British journal of clinical pharmacology最新文献

{"title":"Medications, epilepsy and climate change: Added layers of complexity.","authors":"Medine I Gulcebi, Seyhmus Gavas, Sanjay M Sisodiya","doi":"10.1002/bcp.70108","DOIUrl":"https://doi.org/10.1002/bcp.70108","url":null,"abstract":"<p><p>Climate change-the global crisis with pervasive health impacts-has adverse consequences for people with epilepsy (PWE) who have low quality of life due to poor seizure control, socioeconomic disadvantages and comorbidities. This review focuses on the potential effects of climate change on the pharmacological characteristics of antiseizure medications (ASMs), antipsychotics and antidepressants. We note that findings particularly obtained from physicochemical stability studies have been demonstrated experimentally for some specific environmental conditions whereas studies for clinical outcome effects are very limited. Carbamazepine, valproate, phenytoin or lorazepam appear to be ASMs at risk of being affected by high temperature and/or humidity. Even the stability of blood samples needs to be considered during transportation to therapeutic drug monitoring units, particularly for the PWE living in low-income countries that are facing the most challenges of climate change effects attributed to low infrastructure and healthcare system capacity. We need more urgent research investigating drug responses of PWE regarding especially the effects of adverse weather events such as heatwaves on physicochemical stability or pharmacokinetics of drugs in a complex interaction with the vulnerabilities of individuals, accompanying neuropsychiatric disorders and geographical challenges. Then we will be able to develop pharmacological treatment strategies to improve the quality of life of PWE during adverse weather events.</p>","PeriodicalId":9251,"journal":{"name":"British journal of clinical pharmacology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144156769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expert insight into the education of healthcare professionals on medication adherence.","authors":"Fatima Rezae, Stephen Carter, Rebekah Moles, Ayano Kelly","doi":"10.1002/bcp.70114","DOIUrl":"https://doi.org/10.1002/bcp.70114","url":null,"abstract":"<p><strong>Aims: </strong>Medication non-adherence is a global health problem affecting patients with numerous medical conditions. Training healthcare professionals (HCPs) on managing the challenging issue of medication non-adherence requires an evidence-based approach. Therefore, we aimed to describe the perspectives and experiences of adherence experts on educating HCPs about medication adherence in order to guide the content and delivery of medication adherence education to HCPs.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted online, face-to-face and by phone. Interviews were video or audio recorded and professionally transcribed. Data was coded line by line into the preliminary coding framework and analysed using inductive thematic analysis.</p><p><strong>Results: </strong>Fifteen adherence experts were interviewed between May 2022 and March 2023. Five major themes with subthemes were identified: enhancing awareness among HCPs, seeing life through the patient's lens, communicating to build empathy and rapport, having a structured approach to address individual patient behaviours, and delivering enriching and targeted training.</p><p><strong>Conclusions: </strong>Adherence experts emphasized the impact HCPs can play by regularly addressing the pervasive issue of adherence in their clinical setting. HCPs can elicit behaviour change by understanding the patient's perspective, the complexity of adherence and communicating effectively. Structured approaches include using tools, frameworks and communication methods. Continuous training that is clinically relevant and builds on existing professional expertise is required to overcome HCPs' own barriers to behaviour change. The findings of this study guide the content and delivery of medication adherence education and training to HCPs.</p>","PeriodicalId":9251,"journal":{"name":"British journal of clinical pharmacology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144156764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing the Inpatient Mental Health Pharmaceutical Assessment and Care Tool (IMPACT) for use by UK mental health pharmacy teams-a modified Delphi study.","authors":"Fatima Q Alshaikhmubarak, Richard N Keers, Petra Brown, Penny J Lewis","doi":"10.1002/bcp.70083","DOIUrl":"https://doi.org/10.1002/bcp.70083","url":null,"abstract":"<p><strong>Aims: </strong>To develop an evidence- and consensus-based patient prioritization tool for use by UK mental health inpatient pharmacy teams.