Ozanimod for the treatment of relapsing remitting multiple sclerosis.
Authors: Rasche L, Paul F Abstract INTRODUCTION: Ozanimod is a selective sphingosine 1-phosphate receptor 1 and 5 modulator under development by Celgene, for the treatment of relapsing remitting multiple sclerosis. Extensive clinical experience has become available for the related compound fingolimod, favoring the sphingosine 1-phosphate therapeutic concept. Off-target effects have been attributed to its low receptor specificity and have prompted the development of next generation sphingosine 1-phosphate receptor modulators. Areas covered: The authors evaluate the literature of ozanimod, using the PubMed database a...
Source: Expert Opinion on Pharmacotherapy - November 10, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Current and emerging medical therapeutic agents for idiopathic male infertility.
This article reviews the literature about the medical treatments available for idiopathic male infertility. These treatments can be divided into two main categories: hormonal therapies and non-hormonal therapies. The compounds with the strongest evidence of efficacy and the most used in clinical practice for the treatment of idiopathic male infertility are follicle-stimulating hormone (FSH) and estrogen receptor selective modulators (SERMs). Non-hormonal treatments include a series of compounds with antioxidant and prokinetic properties, supported by variable degrees of evidence of clinical efficacy. Expert opinion: Patien...
Source: Expert Opinion on Pharmacotherapy - November 10, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Resistance is not futile: treatment-refractory schizophrenia - overview, evaluation and treatment.
Authors: Faden J, Citrome L Abstract INTRODUCTION: Schizophrenia is a debilitating condition with three main symptom domains: positive, negative, and cognitive. Approximately one-third of persons with schizophrenia will fail to respond to treatment. Growing evidence suggests that treatment-resistant (refractory) schizophrenia (TRS) may be a distinct condition from treatment-respondent schizophrenia. There is limited evidence on effective treatments for TRS, and a lack of standardized diagnostic criteria for TRS has hampered research. Areas covered: A literature search was conducted using Pubmed.gov and the EMBASE l...
Source: Expert Opinion on Pharmacotherapy - November 10, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Brimonidine tartrate for the treatment of glaucoma.
Authors: Oh DJ, Chen JL, Vajaranant TS, Dikopf MS Abstract INTRODUCTION: Brimonidine tartrate is a commonly used eyedrop for short- and long-term lowering of intraocular pressure. Its use has been popularized due to its effects on aqueous suppression and uveoscleral outflow, as well as the suggestion of neuroprotection. Although available with alternative preservative vehicles, brimonidine is associated with high rates of local allergy and is contraindicated in breastfeeding women, neonates, young children, and the elderly due to risk of central nervous system depression. Other topical agents with differing advanta...
Source: Expert Opinion on Pharmacotherapy - November 10, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Present and emerging pharmacotherapies for non-alcoholic steatohepatitis in adults.
Authors: Ogawa Y, Yoneda M, Kobayashi T, Honda Y, Kessoku T, Imajo K, Saito S, Nakajima A Abstract INTRODUCTION: Multiple parallel factors are implicated in the pathogenesis and progression of non-alcoholic fatty liver disease (NAFLD)/non-alcoholic steatohepatitis (NASH). Currently recommended therapies for NASH include vitamin E and pioglitazone, besides dietary and lifestyle changes. Areas covered: This review focuses on the clinical development of several emerging drugs for the treatment of NASH and the impact of these drugs on current treatment standards. Expert opinion: Four drug classes (FXR agonists, CCR2/CC...
Source: Expert Opinion on Pharmacotherapy - November 10, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Chemical management of levodopa-induced dyskinesia in Parkinson's disease patients.
Authors: Dragašević-Mišković N, Petrović I, Stanković I, Kostić VS Abstract INTRODUCTION: Levodopa-induced dyskinesias (LID) appears in more than 50% of Parkinson's disease patients after 5 years of treatment and clinicians always have to ensure that there is a balance between the beneficial effect of the treatment and the potential complications. Areas covered: In this review, the authors discuss the treatment of LID. Treatment can be divided into strategies for preventing their occurrence, modification of dopaminergic therapy, and providing more continuous dopaminergic stimulation as well ...
Source: Expert Opinion on Pharmacotherapy - November 10, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Systemic treatments for metastatic urothelial carcinoma.
