Agomelatine for depression: expanding the horizons?
Authors: Norman TR, Olver JS Abstract INTRODUCTION: Agomelatine is an antidepressant with unique pharmacological actions; it is both a melatonin agonist and selective serotonin antagonist. Both actions combined are necessary for antidepressant efficacy. Effects on melatonin receptors enable resynchronisation of disrupted circadian rhythms with beneficial effects on sleep patterns. Areas covered: The issue of use of an antidepressant for depression co-morbid with somatic disorders is covered by the authors. A review of the literature from 2000 to August 2018 was undertaken using Scopus and Web of Science with the ke...
Source: Expert Opinion on Pharmacotherapy - February 15, 2019 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Pharmacotherapeutic options for patients with refractory breast cancer.
Authors: Fedele P, Ciccarese M, Surico G, Cinieri S Abstract INTRODUCTION: The development of resistance to therapy is a concern in all three subtypes of breast cancer (BC). Yet, outcomes of patients with BC have improved in the past few years thanks to a molecularly targeted approach and a greater understanding of the many mechanisms through which cancer cells adapt to evade drug therapies. Indeed, there have been a number of different and active treatment strategies for hormone receptor positive (HR+ and Her2 positive BC although triple-negative breast cancer treatment remains problematical because of the early o...
Source: Expert Opinion on Pharmacotherapy - February 9, 2019 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Droxidopa for the treatment of neurogenic orthostatic hypotension in neurodegenerative diseases.
Authors: Pérez-Lloret S, Quarracino C, Otero-Losada M, Rascol O Abstract INTRODUCTION: L-threo-3,4-dihydroxyphenylserine (droxidopa), a pro-drug metabolized to norepinephrine in nerve endings and other tissues, has been commercially available in Japan since 1989 for treating orthostatic hypotension symptoms in Parkinson's disease (PD) patients with a Hoehn & Yahr stage III rating, as well as patients with Multiple System Atrophy (MSA), familial amyloid polyneuropathy, and hemodialysis. Recently, the FDA has approved its use in symptomatic neurogenic orthostatic hypotension (NOH). Areas covered: The autho...
Source: Expert Opinion on Pharmacotherapy - February 9, 2019 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

The efficacy and safety of exenatide once weekly in patients with type 2 diabetes.
Authors: Heimbürger SM, Brønden A, Johansen NJ, Dejgaard TF, Vilsbøll T, Knop FK Abstract INTRODUCTION: Exenatide once weekly (QW) is a glucagon-like peptide 1 receptor agonist (GLP-1RA) that was approved in 2012 in Europe and the U.S.A. for the treatment of type 2 diabetes (T2D). Areas covered: This review provides an overview of the safety and efficacy of exenatide QW for the treatment of T2D and evaluates the benefit-risk ratio compared to other available long-acting GLP-1RAs. In addition, the authors provide an outline of the novel formulations and delivery methods of exenatide. Expert opinio...
Source: Expert Opinion on Pharmacotherapy - February 9, 2019 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Zoledronic acid for the treatment of prostate cancer.
Authors: Finianos A, Aragon-Ching JB Abstract INTRODUCTION: Prostate cancer remains the most common solid tumor afflicting men in the developed world. Metastatic prostate cancer is a source of great morbidity and mortality especially due to osseous involvement that gives rise to significant symptoms of pain or pathologic fractures or cord compression. Bisphosphonates had been widely used in the treatment of metastatic prostate bone metastases given their demonstrated benefit with a delay of skeletal-related events (SREs) but without prostate-specific antigen (PSA) response or overall survival benefit. Areas covered...
Source: Expert Opinion on Pharmacotherapy - February 9, 2019 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

An evaluation of roflumilast and PDE4 inhibitors with a focus on the treatment of asthma.
Authors: Al-Sajee D, Yin X, Gauvreau GM Abstract INTRODUCTION: Asthma is a common chronic airway inflammatory disease characterized by diverse inflammatory events leading to airway hyperresponsiveness and reversible airflow obstruction. Corticosteroids have been the mainstay for asthma treatment due to their broad anti-inflammatory actions; however, other medications such as phosphodiesterase 4 inhibitors also demonstrate anti-inflammatory activity in the airways. Areas covered: This review describes tissue expression of phosphodiesterase 4 in the airways, the different phosphodiesterase 4 isoenzymes identified, an...
Source: Expert Opinion on Pharmacotherapy - February 8, 2019 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Current state of the art and emerging pharmacotherapy for uterine leiomyosarcomas.
Authors: Tantari M, Barra F, Di Domenico S, Ferraioli D, Vellone VG, De Cian F, Ferrero S Abstract INTRODUCTION: Uterine leiomyosarcomas (ULMS) account for 1% of all uterine malignancies and for 30% of all uterine sarcomas. The preoperative diagnosis of ULMS is challenging for the physicians, as the symptoms of these tumors are often vague and nonspecific. Moreover, as ULMS have an aggressive biologic behavior, affected women frequently have very poor prognosis. Areas covered: The aim of this review is to describe the current pharmacotherapy for ULMS, including the ongoing clinical trials. Expert opinion: Surgery i...
Source: Expert Opinion on Pharmacotherapy - February 8, 2019 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Choosing the right pharmacotherapeutic strategy for HIV maintenance in patients with alcohol addiction.
Authors: Kodidela S, Kumar S PMID: 30724618 [PubMed - as supplied by publisher] (Source: Expert Opinion on Pharmacotherapy)
Source: Expert Opinion on Pharmacotherapy - February 8, 2019 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Antimuscarinic drug therapy for overactive bladder syndrome in the elderly - are the concerns justified?
