Annals of Pharmacotherapy最新文献

{"title":"Weighing in on the Recent Approval of Tenecteplase for Acute Ischemic Stroke: Significance of Body Weight and the New Dosing Schedule.","authors":"Harn J Shiue, Oana M Dumitrascu, Kara A Sands","doi":"10.1177/10600280251361357","DOIUrl":"10.1177/10600280251361357","url":null,"abstract":"","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"308-309"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144726614","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":"Acoramidis: A New Transthyretin Stabilizer for Transthyretin Amyloid Cardiomyopathy.","authors":"Taylor Clark, Rachel Lucas, Azadeh Nasuhidehnavi, Nathan Sauers, Kelly Bach","doi":"10.1177/10600280251368386","DOIUrl":"10.1177/10600280251368386","url":null,"abstract":"<p><strong>Objective: </strong>The objective of the study was to review acoramidis, a new transthyretin stabilizer, for treatment of transthyretin amyloid cardiomyopathy by means of pharmacology, efficacy, and safety.</p><p><strong>Data sources: </strong>An Embase, PubMed, and ClinicalTrials.gov search was conducted using the keywords acoramidis, Attruby, and AG10.</p><p><strong>Study selection and data extraction: </strong>We included full-text, English-language studies that evaluated the pharmacology, efficacy, and safety of acoramidis in transthyretin amyloid cardiomyopathy.</p><p><strong>Data synthesis: </strong>Acoramidis slows or halts the accumulation of amyloid deposits in the heart by binding to the thyroxine-binding sites on the tetrameric transthyretin (TTR) protein preventing the TTR tetramer from dissociating into monomers. Acoramidis did not achieve statistical significance in terms of mortality reduction, but it outperformed placebo with respect to death from any cause, cardiovascular-related hospitalization, change in N-terminal pro-B-type natriuretic peptide, and change in 6-minute walk distance. In addition, by the end of the phase II clinical trial all acoramidis-treated patients achieved normal serum TTR concentrations. The overall incidence of subjects who experienced any treatment-emergent adverse events was similar between the acoramidis and placebo groups.Relevance to patient care and clinical practice in comparison to existing drugs:Acoramidis is the second TTR stabilizer approved for the treatment of transthyretin amyloid cardiomyopathy (ATTR-CM). Each medication to manage ATTR-CM similarly decreases the combined endpoints of all-cause mortality and progression of heart failure symptoms, when adjusted for risk factors. However, its place in therapy remains unclear among the treatment options for the management of ATTR-CM due to the lack of head-to-head trials.</p><p><strong>Conclusions: </strong>Acoramidis is an effective and safe medication for the treatment of transthyretin amyloidosis cardiomyopathy.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"287-295"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145102639","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":"Effect of Propranolol on Hyperthermia Secondary to Paroxysmal Sympathetic Hyperactivity in Critically Ill Patients With Traumatic Brain Injury.","authors":"Kameron Walker, Joseph M Swanson, Saskya Byerly, Dina M Filiberto, Julie E Farrar","doi":"10.1177/10600280251355632","DOIUrl":"https://doi.org/10.1177/10600280251355632","url":null,"abstract":"<p><strong>Background: </strong>Patients with traumatic brain injury (TBI) may develop paroxysmal sympathetic hyperactivity (PSH), a syndrome manifesting as cyclic increases in vital signs and motor activity. Previous studies show propranolol mitigating sympathetic symptoms and negative outcomes, but few reports assess its effect on body temperature.</p><p><strong>Objective: </strong>The purpose of this study was to determine if propranolol attenuates hyperthermia secondary to PSH in patients with TBI.</p><p><strong>Methods: </strong>This study evaluated febrile patients with TBI treated with propranolol. The primary outcome was the difference in maximum (Tmax), minimum (Tmin), and average (Tavg) daily temperatures and temperature variability (Tvar). Secondary outcomes included similar evaluation of heart rate (HR) and mean arterial pressure (MAP), differences in a modified clinical features scale (mCFS), and number of infectious work-ups before and after propranolol initiation. Data were collected one day before, the day of, and 3 days after propranolol initiation. Repeated measures analysis of variance (ANOVA) was used to evaluate vital sign differences among days of therapy. Post-hoc Tukey's tests were performed to identify between-day differences if they existed.