This article provides a comprehensive summary of the currently available treatments for metastatic urothelial carcinoma (mUC). The authors also review ongoing, phase-III studies with novel therapeutic targets and highlight recent insights into tumor biology that may help better understand the disease. Expert opinion: The treatment landscape for first-line therapy of mUC continues to include platinum-based chemotherapy for patients who are eligible. While the approval of ICI has changed the management in those who are post-platinum or platinum-ineligible, the wider use of ICI in the first-line setting requires further clari...
Source: Expert Opinion on Pharmacotherapy - November 10, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Pharmacoeconomic evaluation of sodium-glucose transporter-2 (SGLT2) inhibitors for the treatment of type 2 diabetes.
Authors: Rahman W, Solinsky PJ, Munir KM, Lamos EM Abstract INTRODUCTION: Clinicians have many safe and effective options for the treatment of type 2 diabetes that can improve glycemic control and effect other cardio-metabolic parameters. Sodium-glucose transporter-2 inhibitors (SGLT-2) are the most recent class of therapies, have a novel mechanism of action, and provide good glycemic efficacy and a favorable cardiovascular risk profile. Cost-effectiveness data can play an important role in assessing the benefits of this class of therapy in anti-diabetes treatment regimens. Areas covered: This review summarizes all...
Source: Expert Opinion on Pharmacotherapy - November 10, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

How do you choose the appropriate migraine pharmacotherapy for an elderly person?
Authors: Curto M, Capi M, Martelletti P, Lionetto L PMID: 30403889 [PubMed - as supplied by publisher] (Source: Expert Opinion on Pharmacotherapy)
Source: Expert Opinion on Pharmacotherapy - November 9, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Pharmacology of new and developing intravenous therapies for the management of seizures and epilepsy.
Authors: Morano A, Iannone L, Palleria C, Fanella M, Giallonardo AT, De Sarro G, Russo E, Di Bonaventura C Abstract INTRODUCTION: Antiepileptic drugs (AEDs) are administered orally for chronic use. Parenteral formulations might be necessary when the oral route is not feasible (e.g. an impairment of consciousness, trauma, dysphagia, gastrointestinal illness) or for treatment of seizure emergencies. At present, few intravenous (IV) formulations are available on the market. Areas covered: The purpose of this review is to summarize the pharmacological characteristics and clinical applications of IV medications that hav...
Source: Expert Opinion on Pharmacotherapy - November 9, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Afatinib and Erlotinib in the treatment of squamous-cell lung cancer.
Authors: Tagliamento M, Genova C, Rijavec E, Rossi G, Biello F, Dal Bello MG, Alama A, Coco S, Boccardo S, Grossi F Abstract INTRODUCTION: Squamous-cell carcinoma (SCC) of the lung represents around 20% of non-small cell lung cancers. Although activating mutations of EGFR are rare in this subtype, its overexpression occurs in more than half the cases. Consequently, many epidermal growth factor receptor (EGFR)-targeted agents have been investigated in patients with SCC. Areas covered: This review summarizes the potential roles of erlotinib and afatinib in SCC of the lung. The authors explore the rationale of targeti...
Source: Expert Opinion on Pharmacotherapy - November 7, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

An evaluation of fevipiprant for the treatment of asthma: a promising new therapy?
Authors: Murillo JC, Dimov V, Gonzalez-Estrada A Abstract INTRODUCTION: Asthma is a heterogeneous disease characterized by chronic airway inflammation that affects more than 230 million people worldwide. Current guidelines recommend an escalating stepwise decision model for the management of asthma. However, disease control continues to be a challenge, particularly in patients with severe asthma. Biologics have proven to be an effective add-on treatment especially in eosinophilic or type 2 airway disease. Comparatively, pre-biologics may represent a successful novel therapy. Fevipiprant (QAW039) is a selective, rev...
Source: Expert Opinion on Pharmacotherapy - November 7, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

How does one decide the best pharmacotherapeutic strategy for bacterial peritonitis?
Authors: Schlabe S, Lutz P PMID: 30395739 [PubMed - as supplied by publisher] (Source: Expert Opinion on Pharmacotherapy)
Source: Expert Opinion on Pharmacotherapy - November 7, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Efficacy of carbidopa-levodopa extended-release capsules (IPX066) in the treatment of Parkinson Disease.