</p><p><strong>Methods: </strong>A modified-Delphi technique was used to obtain experts' agreement on the content, design and practical use of the patient prioritization tool. Two sequential Delphi questionnaires were prepared based on published evidence concerning risk factors for drug-related problems in mental health hospitals and current prioritization practices used by UK mental health inpatient pharmacy teams. Questionnaires were discussed and agreed upon with a group of 5 stakeholders including 3 mental health pharmacy experts and 2 patient representatives. Pharmacy professionals, psychiatrists and academics were recruited through a previous study and professional networks. Agreement was achieved if ≥75 or ≥85% of the panel rated 6-7 or 5-7 in the Likert scale respectively.</p><p><strong>Results: </strong>In Delphi 1 questionnaire, 29 experts agreed to include 82 risk indicators in the tool and to categorize patients into 3 risk groups using a traffic light system (red = high-risk, amber = medium-risk, green = low-risk). In Delphi 2 questionnaire, 30 experts agreed on 13 statements guiding practical use of the tool and the preferred frequency of review was every 1-2 day for the high-risk group, every 2-4 days for the medium-risk group and once every working week for the low-risk group.</p><p><strong>Conclusion: </strong>This study developed the Inpatient Mental Health Pharmaceutical Assessment and Care Tool (IMPACT) for use by UK mental health pharmacy teams. Feasibility and acceptability testing should be carried out to refine the tool and support preparations for formal evaluation of its impact on patient care and service delivery.</p>","PeriodicalId":9251,"journal":{"name":"British journal of clinical pharmacology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spotlight commentary: New Frontiers in pneumonia treatment","authors":"Duda Matija,&nbsp;Damjanović Ivan,&nbsp;Likić Robert","doi":"10.1002/bcp.70107","DOIUrl":"10.1002/bcp.70107","url":null,"abstract":"&lt;p&gt;Community-acquired pneumonia (CAP) is a leading cause of hospitalization and mortality worldwide, necessitating continuous advancements in its management. As antimicrobial resistance rises and treatment complexities grow, researchers are exploring innovative therapeutic strategies to enhance patient outcomes. From evaluating the efficacy of adjunct therapies to investigating novel antibiotics and optimizing dosing regimens, recent studies have shed light on critical aspects of CAP treatment. The aim of this commentary is to highlight key emerging studies on adjunctive therapies, new antimicrobial agents, innovative dosing strategies and machine learning tools in order to demonstrate the expanding potential for a more individualized approach to the treatment of CAP. These developments collectively challenge the longstanding one-size-fits-all paradigm and invite a redefinition of how pharmacological care is delivered in this common yet heterogeneous condition.&lt;/p&gt;&lt;p&gt;For patients hospitalized with CAP without severe beta-lactam allergy and lacking risk factors for MRSA or &lt;i&gt;Pseudomonas&lt;/i&gt; spp., empiric first line therapy typically consists of either a combination of an antipneumococcal beta-lactam (such as ceftriaxone, cefotaxime or ampicillin-sulbactam) with a macrolide or respiratory fluoroquinolone monotherapy. The 2023 ERS/ESICM/ESCMID/ALAT guidelines recommend β-lactam–macrolide therapy for severe CAP in ICU patients, while the 2019 ATS/IDSA guidelines support this combination in non-severe CAP when atypical pathogens are suspected.&lt;span&gt;&lt;sup&gt;1, 2&lt;/sup&gt;&lt;/span&gt; However, much of this support is derived from observational studies and expert consensus rather than robust randomized evidence. The ACCESS trial,&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; conducted between 2021 and 2023 across 18 Greek hospitals, provides timely randomized data. It enrolled 278 adults with more severe CAP, defined by a SOFA score ≥2 and procalcitonin (PCT) ≥0.25 ng/mL, who were randomized to receive either clarithromycin or placebo in addition to standard β-lactam therapy. The primary composite endpoint, defined as improvement in respiratory symptoms plus either a ≥30% reduction in SOFA score or favourable PCT kinetics, was achieved in 68% of patients in the clarithromycin group compared to 38% in the placebo group (&lt;i&gt;p&lt;/i&gt; &lt; 0.0001). A subgroup analysis suggested that patients with elevated inflammatory markers such as CRP and PCT derived the greatest benefit, supporting a biomarker-guided approach to macrolide use.