Management of Advanced Urothelial Carcinoma in Older and Frail Patients: Have Novel Treatment Approaches Improved Their Care?
AbstractPatients with urothelial carcinoma tend to be older and frailer with a large number of chronic medical conditions. This is particularly pronounced in those with unresectable locally advanced and metastatic urothelial carcinoma. Prior to 2016, treatment options in advanced urothelial carcinoma were limited to chemotherapy, and as a result, a large number of patients were not receiving disease-directed management. Over the last 6 years, multiple alternative modalities including immune checkpoint inhibitors and targeted therapies have been introduced. They are being utilized clinically in older and frail patients, b...
Source: Drugs and Aging - March 28, 2022 Category: Geriatrics Source Type: research
Adjunctive Brivaracetam in Older Patients with Focal Seizures: Evidence from the BRIVAracetam add ‑on First Italian netwoRk Study (BRIVAFIRST)
ConclusionsAdjunctive brivaracetam was efficacious, had good tolerability, and no new or unexpected safety signals emerged when used to treat older patients with uncontrolled focal seizures in clinical practice. Adjunctive brivaracetam can be a suitable therapeutic option in this special population. (Source: Drugs and Aging)
Source: Drugs and Aging - March 28, 2022 Category: Geriatrics Source Type: research
Pharmacotherapeutic Management of Well-Differentiated Neuroendocrine Tumors in Older Patients: Current Status and Potential Therapies
AbstractNeuroendocrine tumors are a rare and heterogenous group of neoplasms that arise from hormone-producing cells throughout the body, with the greatest increase in incidence occurring among older adults aged ≥ 65 years. Despite this, there is currently a lack of data regarding the safety and efficacy of systemic treatment for older adults with neuroendocrine tumors. In this review, we provide a synopsis of the current standard-of-care pharmacotherapeutic treatments for neuroendocrine tumors, with an emphasis on available data in older adults. The benefits of various systemic options such as somatostatin analogs, try...
Source: Drugs and Aging - March 25, 2022 Category: Geriatrics Source Type: research
Opioids and Falls Risk in Older Adults: A Narrative Review
AbstractPain treatment is important in older adults but may result in adverse events such as falls. Opioids are effective for nociceptive pain but the evidence for neuropathic pain is weak. Nevertheless, both pain and opioids may increase the risk of falls. This narrative literature review aims to summarize the existing knowledge on the opioid-related fall risk in older adults, including the pharmacokinetics and pharmacodynamics, and assist clinicians in prescribing and deprescribing opioids in older persons. We systematically searched relevant literature on opioid-related fall risk in older adults in PubMed and Scopus in ...
Source: Drugs and Aging - March 15, 2022 Category: Geriatrics Source Type: research
Drug Treatment of Hypercholesterolemia in Older Adults: Focus on Newer Agents
AbstractThere is increasing research interest in cholesterol-lowering therapy in older patients. The newer lipid-lowering agents (the proprotein convertase subtilisin/kexin type 9 [PCSK9] inhibitors evolocumab and alirocumab; the PCSK9 synthesis inhibitor inclisiran, and the adenosine triphosphate –citrate lyase inhibitor bempedoic acid) might also provide more options for the future treatment of older patients. Data analyses of the phase III outcome trials of the PCSK9 inhibitors suggest that their clinical benefits are maintained at older ages and that there is no increased relative risk of adverse events in older pati...
Source: Drugs and Aging - March 12, 2022 Category: Geriatrics Source Type: research
HOSPITAL Score and LACE Index to Predict Mortality in Multimorbid Older Patients
ConclusionThe HOSPITAL score and LACE index showed similar performance to predict 1-year and 30-day mortality in older multimorbid patients with polypharmacy. Their overall accuracy was good, their discrimination low to moderate, and the calibration good. These simple tools may help predict older multimorbid patients ’ mortality after hospitalization, which may inform post-hospitalization intensity of care. (Source: Drugs and Aging)
Source: Drugs and Aging - March 9, 2022 Category: Geriatrics Source Type: research
Hexanic Extract of Serenoa repens (Permixon ®): A Review in Symptomatic Benign Prostatic Hyperplasia
AbstractThe hexanic extract (HE) ofSerenoa repens (Permixon®) is indicated for the symptomatic treatment of benign prostatic hyperplasia (BPH). The drug is the n-hexane lipidosterolic extract of the American dwarf palm tree (also known as saw palmetto). The anti-inflammatory activity of HES.repens has been demonstrated in vitro, in vivo and in men with prostatic inflammation. In randomized clinical trials, the efficacy of HES. repens was similar to that of an α-blocker in terms of improving voiding and storage symptoms, increasing urinary flow rate and reducing prostate volume in men with BPH. HES. repens was also as eff...