Authors: Müller T, Möhr JD Abstract INTRODUCTION: Levodopa is the most efficacious and best-tolerated drug for treating Parkinson's disease (PD). To improve the treatment of PD, recent research initiatives have aimed to optimize the pharmacokinetic plasma behavior of L-dopa. Areas covered: This non-systematic, narrative drug evaluation brings the therapeutic value of IPX066 up for discussion. IPX066 is an orally applied levodopa/carbidopa containing formulation with modified drug release. It is rapidly absorbed, similar to conventional immediate-release levodopa preparations. The IPX066 capsule continuous...
Source: Expert Opinion on Pharmacotherapy - November 7, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

What is the best pharmacotherapeutic strategy for HER-2 positive breast cancer?
Authors: Giannone G, Milani A, Geuna E, Galizia D, Biello F, Montemurro F PMID: 30396301 [PubMed - as supplied by publisher] (Source: Expert Opinion on Pharmacotherapy)
Source: Expert Opinion on Pharmacotherapy - November 7, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Chemical Pharmacotherapy for the Treatment of Orthostatic Hypotension.
Authors: Cheshire WP Abstract INTRODUCTION: Orthostatic hypotension (OH) is a common yet often overlooked condition. Particularly debilitating is neurogenic orthostatic hypotension (nOH) caused by deficient neurotransmission of norepinephrine, which is the primary neurotransmitter released at sympathetic peripheral vascular nerve terminals in response to orthostatic stress. Areas covered: In this review, the author summarizes and critiques established and emerging pharmacologic approaches for the management of nOH. Two drugs are currently approved. Midodrine, an α1-adrenoreceptor agonist, acts on capacitance ...
Source: Expert Opinion on Pharmacotherapy - November 2, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

A systematic review of the use of risperidone, paliperidone and aripiprazole as augmenting agents for obsessive-compulsive disorder.
Authors: Brakoulias V, Stockings E Abstract Introduction Obsessive-compulsive disorder (OCD) is often viewed as a difficult to treat disorder. In some patients, antipsychotics are used to augment the action of serotonin reuptake inhibitors (SRIs), particularly when there is only a partial response to treatment. Areas covered This comprehensive literature review aims to assess the effectiveness and tolerability of three commonly used atypical antipsychotic agents: risperidone, paliperidone and aripiprazole, as augmentation agents in the treatment of OCD. Expert opinion Antipsychotic augmentation should only be trial...
Source: Expert Opinion on Pharmacotherapy - October 28, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

The evolving role of pemetrexed disodium for the treatment of non-small cell lung cancer.
Authors: Rossi G, Alama A, Genova C, Rijavec E, Tagliamento M, Biello F, Coco S, Dal Bello MG, Boccardo S, Grossi F Abstract INTRODUCTION: Non-small cell lung cancer (NSCLC) remains one of the big cancer killers, despite the introduction of a number of approved therapeutics in recent times. Pemetrexed is a multi-target folate inhibitor, which is currently available to patients affected by advanced non-squamous NSCLC in combination with a platinum derivate in first-line therapy and as a single agent in second-line therapy. Areas covered: This review covers presents the use pemetrexed in the management of NSCLC by ex...
Source: Expert Opinion on Pharmacotherapy - October 27, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Current and emerging pharmacotherapy for ischemic stroke prevention in patients with atrial fibrillation.
Authors: Székely O, Miyazawa K, Lip GYH Abstract INTRODUCTION: Atrial fibrillation (AF) is associated with high morbidity and mortality rates due to thromboembolic complications, and anticoagulation is central to the management of this common arrhythmia to prevent acute thromboembolic events. The traditional anticoagulants: heparin, fondaparinux, and vitamin K antagonists (VKA, e.g. warfarin, acenocoumarol or phenprocoumin) have long served as pharmacotherapy for ischemic stroke prophylaxis. Areas covered: In this review article, the authors provide an overview on current and emerging pharmacotherapy for isc...
Source: Expert Opinion on Pharmacotherapy - October 27, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Current pharmacotherapeutic options for pediatric lower respiratory tract infections with a focus on antimicrobial agents.