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; In contrast, a recent meta-analysis by Prizão et al.,&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; which included over 2600 patients across six randomized trials, found no significant mortality benefit from β-lactam and macrolide combination therapy at discharge, 30 or 90 days. Although treatment success was nominally higher in some cases, substantial heterogeneity limited the interpretability of pooled results and may have obscured benefits in select subgroups","PeriodicalId":9251,"journal":{"name":"British journal of clinical pharmacology","volume":"91 7","pages":"1877-1880"},"PeriodicalIF":3.1,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bcp.70107","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Population pharmacokinetic modelling of prednisolone in systemic lupus erythematosus patients: Analysis of exposure and disease activity.","authors":"Naïm Bouazza, Michaela Semeraro, Gabrielle Lui, Léo Froelicher-Bournaud, Laure Choupeaux, Jean-Marc Treluyer, Sihem Benaboud, Joelle Terzic, Eric Hachulla, Philippe Remy, Jérôme Harambat, Alexandre Karras, Caroline Rousset-Rouviere, Anne Jolivot, Zahir Amoura, Eric Daugas, Aurélie Hummel, Rémi Salomon, Jean-Christophe Lega, Stéphane Decramer, Alexandre Belot, Delphine Gobert, Nathalie Costedoat-Chalumeau, Stanislas Faguer, Isabelle Melki, Noémie Jourde-Chiche, Brigitte Bader-Meunier","doi":"10.1002/bcp.70103","DOIUrl":"https://doi.org/10.1002/bcp.70103","url":null,"abstract":"<p><strong>Aims: </strong>Prednisone is a widely used glucocorticoid in the treatment of lupus, although its dosing is often determined empirically. Prednisolone, the active metabolite of prednisone, is found in its free form in the serum. The goal of this study was to develop a population pharmacokinetic model in patients with systemic lupus erythematosus (SLE) to forecast free prednisolone concentrations and its association with disease activity.</p><p><strong>Methods: </strong>A total of 66 active SLE patients (adults and children) were included, and followed up prospectively (242 observations available). Plasma prednisolone concentrations were assessed using liquid chromatography-mass spectrometry, and the data were analysed using Monolix software. The pharmacokinetic model was a one-compartment open model with absorption lag time representing the delay for both absorption and metabolism from inactive (prednisone) to active form (prednisolone). This model predicted free concentrations, which were then used to calculate total concentrations based on established binding constants.</p><p><strong>Results: </strong>Free prednisolone clearance (CLu/F) and volume of distribution (Vu/F) were scaled allometrically to body weight. The typical population estimates (95% confidence interval) were 54 (48-62) L/h/70 kg and 235 (203-274) L/70 kg, respectively. Additionally, the bioavailability parameter was found to decrease non-linearly with the dose. Prednisolone cumulative exposure was not different between patients who responded at 3 months and those who did not.</p><p><strong>Conclusions: </strong>Robust pharmacokinetic targets are not yet clearly defined regarding toxicity or efficacy and are warranted in order to make a valuable contribution to prednisolone therapeutic drug monitoring in the context of SLE.</p>","PeriodicalId":9251,"journal":{"name":"British journal of clinical pharmacology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Educate to medicate: A clinical pharmacologist's perspective.","authors":"Robert Likic, Michael Rieder","doi":"10.1002/bcp.70110","DOIUrl":"https://doi.org/10.1002/bcp.70110","url":null,"abstract":"","PeriodicalId":9251,"journal":{"name":"British journal of clinical pharmacology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relevance of selected pharmacogenetic polymorphisms to bleeding and thromboembolic risks in Chinese patients taking direct-acting oral anticoagulants.","authors":"Dongxu Wang, Yang An, Xiaoyue Zhou, Huaru Chai, Jiani Huo, Chunrong Li, Minghui Du, Dapeng Dai, Chuanbao Li, Hao Chen","doi":"10.1002/bcp.70078","DOIUrl":"https://doi.org/10.1002/bcp.70078","url":null,"abstract":"<p><strong>Aims: </strong>Gene polymorphisms play a critical role in the variability of plasma concentrations of direct-acting oral anticoagulants (DOACs). In this study, we aimed to investigate the effects of genetic variants on the clinical outcomes of Chinese patients treated with DOACs.</p><p><strong>Methods: </strong>The retrospective study recruited 720 patients with nonvalvular atrial fibrillation who were receiving dabigatran, rivaroxaban or edoxaban. Cox regression models were employed to compare the clinical outcomes between carriers and noncarriers of the key single nucleotide polymorphisms.</p><p><strong>Results: </strong>Results revealed that the CES1 rs2244613 C allele significantly reduced bleeding events in patients treated with dabigatran (adjusted hazard ratio 0.33, 95% confidence interval 0.13-0.85, P = .021). The carriage of ABCB1 rs1045642 T allele was associated with a lower risk of thromboembolism in rivaroxaban users (adjusted hazard ratio 0.19, 95% confidence interval 0.07-0.57, P = .003). Additionally, a trend toward statistical significance (P = .052) was observed between the SLCO1B1 rs4149056 C allele and bleeding risk among the edoxaban users.