Source: Drugs and Aging - March 3, 2022 Category: Geriatrics Source Type: research
The FORTA (Fit fOR The Aged) List 2021: Fourth Version of a Validated Clinical Aid for Improved Pharmacotherapy in Older Adults
(Source: Drugs and Aging)
Source: Drugs and Aging - February 23, 2022 Category: Geriatrics Source Type: research
Barriers and Enablers of Healthcare Providers to Deprescribe Cardiometabolic Medication in Older Patients: A Focus Group Study
ConclusionHCPs recognized the importance of deprescribing cardiometabolic medication as a medical decision that can only be made in close cooperation with the patient. To successfully accomplish the process of deprescribing they strongly recommended a multidisciplinary approach. (Source: Drugs and Aging)
Source: Drugs and Aging - February 21, 2022 Category: Geriatrics Source Type: research
Effects of Resveratrol Supplementation on the Cognitive Function of Patients with Alzheimer's Disease: A Systematic Review of Randomized Controlled Trials
ConclusionsSupplementation with resveratrol seems to influence the progressive cognitive and functional decline in AD patients, when compared with a placebo group.Systematic review registrationPROSPERO CRD42021229234. (Source: Drugs and Aging)
Source: Drugs and Aging - February 21, 2022 Category: Geriatrics Source Type: research
Correction to: Assessment of Comorbidity Burden and Treatment Response: Reanalysis of the SCD-HEFT Trial
(Source: Drugs and Aging)
Source: Drugs and Aging - February 18, 2022 Category: Geriatrics Source Type: research
Correction to: SGLT2 Inhibitors in Older Adults with Heart Failure with Preserved Ejection Fraction
(Source: Drugs and Aging)
Source: Drugs and Aging - February 16, 2022 Category: Geriatrics Source Type: research
Topical Pharmacotherapy for Actinic Keratoses in Older Adults
AbstractActinic keratosis is caused by excessive lifetime sun exposure. It must be treated, regardless of thickness, because it is the biologic precursor of invasive squamous cell carcinoma, a potentially deadly malignancy. Physical ablative techniques such as cryotherapy, lasers, and curettage are the most used treatments for isolated lesions. Multiple lesions are treated with topical drugs, chemical peelings, and physical techniques. Drug preparations containing diclofenac plus hyaluronate, aminolevulinic acid, and methyl aminolevulinate and different concentrations of imiquimod and 5-fluorouracil are approved for this c...
Source: Drugs and Aging - February 14, 2022 Category: Geriatrics Source Type: research
SGLT2 Inhibitors in Older Adults with Heart Failure with Preserved Ejection Fraction
AbstractHeart failure is an important medical condition that is prevalent in older adults. Multiple therapies have been identified that improve clinical outcome in heart failure with a reduced ejection fraction. Conversely, this has not been the case in heart failure with preserved ejection fraction (HFpEF). Until now, empagliflozin is the first therapy that has convincingly been shown to improve clinical outcome in HFpEF. Importantly, some key points should be considered to better understand the impact of empagliflozin on the patient trajectory, particularly in older adults with HFpEF. In this current opinion article, we ...
Source: Drugs and Aging - February 4, 2022 Category: Geriatrics Source Type: research
Which Potentially Inappropriate Medications List Can Detect Patients At Risk of Readmissions in the Older Adult Population Admitted for Falls? An Observational Multicentre Study Using a Clinical Data Warehouse
ConclusionsOur study evidenced that not all lists published allow the accurate prediction of hospital readmissions to the same extent. We found that the Laroche and PRISCUS lists were associated with increased 30-day all-cause hospital readmissions after an index admission with a fall-related injury. (Source: Drugs and Aging)
Source: Drugs and Aging - February 4, 2022 Category: Geriatrics Source Type: research