</p><p><strong>Results: </strong>Fifty-nine patients were included. The majority were male (76.3%) and had a severe TBI (78.0%). Tmax, Tmin, Tavg, and Tvar were all not different between Day -1 and Day 3. Tmax decreased from 38.6 ± 0.11°C on Day 0 (the day of propranolol initiation) to 38.3 ± 0.14°C on Day 3 (<i>P</i> = 0.22). Maximum and average HRs were significantly decreased after propranolol initiation on Day 3 (<i>P</i> < 0.001) and on Days 2 (<i>P</i> = 0.04) and 3 (<i>P</i> = 0.01), respectively. Changes in MAP were not statistically significant. The mCFS and number of infectious work-ups were significantly lower after propranolol initiation.</p><p><strong>Conclusion and relevance: </strong>Temperature was not significantly decreased after propranolol initiation in patients with TBI and hyperthermia; however, HR and mCFS were significantly lower. Larger studies are needed to characterize the effect of propranolol on temperature in patients with PSH.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":"60 3","pages":"229-237"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146111859","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":"Outcomes of Intravenous Ganciclovir Administration via an Outpatient Parenteral Antimicrobial Therapy Program: A Single-Center Experience.","authors":"Dhruv P Patel, Ryan Mynatt, Ashley Logan, Evelyn Villacorta, Armaghan-E-Rehman Mansoor","doi":"10.1177/10600280251349570","DOIUrl":"10.1177/10600280251349570","url":null,"abstract":"<p><strong>Background: </strong>Intravenous (IV) ganciclovir is used in the management of herpesvirus infections, including cytomegalovirus (CMV). Ganciclovir is usually administered inpatient given the need for close monitoring of laboratory parameters.</p><p><strong>Objective: </strong>This study describes our experience with administering IV ganciclovir via an outpatient parenteral antimicrobial therapy (OPAT) program.</p><p><strong>Methods: </strong>This is a retrospective review of patients discharged on IV ganciclovir via OPAT at a tertiary medical center from August 2019 to August 2024. Demographics and treatment outcomes were collected.</p><p><strong>Results: </strong>Ganciclovir was the preferred agent in all patients either due to concern for gastrointestinal absorption or provider preference. Eighteen patients with a median age of 59.5 (interquartile range [IQR]: 53-65) years met criteria. The most common underlying immunocompromising condition was receipt of a transplanted organ in 16 (88.9%) patients, most commonly heart (8 patients) and kidney transplants (7 patients). Median duration of therapy after hospital discharge was 22 (IQR: 20-27) days. Fifteen (83.3%) patients transitioned to valganciclovir on completion of parenteral therapy either as secondary prophylaxis or continuation of therapy. The most common adverse event was leukopenia in 6 (33.3%) patients. One patient developed acute kidney injury (AKI) requiring dose modification and eventual discontinuation.</p><p><strong>Conclusion and relevance: </strong>Ganciclovir via OPAT is a viable option in patients requiring an extended duration of IV therapy. In our cohort of 18 patients, only one had early discontinuation of therapy due to ganciclovir-related AKI. Close monitoring of labs and an established OPAT protocol can allow for successful completion of therapy.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"271-275"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332341","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 Combination of Aztreonam-Avibactam in Multidrug-Resistant Gram-Negative Infections.","authors":"Maria Roye-Azar, Mackenzie Prater, Christopher Giuliano, Pramodini B Kale-Pradhan","doi":"10.1177/10600280251366033","DOIUrl":"10.1177/10600280251366033","url":null,"abstract":"<p><strong>Objective: </strong>Aztreonam-avibactam (ATM-AVI) is used for difficult-to-treat gram-negative infections. The objective of this review is to analyze the pharmacology, safety, and clinical application of ATM-AVI.</p><p><strong>Data sources: </strong>PubMed, Embase, and ClinicalTrials.gov were searched using the terms aztreonam avibactam, PF-06947387, Emblaveo, and ATM-AVI.</p><p><strong>Study selection and data extraction: </strong>Articles written in English and published from January 1, 1985, to June 10, 2025, that related to pharmacology, safety, clinical trials, and clinical application of ATM-AVI were reviewed.</p><p><strong>Data synthesis: </strong>The ATM-AVI has shown similar efficacy to comparator antibiotics in complicated intra-abdominal infection (cIAI) and hospital/ventilator-acquired pneumonia (HAP/VAP). The REVISIT trial showed cIAI clinical cure rates of 76.4% and 74% for the ATM-AVI and meropenem groups, respectively (treatment difference 2.4% [95% confidence interval, CI = -7.4 to 13.0]). For HAP/VAP, clinical cure rates were 45.9% and 41.7% for the ATM-AVI and meropenem groups, respectively (treatment difference 4.3% [95% CI = -15.1 to 23.1]). The ATM-AVI was generally well tolerated, with hepatic adverse effects being the most commonly reported.Relevance to patient care and clinical practice comparison to existing drugs:The ATM-AVI has demonstrated clinical efficacy for the treatment of cIAI. However, its role needs to be further studied for other infections such as HAP/VAP, urinary tract, and other serious infections. Pharmacoeconomic analysis may be needed to assess the cost-benefit impact in the United States.