</p><p><strong>Conclusions: </strong>Our study showed that the CES1 rs2244613 and ABCB1 rs1045642 alleles were associated with outcome events in Chinese patients taking dabigatran and rivaroxaban, respectively. The findings could help predict clinical outcomes and develop personalized anticoagulation treatment strategies for Chinese patients taking DOACs.</p>","PeriodicalId":9251,"journal":{"name":"British journal of clinical pharmacology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to “Recommended approaches for integration of population pharmacokinetic modelling with precision dosing in clinical practice”","authors":"","doi":"10.1002/bcp.70106","DOIUrl":"10.1002/bcp.70106","url":null,"abstract":"<p>\u0000 <span>Berezowska, M</span>, <span>Hayden, IS</span>, <span>Brandon, AM</span>, et al. <span>Recommended approaches for integration of population pharmacokinetic modelling with precision dosing in clinical practice</span>. <i>Br J Clin Pharmacol</i>. <span>2025</span>; <span>91</span>(<span>4</span>): <span>1064</span>-<span>1079</span>. 10.1111/bcp.16335</p><p>In Section 7 (“Outlook for MIPD”), the citation to reference 115 in the phrase “hybridising NLME and ML models to improve upon MAP parameter estimates” was incorrect. This should have referred to a different publication authored by the same group.</p><p>The corrected sentence should read:</p><p>“Several proof-of-concept works have successfully demonstrated replacing popPK models with ML models for PK parameter prediction [143], hybridising NLME and ML models to improve upon MAP parameter estimates [new reference], using ML algorithms to accelerate NLME model development [144] and creating more realistic synthetic PK data by use of ML [145].”</p><p>The newly cited reference is:</p><p>Hughes JH, Keizer RJ. A hybrid machine learning/pharmacokinetic approach outperforms maximum a posteriori Bayesian estimation by selectively flattening model priors. CPT Pharmacometrics Syst Pharmacol. 2021; 10: 1150–1160. https://doi.org/10.1002/psp4.12684</p><p>We apologize for this error.</p>","PeriodicalId":9251,"journal":{"name":"British journal of clinical pharmacology","volume":"91 7","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bcp.70106","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to: Methotrexate toxicity and glucarpidase: A call for dose optimization. Koppen A, et al. Br J Clin Pharmacol. 2025;91(5):1289-1292 doi:10.1002/bcp.70044.","authors":"Carmelo Rizzari, Stefan Schwartz","doi":"10.1002/bcp.70105","DOIUrl":"https://doi.org/10.1002/bcp.70105","url":null,"abstract":"","PeriodicalId":9251,"journal":{"name":"British journal of clinical pharmacology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alterations of appetite-regulating hormones in risperidone treated children and adolescents—a post hoc analysis of the SPACe study","authors":"Jiayi Liang,&nbsp;Brenda C. M. de Winter,&nbsp;Rebecca A. Hermans,&nbsp;Sanne M. Kloosterboer,&nbsp;Susanne Kuckuck,&nbsp;Izgi Bayraktar,&nbsp;Liesbeth F. C. van Rossum,&nbsp;Manon H. J. Hillegers,&nbsp;Sander A. A. van den Berg,&nbsp;Birgit C. P. Koch,&nbsp;Bram Dierckx","doi":"10.1002/bcp.70095","DOIUrl":"10.1002/bcp.70095","url":null,"abstract":"<p>Weight gain and metabolic disruptions are common in children and adolescents treated with antipsychotics, but the underlying mechanisms are unclear, complicating prevention and treatment. This study examines the impact of risperidone on appetite-regulating hormones (insulin, leptin and bioleptin) and their relationship to body weight changes over time. In a post hoc analysis, we evaluated the correlation of appetite-regulating hormones with BMI z-scores during treatment and at a 6-month follow-up. The sample consisted of 10 participants (80% male, median age 9.7 years). A significant increase in bioleptin (<i>p</i> &lt; .05) and BMI z-scores was observed over the 6 month period. At baseline, HOMA-IR, insulin, leptin, and bioleptin were significantly correlated with the BMI z-score; however, these associations were no longer observed after 6 months of treatment. Additionally, higher risperidone exposure correlated with lower appetite-regulating hormone levels at the 6-month mark. These findings indicate that risperidone significantly affects appetite-regulating hormones in children and adolescents, potentially contributing to antipsychotic-induced weight gain.</p>","PeriodicalId":9251,"journal":{"name":"British journal of clinical pharmacology","volume":"91 7","pages":"2090-2094"},"PeriodicalIF":3.1,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bcp.70095","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}