A Systematic Review and Meta-Analysis of Studies of Defibrotide Prophylaxis for Veno-Occlusive Disease/Sinusoidal Obstruction Syndrome
ConclusionsThis analysis suggests a low incidence of VOD/SOS following intravenous defibrotide prophylaxis, regardless of age group, and a lower relative risk for VOD/SOS with defibrotide prophylaxis vs controls in patient populations at high risk of VOD/SOS. (Source: Clinical Drug Investigation)
Source: Clinical Drug Investigation - May 20, 2022 Category: Drugs & Pharmacology Source Type: research
Rare Mycobacteria and HIV in Children: Two Case Reports
(Source: Clinical Drug Investigation)
Source: Clinical Drug Investigation - May 16, 2022 Category: Drugs & Pharmacology Source Type: research
Management of Hepatic Encephalopathy Associated with Advanced Liver Disease
AbstractHepatic encephalopathy (HE) is a very prevalent condition in patients with advanced liver disease and has a high recurrence rate. The pathophysiology has a multifactorial origin where hyperammonaemia and inflammation become particularly relevant. There are no HE-specific diagnostic tests, and diagnosis is usually made by taking into account the presence of suggestive and compatible clinical symptoms, the existence of a predisposing liver condition and ruling out other causes with similar clinical manifestations. Once the diagnosis of HE is established, it is essential to carry out an adequate classification based o...
Source: Clinical Drug Investigation - May 10, 2022 Category: Drugs & Pharmacology Source Type: research
Foreword
(Source: Clinical Drug Investigation)
Source: Clinical Drug Investigation - May 9, 2022 Category: Drugs & Pharmacology Source Type: research
Management of Pharmacologic Adverse Effects in Advanced Liver Disease
AbstractAs a consequence of the altered hepatic architecture in advanced liver disease, drug metabolism is modified by changes in pharmacokinetic and pharmacodynamic properties, leading to the appearance of adverse effects and drug interactions and increasing the risk of over- or underdosing of medications. However, there are no tests that accurately determine the degree of impairment of liver metabolic function; therefore, general recommendations are established based on the degree of hepatic extraction, degree of hepatic metabolism, and degree of protein binding. Although the hepatic toxicity of some frequently used drug...
Source: Clinical Drug Investigation - May 6, 2022 Category: Drugs & Pharmacology Source Type: research
Management of Liver Decompensation in Advanced Liver Disease (Renal Impairment, Liver Failure, Adrenal Insufficiency, Cardiopulmonary Complications)
AbstractSystemic complications often occur in patients with advanced liver disease. In particular, the development of renal complications (acute kidney injury, hepatorenal syndrome), acute-on-chronic liver failure, cardiopulmonary diseases, or relative adrenal insufficiency can be serious in patients with advanced liver disease and may determine the patient ’s quality of life and prognosis. Therefore, the early diagnosis of possible complications is the key to the prompt initiation of specific treatments that can improve quality of life and survival. For this purpose, networking with reference centers where multidiscipli...
