocortisone was associated with lower in-hospital mortality (53.3% vs. 37.3%, adjusted hazard ratio [HR] 1.80, 95% confidence interval [CI] 1.19-2.74, <i>P</i> = 0.006). Shorter hospital LOS and lower RRT initiation were observed with hydrocortisone. A longer time to initiation of the initial adjunctive agent was associated with an increased risk of in-hospital mortality (HR 1.08, 95% CI 1.04-1.11, <i>P</i> < 0.001).</p><p><strong>Conclusion and relevance: </strong>Administration of hydrocortisone as an adjunct to norepinephrine in septic shock was associated with lower in-hospital mortality compared to vasopressin. The addition of hydrocortisone as the initial adjunct to norepinephrine may improve clinical outcomes in septic shock, and early initiation should be considered in patients with escalating norepinephrine requirements.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"843-851"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145916709","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":"Low-Dose Oral Ketamine for Pain Management: A Primer for Clinicians.","authors":"Jason H Phan, Michael A Smith","doi":"10.1177/10600280261419147","DOIUrl":"10.1177/10600280261419147","url":null,"abstract":"<p><strong>Objective: </strong>To critically evaluate the available evidence for low-dose oral ketamine for analgesia and provide summary recommendations for clinicians on its use in practice.</p><p><strong>Data sources: </strong>A search of the primary literature was performed in PubMed from 2010 through 2025 using the following keywords: \"Administration, oral,\" \"Administration, sublingual,\" \"ketamine,\" and \"pain.\"</p><p><strong>Study selection and data extraction: </strong>All studies and case reports involving the use of oral or sublingual ketamine for analgesia as the primary focus were included.</p><p><strong>Data synthesis: </strong>Oral ketamine was well tolerated in dose ranges from 25 to 300 mg/day, which were associated with reduced pain scores, improved quality of life, and decreased opioid requirements in line with low-dose infusions for pain management. Weight-based doses above 6 mg/kg corresponded with an increase in adverse effects. Optimal parenteral-to-oral dose conversions are not known; however, dose reductions by 75% from the daily infusion dose maintained analgesia in a small number of cases. Treatment durations ranged from single doses up to 12 years but were predominantly studied in less than 2 years of use.</p><p><strong>Relevance to patient care and clinical practice: </strong>There remains a dearth of safe and effective pharmacologic pain management options which serve as alternatives to opioids. Low-dose ketamine is an oft-overlooked analgesic with evidence dating back over 50 years, but clinical uptake is poor. Oral ketamine presents a pragmatic formulation, and this review uses the current evidence to address pertinent clinical queries raised by clinicians in practice.</p><p><strong>Conclusions: </strong>Subanesthetic oral ketamine is an analgesic with continually growing evidence investigating use in a variety of acute and chronic pain syndromes. Based on the current evidence, ketamine may be helpful for refractory pain, as a component of multimodal analgesia, or in patients with high opioid requirements. Adverse effects are typically mild, but the risks of long-term use ultimately remain unclear.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"878-894"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146218194","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":"Successful Long-Term Management of Psoriatic Arthritis With Apremilast Following Multiple Myeloma Diagnosis During Etanercept Therapy: A 20-Month Follow-up.","authors":"Angelo Nigro","doi":"10.1177/10600280261420425","DOIUrl":"10.1177/10600280261420425","url":null,"abstract":"","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"913-915"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146140876","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":"Intravenous Fosfomycin in Complicated Urinary Tract Infection.","authors":"Zachary J Nuss, Sydney Berthold","doi":"10.1177/10600280261421571","DOIUrl":"10.1177/10600280261421571","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to determine the place in therapy of intravenous (IV) fosfomycin (Contepo) for the new Food and Drug Administration (FDA)-approved indication of complicated urinary tract infection (cUTI).</p><p><strong>Data sources: </strong>ClinicalTrials.gov and PubMed (through 11/2025).</p><p><strong>Study selection and data extraction: </strong>Data sources were searched and filtered to identify randomized controlled trials (RCTs) studying IV fosfomycin in cUTIs. Two primary phase III trials evaluating IV fosfomycin in cUTI were identified and analyzed. Additional ancillary studies were selected to contextualize primary studies.</p><p><strong>Data synthesis: </strong>The ZEUS trial showed IV fosfomycin was noninferior to piperacillin-tazobactam (PIP-TAZ) in cUTI/acute pyelonephritis (AP), with similar results between cUTI, AP, and extended spectrum beta-lactamase (ESBL) subgroups. The FOREST trial showed fosfomycin did not meet noninferiority to comparators (ceftriaxone, meropenem) in multi-drug resistant (MDR) bacteremia with urinary source and had more treatment-limiting adverse effects that prevented attainment of the primary endpoint. Clinical practice guidelines were referenced to compare IV fosfomycin to existing antibiotic recommendations.Relevance to Patient Care and Clinical Practice in Comparison to Existing Drugs:Intravenous fosfomycin is a promising carbapenem- and fluoroquinolone-sparing therapy in cUTI/AP. It is an efficacious option empirically or as a targeted therapy. The best case to support the use of IV fosfomycin may be in ESBL-producing, non-bacteremic cUTI/AP, in hemodynamically stable patients.</p><p><strong>Conclusion: </strong>Intravenous fosfomycin is a newly approved antibiotic formulation in the United States that may have a role in preventing the emergence of drug-resistant cUTI.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"895-901"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146225157","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 on \"The Efficacy and Safety of Ketamine or Ketorolac Compared to Opioids in Painful Vaso-Occlusive Crisis: A Systematic Review and Meta-Analysis\".","authors":"Ramenani Hari Babu, Singh Shekhar Gautam, Sulakshana Pal Singh, Vasundhara Saxena","doi":"10.1177/10600280251410931","DOIUrl":"10.1177/10600280251410931","url":null,"abstract":"","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"920-921"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146140962","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}