Authors: Matera MG, Rogliani P, Ora J, Cazzola M Abstract INTRODUCTION: Antibiotics are frequently prescribed to children in the community and in nosocomial settings, mainly because of lower respiratory tract infections(LRTIs), which include influenza, bronchitis, bronchiolitis, pneumonia, and tuberculosis, in addition to bronchiectasis and cystic fibrosis lung disease. It is important to note, however, that more than 50% of these prescriptions are unnecessary or inappropriate. Areas covered: The current choice of antimicrobial therapy for etiological agents of LRTIs is examined and discussed considering each type ...
Source: Expert Opinion on Pharmacotherapy - October 27, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Chronic rhinosinusitis: pathogenesis, therapy options, and more.
Authors: Kucuksezer UC, Ozdemir C, Akdis M, Akdis CA Abstract INTRODUCTION: When rhinosinusitis - the inflammation of the nasal cavity and paranasal sinuses - persists for over 12 weeks, it is termed 'chronic rhinosinusitis' (CRS). Both innate and adaptive immunity contribute to the heterogeneous inflammatory pathogenesis of CRS, which is driven by genetic and environmental factors and the microbiome. CRS is classified by the presence of polyps. Molecular mechanisms in CRS with nasal polyps are similar to those in atopic diseases. Areas covered: This review focuses on the immune pathogenesis of CRS, difference...
Source: Expert Opinion on Pharmacotherapy - October 24, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Pharmacotherapeutic management of gout in patients with cardiac disease.
Authors: Chan CW, Yap YN Abstract INTRODUCTION: Hyperuricemia has been identified as an independent risk factor for coronary artery disease (CAD). Uric acid lowering therapy could potentially lower the risk of CAD. Conventional treatments have been effective in treating acute gout flares in most patients, but certain options, like NSAIDs could increase the risk of CAD. Area covered: This review covers the aspect of cardiac safety with traditional and new medications used in treating both acute flares and chronic gout according to the most recent international guidelines. Expert opinion: All NSAIDs, not just selecti...
Source: Expert Opinion on Pharmacotherapy - October 24, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Regorafenib: a promising treatment for hepatocellular carcinoma.
Authors: Cerrito L, Ponziani FR, Garcovich M, Tortora A, Annicchiarico BE, Pompili M, Siciliano M, Gasbarrini A Abstract INTRODUCTION: Hepatocellular carcinoma (HCC) is one of the most frequent malignant tumors with 854,000 new cases per year and represents the second most frequent cause of cancer-death. Despite surveillance, the number of patients that are diagnosed at a stage in which they are eligible for curative treatments ranges from 30% to 60%. Advanced HCC (BCLC-C) is characterized by a median survival of 6 months. Sorafenib, the first systemic drug proven to be effective in prolonging survival of unre...
Source: Expert Opinion on Pharmacotherapy - October 24, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

The Antibiotic Arms Race: Current and Emerging Therapy for Klebsiella pneumoniae Carbapenemase (KPC) - Producing Bacteria.
This article encompasses both the past and present treatment options for the management of KPC-producing bacterial infections via an extensive review and critical appraisal of the current literature. Expert opinion: Traditional treatment options can no longer be recommended as first-line options for the management of KPC-producing bloodstream infections (BSIs). Ceftazidime-avibactam or meropenem-vaborbactam plus or minus an aminoglycoside or polymyxin should be utilized as backbone therapies given their superior efficacy and safety profiles when compared to traditional treatment options. For susceptible KPC-producing urina...
Source: Expert Opinion on Pharmacotherapy - October 24, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Preservative-free tafluprost/timolol fixed combination: comparative 24-h efficacy administered morning or evening in open-angle glaucoma patients.
This study was a prospective, observer-masked, placebo-controlled, crossover, comparison in 42 consecutive open-angle glaucoma patients whose intraocular pressure (IOP) was insufficiently controlled with preserved latanoprost monotherapy (mean 24-h IOP >20 mmHg). Patients were randomized to either morning (08:00) or evening (20:00) PF TTFC for 3 months and then crossed over. After each treatment period, patients underwent habitual 24-h IOP monitoring with Goldmann tonometry in the sitting position (at 10:00, 14:00, 18:00, and 22:00) and Perkins tonometry in the supine position (at 02:00 and 06:00). RE...