</p><p><strong>Conclusion: </strong>The ATM-AVI may be an alternative option for the treatment of cIAI and other complicated gram-negative infections. Further studies are needed to delineate the role of ATM-AVI in clinical practice.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"296-302"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145063163","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":"Therapeutic Drug Monitoring of Voriconazole: Unbound Concentration With Clinical Efficacy and Adverse Events.","authors":"Tiantian Zhang, Zhicong Qiu, Wenhao Chu, Wenli Li, Xikun Wu, Yuxin Wang, Yishuo Zhai, Wei Zhang, Zhiqing Zhang","doi":"10.1177/10600280251352876","DOIUrl":"10.1177/10600280251352876","url":null,"abstract":"<p><strong>Background: </strong>Voriconazole is widely used for patients with fungal infections, but the correlations between the unbound concentration (C_free) of voriconazole in plasma and clinical outcomes remains unclear.</p><p><strong>Objective: </strong>The aim of this study was to analyze the correlation between C_free and clinical outcomes.</p><p><strong>Methods: </strong>A retrospective analysis was conducted at the Second Hospital of Hebei Medical University from February 2021 to March 2024 (Shijiazhuang, China). Patients who received voriconazole with at least one measured concentration in our center were enrolled. Based on determined the C_free of voriconazole, factors that might affect C_free were analyzed in conjunction with patient characteristics, and the correlations between voriconazole C_free and the clinical efficacy as well as AEs in patients were investigated.</p><p><strong>Results: </strong>A total of 60 blood samples were collected from 56 patients. Voriconazole C_free was positive correlation with creatinine, while negative correlation with creatinine clearance. The C_free of patients in the clinical effective group was significantly higher than that in the clinical ineffective group, and the C_free of patients in the group with AEs was significantly higher than that in the group without AEs (<i>P</i> = 0.006, 0.025). Voriconazole C_free (odds ratio [OR] = 2.617, 95% confidence interval [CI]:1.142-6.000, <i>P</i> = 0.023) and albumin level (OR = 1.085, 95% CI: 1.000-1.177, <i>P</i> = 0.050) were independent influencing factors of clinical efficacy, the receiver operating characteristic (ROC) cut off for C_free and efficacy was 0.8 μg·mL^-1. Voriconazole C_free (OR = 1.979, 95% CI: 1.008-3.888, <i>P</i> = 0.048) was an independent risk factor for AEs, the ROC cut off for C_free and AEs was 1.2 μg·mL^-1.</p><p><strong>Conclusions and relevance: </strong>Voriconazole C_free was positively correlated with clinical efficacy and the incidence of AEs in patients.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"238-247"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697437","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":"Levothyroxine Absorption in Patients With Celiac Disease: Challenges and Therapeutic Strategies.","authors":"Maha Saad, Nicole M Maisch","doi":"10.1177/10600280251361914","DOIUrl":"10.1177/10600280251361914","url":null,"abstract":"<p><p>Celiac disease can significantly impair levothyroxine absorption, complicating hypothyroidism management despite appropriate dosing. While a gluten-free diet often improves absorption, some patients continue to require high doses. Switching to liquid or softgel formulations can enhance levothyroxine bioavailability and symptom control. Optimizing therapy requires individualized approaches, including dietary intervention, formulation changes, and close monitoring, to achieve and maintain a euthyroid state. Relevant studies were reviewed and incorporated into this commentary to support evidence-based recommendations and highlight clinical considerations.