Source: Clinical Drug Investigation - May 6, 2022 Category: Drugs & Pharmacology Source Type: research
Combination of Bevacizumab and Osimertinib in Patients with EGFR T790M-Mutated Non-small Cell Lung Cancer
ConclusionConcomitant use of bevacizumab and osimertinib in NSCLC patients with EGFR T790M mutation may have potential therapeutic effect than osimertinib alone. Further studies with a larger number of patients are warranted to confirm results of this study. (Source: Clinical Drug Investigation)
Source: Clinical Drug Investigation - May 5, 2022 Category: Drugs & Pharmacology Source Type: research
Military Health System Opioid, Tramadol, and Gabapentinoid Prescription Volumes Before and After a Defense Health Agency Policy Release
ConclusionOverall, CPGs and policies targeting opioid prescribing practices may have provided the maximal impetus for providers to re-evaluate their prescribing practices, as the policy did not appear to change the slope in prescribing rates. However, it is unclear whether the policies mitigated the likelihood of plateaus in prescribing rates. Further work is needed to assess the degree to which providers simultaneously altered other non-opioid pain medication prescribing practices, self-management recommendations, and non-pharmacological therapy referrals. (Source: Clinical Drug Investigation)
Source: Clinical Drug Investigation - April 30, 2022 Category: Drugs & Pharmacology Source Type: research
Effect of Genetic Polymorphism Including NUP153 and SVEP1 on the Pharmacokinetics and Pharmacodynamics of Ticagrelor in Healthy Chinese Subjects
ConclusionsGenetic variation affects the pharmacokinetics and pharmacodynamics of ticagrelor in healthy individuals. The detection of NUP153, SVEP1 gene variation will be helpful for pharmacodynamic prediction and evaluation, and the regulation of these genes may be the target of new drug development. Further studies are required to confirm the results and explore whether these single-nucleotide polymorphisms are associated only with platelet activity or also with cardiovascular events and all-cause mortality.Clinical Trial RegistrationNCT03161002. (Source: Clinical Drug Investigation)
Source: Clinical Drug Investigation - April 30, 2022 Category: Drugs & Pharmacology Source Type: research
An Umbrella Review of the Cost Effectiveness of Human Papillomavirus Vaccines
ConclusionsAdditional evidence is needed for vulnerable populations (e.g., childhood cancer survivors) who are at high risk for human papillomavirus vaccine-related cancers and, therefore, may be more cost effective when receiving human papillomavirus vaccines. Quantifying human papillomavirus vaccine cost effectiveness via meta-analyses is feasible if investigators can increase the homogeneity of their populations. (Source: Clinical Drug Investigation)
Source: Clinical Drug Investigation - April 30, 2022 Category: Drugs & Pharmacology Source Type: research
Nutrition and Chronic Liver Disease
This article reviews these topics, including dietary modifications before and after liver transplantation. Additio nally, nutritional recommendations are offered to patients with metabolic hepatic steatosis. (Source: Clinical Drug Investigation)
Source: Clinical Drug Investigation - April 29, 2022 Category: Drugs & Pharmacology Source Type: research
Associations Between Low-Value Medication in Dementia and Healthcare Costs
ConclusionLvm were prevalent, more likely occurring in the early stages of dementia, and cause financial harm for payers due to higher direct medical care costs. Further research is required to derive measures to prevent cost-driving Lvm in primary care, that is, implementing deprescribing interventions and moving health expenditures towards higher value resource use. (Source: Clinical Drug Investigation)
Source: Clinical Drug Investigation - April 28, 2022 Category: Drugs & Pharmacology Source Type: research
Management of Liver Decompensation in Advanced Chronic Liver Disease: Ascites, Hyponatremia, and Gastroesophageal Variceal Bleeding
This article focuses on the management of ascites, hyponatremia, a nd gastroesophageal variceal bleeding. (Source: Clinical Drug Investigation)
Source: Clinical Drug Investigation - April 27, 2022 Category: Drugs & Pharmacology Source Type: research
General Overview About the Current Management of Nonalcoholic Fatty Liver Disease
AbstractNonalcoholic fatty liver disease includes a wide spectrum of manifestations from simple steatosis to nonalcoholic steatohepatitis, fibrosis, and eventually cirrhosis or even hepatocellular carcinoma. This disorder is also associated with an increased cardiovascular risk, renal involvement, oncologic processes, metabolic disturbances, and an increased risk of all-cause mortality or hepatic mortality. For this reason, nonalcoholic fatty liver disease should be considered a disorder with high morbidity and mortality that must be diagnosed appropriately as soon as possible to establish adequate treatment. Noninvasive m...
Source: Clinical Drug Investigation - April 25, 2022 Category: Drugs & Pharmacology Source Type: research
Management of Alcohol-Related Liver Disease and Its Complications
AbstractAlcohol-related liver disease (ALD) is a major healthcare/economic burden and one of the leading causes of liver transplantation. New epidemiological studies that detail the course of the disease are needed since, despite its high prevalence, it is still a stigmatised condition with underlying pathology. Alcoholic hepatitis, as the highest expression of ALD, has high morbidity. Current treatments have suboptimal results with the exception of liver transplantation. Epidemiological studies must also be developed to improve prevention and implement early diagnosis policies. It is essential to develop multidisciplinary...
Source: Clinical Drug Investigation - April 25, 2022 Category: Drugs & Pharmacology Source Type: research