Source: Expert Opinion on Pharmacotherapy - October 18, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Current and emerging pharmaceutical strategies for smoking cessation during pregnancy.
Authors: Barboza J Abstract INTRODUCTION: Tobacco use is the most preventable cause of death worldwide, with over 7 million deaths per year. Smoking during pregnancy causes harm to the mother, fetus, and can result in problems for the infant from childhood into adulthood. Practitioners should ask all expectant mothers about tobacco use. For expectant mothers who smoke or recently quit, practitioners should advice to quit and provide psychosocial interventions. Rates of smoking during pregnancy differ between geographical locations, with estimates of 10.8% in the UK and 7.2% in the US. Practitioners should provide e...
Source: Expert Opinion on Pharmacotherapy - October 18, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Current and up-and-coming pharmacotherapy for obsessive-compulsive disorder in adults.
Authors: Grassi G, Pallanti S Abstract INTRODUCTION: Only 40-60% of obsessive-compulsive patients respond to first line treatments, such as selective serotonin reuptake inhibitors (SSRIs) and cognitive-behavioral therapy. Several second-line treatments have been investigated in the last two decades, and most of them seem to work, at least in a subset of patients. However, since there is still a lack of treatment predictors, the treatment of obsessive-compulsive disorder (OCD) is still empirical and non-evidence based. Areas covered: In this paper, we review current and up-and-coming pharmacotherapy for OCD in adult...
Source: Expert Opinion on Pharmacotherapy - October 17, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Currently available first-line drug therapies for treating pancreatic cancer.
Authors: Olson JL, Bold RJ Abstract INTRODUCTION: Pancreatic adenocarcinoma is the 9th most common cancer in the United States and the 4th most common cause of cancer-related death given its poor prognosis. Areas covered: The authors have performed a literature search for pertinent published clinical trials, ongoing Phase 3 clinical trials, and current treatment guidelines using PubMed, Clinicaltrials.gov, and NCCN, ASCO, ESMO, and JPS websites. The review itself discusses landmark studies and ongoing research into the chemotherapy regimens recommended by each oncologic society. The authors also examine drugs that ...
Source: Expert Opinion on Pharmacotherapy - October 17, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Olodaterol for the treatment of chronic obstructive pulmonary disease: a narrative review.
This article reviews the several trials that have assessed olodaterol as a COPD therapy. It covers safety and tolerability data and provides the reader with an expert opinion on its use as a treatment for COPD. Expert opinion: Olodaterol improves lung function for 24 h and reduces rescue medication use. It may also improve dyspnea, exercise tolerance, and health-related quality of life. It is well tolerated with an acceptable cardiovascular and respiratory adverse event profile. There is some evidence that olodaterol, as well as other LABAs, can reduce exacerbation frequency, but not FEV1 decline and death. LABAs alon...
Source: Expert Opinion on Pharmacotherapy - October 14, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Advancing therapies in metastatic castration-resistant prostate cancer.
Authors: Baciarello G, Gizzi M, Fizazi K Abstract INTRODUCTION: Prostate cancer is the second most common cause of cancer worldwide and is the most frequently detected cancer in the European Union in men over 50 years of age. Androgen deprivation therapy remains the cornerstone of treatment for recurrent or metastatic disease. Unfortunately, nearly all patients will develop resistance to androgen blockade leading to castration-resistant prostate cancer (CRPC). Over the last 10 years, new treatments have dramatically improved overall survival of men with mCRPC. Current therapies are based on AR-axis inhibitors ...
Source: Expert Opinion on Pharmacotherapy - October 14, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Managing urinary incontinence in women - a review of new and emerging pharmacotherapy.
Authors: Bientinesi R, Sacco E Abstract INTRODUCTION: The pharmacological treatment of urinary incontinence and overactive bladder (OAB) has been, for a longer time, based on antimuscarinic agents. In recent years, two other pharmacological principles have been introduced for the treatment of OAB and urgency urinary incontinence: the β3-adrenergic agent mirabegron and botulinum neurotoxin. Meanwhile, there is lack of effective drugs for the treatment of stress incontinence. Areas covered: This literature review presents synthetic compounds aimed to treat female urinary incontinence that are in phase II-III cli...