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"303-305"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144726612","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":"What's Your C. diff-erential? Evaluating Clinical Management of Discordant <i>Clostridioides difficile</i> Two-Step Testing.","authors":"Adam Siddique, Nicolas Daoura, Punit J Shah","doi":"10.1177/10600280251357424","DOIUrl":"10.1177/10600280251357424","url":null,"abstract":"","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"310-312"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144615797","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":"Impact of Glucagon-like Peptide-1 Receptor Agonists on Bowel Preparation for Colonoscopy: A Large, Matched Regional Cohort.","authors":"Jennifer L Cole, Jennifer E Stark","doi":"10.1177/10600280251349583","DOIUrl":"10.1177/10600280251349583","url":null,"abstract":"<p><strong>Background: </strong>Poor colon preparation may negatively affect colonoscopy accuracy, result in cancelation, or need for repeat procedure. The glucagon-like peptide-1 receptor agonist (GLP-1RA) class of medications delay gastric emptying, although the clinical impact of this on the quality of colon preparation is not known.</p><p><strong>Methods: </strong>This was a retrospective matched cohort study in a multi-center, outpatient setting. Colonoscopy reports for patients prescribed GLP-1RA at the time of procedure were compared to a cohort matched for diabetes and cirrhosis who were not prescribed GLP-1RA at the time of procedure. The primary endpoint was a composite of indicators for inadequate bowel preparation.</p><p><strong>Objective: </strong>The current study's objective is to analyze the effects of GLP-1RA medications on the quality of colonoscopy preparation.</p><p><strong>Results: </strong>There were 503 patients in each cohort and baseline characteristics were similar. Use of GLP-1RA at the time of colonoscopy was associated with a greater odds of the composite outcome (125 vs 56, odds ratio [OR] = 2.6; 95% CI, 1.9-3.7). There were also increased odds for individual outcome components including proceduralist documenting inadequate, suboptimal, or poor bowel preparation, narrative comments related to inadequate bowel preparation, and recommendation for extended bowel preparation with future colonoscopy. Repeat procedure was also more common in the GLP-1RA cohort (26 vs 9, OR = 3.0; 95% CI, 1.4-6.5).</p><p><strong>Conclusion and relevance: </strong>This study assessed the impact of the GLP-1RA class of medication on the quality of bowel preparation for lower endoscopies. Glucagon-like peptide-1 receptor agonist use increased the odds of inadequate bowel preparation and repeat procedure.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"213-220"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526170","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 GLP-1 Receptor Agonists for the Management of Antipsychotic-Induced Weight Gain.","authors":"Sarah Pascale, Justin P Reinert","doi":"10.1177/10600280251414107","DOIUrl":"https://doi.org/10.1177/10600280251414107","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this systematic review and meta-analysis was to compare the efficacy and safety of glucagon-like peptide-1 (GLP-1) receptor agonists for the management of antipsychotic-induced weight gain.</p><p><strong>Data sources: </strong>A systematic review was conducted following PRISMA methodology through July 2025 that evaluated the efficacy and safety of GLP-1 agonists for the management of antipsychotic-induced weight gain.</p><p><strong>Study selection and data extraction: </strong>Efficacy endpoints were change in body weight (kg), change in body mass index (BMI) (kg/m²), and change in HbA_1c (%). The safety endpoint was gastrointestinal (GI) adverse effects. A <i>P</i>-value of 0.05 was considered statistically significant, and heterogeneity was reported as I².</p><p><strong>Data synthesis: </strong>Six studies were included in this systematic review, of which 4 trials were included in the meta-analysis. The difference found between GLP-1 agonists and placebo was a change in weight of -5.85 kg (<i>P</i> = 0.0622, 95% CI = -9.72 to -1.97), a change in BMI of -2.11 kg/m² (<i>P</i> = 0.7692, 95% CI = -5.51 to 1.29), and a change in HbA_1c of -1.58 (<i>P</i> = 0.6659, 95% CI = -4.75 to 1.58). The overall risk ratio for a patient to experience a GI-related adverse effect when taking a GLP-1 agonist compared to placebo was 1.83 (95% CI = 1.42 to 2.37).</p><p><strong>Relevance to patient care and clinical practice: </strong>While the efficacy endpoints did not reach significance, this meta-analysis shows that select GLP-1 receptor agonists may be used to promote weight loss in patients taking antipsychotics. Controlling antipsychotic-induced weight gain helps patients remain adherent to therapeutic doses of their antipsychotic medications.</p><p><strong>Conclusion: </strong>The use of certain GLP-1 agonists may be considered to help promote weight loss in patients experiencing antipsychotic-induced weight gain.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"10600280251414107"},"PeriodicalIF":2.3,"publicationDate":"2026-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146775879","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}