Source: Expert Opinion on Pharmacotherapy - October 13, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Advances in the available non-biological pharmacotherapy prevention and treatment of acute mountain sickness and high altitude cerebral and pulmonary oedema.
Authors: Joyce KE, Lucas SJE, Imray CHE, Balanos GM, Wright AD Abstract INTRODUCTION: The physiological responses on exposure to high altitude are relatively well known, but new discoveries are still being made, and novel prevention and treatment strategies may arise. Basic information has changed little since our previous review in this journal 10 years ago, but considerable more detail on standard therapies, and promising new approaches are now available. Areas covered: Herein, the authors review the role of pharmacological agents in preventing and treating high-altitude illnesses. The authors have drawn on their...
Source: Expert Opinion on Pharmacotherapy - October 13, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Pharmacotherapy of type 2 diabetes in patients with chronic liver disease: focus on nonalcoholic fatty liver disease.
Authors: Raschi E, Mazzotti A, Poluzzi E, De Ponti F, Marchesini G Abstract INTRODUCTION: Pharmacotherapy used to treat type 2 diabetes mellitus (T2DM) is facing a paradigm shift in clinical practice with recent cardiovascular (CV) outcome trials having a substantial impact on drug prescription with treatment having a more tailored approach. In patients with T2DM, the issue of chronic liver disease is multifaceted. However, a clinical evidence is emerging on the beneficial effect of antidiabetic medications on nonalcoholic fatty liver disease (NAFLD). Areas covered: The authors provide a synopsis on the current and...
Source: Expert Opinion on Pharmacotherapy - October 11, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Embracing the polypill as a cardiovascular therapeutic: is this the best strategy?
Authors: Franczyk B, Gluba-Brzózka A, Jurkiewicz Ł, Penson P, Banach M, Rysz J Abstract INTRODUCTION: Cardiovascular disease (CVD) is an important cause of mortality and morbidity worldwide. CVD morbidity and mortality are associated with significant financial costs related to hospitalization, medication, and lost productivity. The concept of the 'polypill' for the reduction of cardiovascular risk was proposed in 2000. A polypill is a fixed combination of drugs in a single tablet or capsule. The initial polypill consisted of three different classes of antihypertensive drugs (each at half dose), in addition ...
Source: Expert Opinion on Pharmacotherapy - October 10, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Efficacy of the combination of carteolol hydrochloride + latanoprost in the treatment of glaucoma and ocular hypertension.
Authors: Soares RR, Razeghinejad MR Abstract INTRODUCTION: The only evidence-based mechanism for prevention and treatment of glaucomatous optic neuropathy is decreasing the intraocular pressure (IOP). Prescribing multiple ocular hypotensive agents, such as the combination of carteolol and latanoprost, may synergistically improve IOP; however, doing so may increase the complexity of a medication regimen, in turn, impairing patient adherence. Fixed-combination glaucoma medications offer convenience and effectiveness. New to this class of glaucoma medication is fixed combination carteolol-latanoprost (FCCL). Area cove...
Source: Expert Opinion on Pharmacotherapy - October 10, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Advances in contraceptive vaginal rings: what does the future hold?
This article provides a review of the developments made with CVRs over the past number of years, while giving focus to the latest CVRs that have gone through clinical development. The author of the article also provides an expert perspective on the future of these useful therapeutic options. Expert opinion: Pharmacokinetic studies have shown that segesterone, an absorbable progestin that is used alone or in combination with ethinyl estradiol (EE) or E2, is the CVR of choice at this present time. Indeed, segesterone has demonstrated safety and efficacy as a CVR and is also an appropriate option for lactating women, as they ...
Source: Expert Opinion on Pharmacotherapy - October 7, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Pharmacotherapeutic management of comorbid polycystic ovary syndrome and diabetes.
Authors: Ortiz-Flores AE, Luque-Ramírez M, Escobar-Morreale HF Abstract INTRODUCTION: Polycystic ovary syndrome (PCOS) is a common endocrine disorder in premenopausal women. Insulin resistance and glucose intolerance are very prevalent metabolic complications in women with PCOS, especially in those presenting with weight excess. Therapeutic strategies targeting insulin resistance in PCOS are of interest because of their overall safety and their beneficial effects on metabolic and reproductive features. Areas covered: The authors review systematically all of the available therapeutic interventions targeting i...
Source: Expert Opinion on Pharmacotherapy - October 7, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Pharmacotherapy for the prevention of malaria in pregnant women: currently available drugs and challenges.
Authors: Moore BR, Davis TME Abstract INTRODUCTION: Malaria in pregnancy continues to be a significant public health burden globally, with over 100 million women at risk each year. Sulfadoxine-pyrimethamine (SP) is the only antimalarial recommended for intermittent preventive therapy in pregnancy (IPTp) but increasing parasite resistance threatens its viability. There are few other available antimalarial therapies that currently have sufficient evidence of tolerability, safety, and efficacy to replace SP. Areas covered: Novel antimalarial combinations are under investigation for potential use as chemoprophylaxis an...
Source: Expert Opinion on Pharmacotherapy - October 7, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

The future of Febuxostat after the Cardiovascular Safety of Febuxostat and Allopurinol in Patients with Gout and Cardiovascular Morbidities (CARES) trial: who CARES?
Authors: Katsiki N, Borghi C PMID: 30285495 [PubMed - as supplied by publisher] (Source: Expert Opinion on Pharmacotherapy)
Source: Expert Opinion on Pharmacotherapy - October 6, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Safety and effectiveness of istradefylline in patients with Parkinson's disease: interim analysis of a post-marketing surveillance study in Japan.
CONCLUSIONS: This PMS provides useful safety and effectiveness data for long-term treatment with istradefylline in a real-world setting for patients with PD exhibiting the wearing-off phenomenon with L-DOPA. PMID: 30281377 [PubMed - as supplied by publisher] (Source: Expert Opinion on Pharmacotherapy)
Source: Expert Opinion on Pharmacotherapy - October 4, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

The challenge of gender-specific pharmacotherapy for stroke prevention and treatment.
Authors: Chatzopoulos G, Tziomalos K PMID: 30269611 [PubMed - as supplied by publisher] (Source: Expert Opinion on Pharmacotherapy)
Source: Expert Opinion on Pharmacotherapy - October 3, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

An evaluation of pixantrone for the treatment of non-Hodgkin's lymphoma.
Authors: Hübel K Abstract INTRODUCTION: The overall prognosis for patients with relapsed or refractory aggressive non-Hodgkin's lymphomas is poor. Only a minority of patients are able to receive autologous stem cell transplantation. Patients not transplant-eligible or patients relapsing after transplantation have an urgent need for effective treatment options. Pixantrone is the only compound approved in Europe for this situation. Areas covered: This review describes the clinical development of pixantrone, starting with phase I trials up to phase III trials in order to define the role of pixantrone in treatment...
Source: Expert Opinion on Pharmacotherapy - October 3, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Synthetic therapeutics for the treatment of hepatitis B during pregnancy.
Authors: Kar P, Sengupta A Abstract INTRODUCTION: Hepatitis B infection in pregnancy mandates careful monitoring and specialized management according to the phase of hepatitis B infection. Perinatal transmission may be prevented by antiviral therapy in mothers with high viral load and timely immunoprophylaxis of the infant. Areas covered: This review focuses on the current first-line therapies for treating hepatitis B in pregnancy, timing of therapy, and prevention of perinatal transmission. Strategies to manage disease at the various phases and potential emerging therapies in phase III of development are also cove...
Source: Expert Opinion on Pharmacotherapy - October 3, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Pharmacotherapy of Down Syndrome.
This article reviews the literature on the pharmacotherapy of psychiatric conditions co-occurring with DS, including major depressive disorder (MDD), bipolar disorder, anxiety disorders, obsessive-compulsive disorder (OCD), attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), psychosis, and catatonia. A section on the phenomenon of regression is included. Expert opinion: For MDD, we typically begin with selective serotonin reuptake inhibitors (SSRIs). For bipolar disorder, we often use carbamazepine. For psychotic symptoms, we begin with risperidone or aripiprazole. We use buspirone to treat anx...
Source: Expert Opinion on Pharmacotherapy - September 28, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Pharmacological treatment of anxiety disorders in adults with epilepsy.
PHARMACOLOGICAL TREATMENT OF ANXIETY DISORDERS IN ADULTS WITH EPILEPSY. Expert Opin Pharmacother. 2018 Sep 25;: Authors: Mula M Abstract INTRODUCTION: Anxiety disorders represent one of the most frequently encountered comorbidities in patients with epilepsy, affecting quality of life and increasing, morbidity, mortality and healthcare costs. However, they are still underdiagnosed and undertreated. Areas covered: This is a narrative review of the pharmacological treatment of anxiety disorders in adult patients with epilepsy discussing also major issues regarding pathophysiology and diagnosis. Expert opi...
Source: Expert Opinion on Pharmacotherapy - September 27, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

The current data on the 3-month paliperidone palmitate formulation for the treatment of schizophrenia.
Authors: Bioque M, Bernardo M Abstract INTRODUCTION: A three-month injection of paliperidone palmitate (PP3M) has been gradually introduced in the market since 2015. Recently, and due to different reasons, there is an increase in the LAIAs prescription rates, including patients in early phases of psychotic disorders. Areas covered: The following article provides an overview of the antipsychotic market before providing the reader with an overview of the efficacy and tolerability data of the 3-month paliperidone palmitate formulation for the treatment of schizophrenia. The authors take into account the current state ...
Source: Expert Opinion on Pharmacotherapy - September 26, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

An evaluation of memantine ER + donepezil for the treatment of Alzheimer's disease.
Authors: Calhoun A, King C, Khoury R, Grossberg GT Abstract INTRODUCTION: Alzheimer's disease (AD) is the most common neurodegenerative disease worldwide and carries an immense societal burden. Unfortunately, no curative or disease-modifying treatment has yet been discovered. The currently approved medications are symptomatic. They include two classes: the cholinesterase inhibitors, such as donepezil, and the NMDA receptor antagonist memantine. Most evidence has shown that combining both classes is superior to monotherapy but may complicate the treatment regimen for patients and families. Namzaric®, a fixed dos...
Source: Expert Opinion on Pharmacotherapy - September 26, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Brexpiprazole: a step forward for precision medicine in resistant depression.
Authors: Serretti A Abstract INTRODUCTION: Resistant depression is still a common and burdensome issue and there is an urgent need for new and effective adjunctive treatments. Areas covered: In this paper, the author discusses the background, trial design, results and implications of a recent study (NCT02196506, Sirius study) which confirmed the possible benefit of brexpiprazole as adjunctive treatment in depressed subjects with inadequate benefit from first line treatments. As secondary aims, the study confirmed the effects in subjects with minimal benefit from standard treatments and in subjects with anxious dist...
Source: Expert Opinion on Pharmacotherapy - September 26, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Istradefylline for the treatment of Parkinson's disease: is it a promising strategy?
The objective of this review is to summarize evidences emerged from clinical studies that have demonstrated the efficacy of ISD in advanced parkinsonian patients. It will then focus on the potential role in treating non-motor symptoms and cognitive decline, which heavily affect quality of life for PD patients. Its putative role as neuroprotective agent will also be discussed. Expert Opinion: ISD might represent an alternative option for patients with advanced PD. The reduction of OFF time highlighted in pivotal trials is comparable to that obtained with different levodopa adjunct therapies. The low profile of side effects ...
Source: Expert Opinion on Pharmacotherapy - September 21, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Do glucagon-like peptide-1 receptor (GLP-1R) agonists have potential as adjuncts in the treatment of type 1 diabetes?
Authors: Doggrell SA Abstract INTRODUCTION: Glucagon-like peptide-1 (GLP-1) is produced by the gut, stimulates insulin secretion from the pancreatic β-cells, and inhibits glucagon secretion from the α-cells. The GLP-1 receptor (GLP-1R) agonists are used in the treatment of type 2 diabetes (T2DM). Area covered: This review covers the clinical trials of the GLP-1R agonists (exenatide and liraglutide) and their potential as adjunct treatment in type 1 diabetes mellitus (T1DM). Expert opinion: GLP-1R agonists are unable to increase insulin secretion, in subjects with T1DM, who are C-peptide negative. Also, t...
Source: Expert Opinion on Pharmacotherapy - September 21, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research