Authors: Khastgir J Abstract INTRODUCTION: The use of antimuscarinic drugs is common in the management of the overactive bladder (OAB). Concerns have been raised over their use in the elderly population in whom the use of these drugs is highly prevalent, consequent to the reported link between these drugs and cognitive impairment and dementia. Areas covered: Recent publications have heightened concerns regarding antimuscarinic drug use in the elderly. In this review, the author discusses the available evidence upon which conclusions have been based and has presented the need for cortical review and need for caution...
Source: Expert Opinion on Pharmacotherapy - February 8, 2019 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Current and emerging pharmacotherapy for emergency management of preeclampsia.
Authors: Cox AG, Marshall SA, Palmer KR, Wallace EM Abstract INTRODUCTION: Preeclampsia is a disease specific to pregnancy characterised by new onset hypertension with maternal organ dysfunction and/or fetal growth restriction. It remains a major cause of maternal and perinatal morbidity and mortality. For fifty years, antihypertensives have been the mainstay of treating preeclampsia, reducing maternal morbidity and mortality. With increased knowledge of the mechanisms underlying the disease has come opportunities for novel therapies that complement antihypertensives by protecting the maternal vasculature. Areas co...
Source: Expert Opinion on Pharmacotherapy - February 4, 2019 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Inhaled therapies and cardiovascular risk in patients with chronic obstructive pulmonary disease.
Authors: Rogliani P, Calzetta L, Matera MG, di Daniele N, Girolami A, Cazzola M, Ora J Abstract INTRODUCTION: Chronic obstructive pulmonary disease (COPD) therapy includes a multi-dimensional approach, taking into account both symptoms of the patient and the number of acute exacerbations of COPD (AECOPDs). There are three main pharmaceutical classes currently available including long-acting muscarinic antagonists (LAMA), long-acting β2-agonists (LABA) and inhaled corticosteroids (ICS). COPD is a major risk factor for most cardiovascular diseases, and cardiac comorbidities are very common in COPD patients. Both...
Source: Expert Opinion on Pharmacotherapy - February 4, 2019 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Current pharmacotherapy options for conduct disorders in adolescents and children.
This article aims to combine a systematic review of the available literature, with a consensus opinion from both child and adolescent psychiatrists and developmental pediatricians on the clinical and pharmacological management of children and adolescents with conduct disorder (CD). Areas covered: The authors review the CD population and provide a systematic review and meta-analysis of the effectiveness and safety of pharmacotherapies using preferred reporting items for systematic review and meta-analysis (PRISMA) and strength of evidence recommendation taxonomy (SORT) guidelines. The authors then provide an expert clinical...
Source: Expert Opinion on Pharmacotherapy - February 2, 2019 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Pharmacotherapeutic strategies for treating binge eating disorder. Evidence from clinical trials and implications for clinical practice.
Authors: Amodeo G, Cuomo A, Bolognesi S, Goracci A, Trusso MA, Piccinni A, Neal SM, Baldini I, Federico E, Taddeucci C, Fagiolini A Abstract INTRODUCTION: Binge eating disorder (BED) is the most common eating disorder and was newly recognized in 2013 in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). BED is frequently associated with obesity and the metabolic syndrome, as well as with other psychiatric diseases, such as mood (49%), anxiety (41%), and substance use (22%) disorders. BED is highly prevalent and carries a high burden of mental and physical illness and disability....
Source: Expert Opinion on Pharmacotherapy - February 1, 2019 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Bictegravir in a fixed-dose tablet with emtricitabine and tenofovir alafenamide for the treatment of HIV infection: pharmacology and clinical implications.
Authors: Pham HT, Mesplède T Abstract INTRODUCTION: Current antiretroviral therapy is more effective and simpler than in previous times due to the development of new drugs with improved pharmacokinetic and pharmacodynamic profiles and the advent of single pill regimens with low toxicity that facilitate long-term adherence. The recent approval of the novel potent integrase strand-transfer inhibitor bictegravir (BIC) co-formulated with emtricitabine (FTC) and tenofovir alafenamide (TAF) in a fixed daily dose pill, B/F/TAF, adds to the list of single-tablet regimens available to treat HIV infection. Areas cover...
Source: Expert Opinion on Pharmacotherapy - February 1, 2019 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Efficacy of nab-paclitaxel in treating metastatic melanoma.
Authors: Specenier P Abstract INTRODUCTION: Systemic treatment of metastatic melanoma has been revolutionized by the advent of checkpoint inhibitors and targeted agents which are widely accepted as standard front-line therapies. However, despite these major advances, a substantial portion of patients still fail checkpoint inhibitors and/or targeted agents and are not candidates for clinical trials. Commonly used cytotoxics in these patients include paclitaxel, dacarbazine, platins, and temozolomide. The overall response rates of these agents are usually disappointing and short-lived. Areas covered: Herein, the auth...
Source: Expert Opinion on Pharmacotherapy - January 30, 2019 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Pharmacotherapy for onychomycosis: new and emerging treatments.
Authors: Lipner SR Abstract INTRODUCTION: Onychomycosis is the most common nail disorder seen in clinical practice. It is not merely an aesthetic disorder and may cause significant disability and affect the quality of life. There are no strict guidelines for onychomycosis therapy. Therefore, medical management is individualized based on drug efficacy, taken together with clinical presentation, infecting organism, co-morbidities, concomitant medications, and patient preferences. Areas covered: This review provides a clinically oriented critical perspective on the pathophysiology of onychomycosis, infecting organisms...
Source: Expert Opinion on Pharmacotherapy - January 30, 2019 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Choosing appropriate pharmacotherapy for drug-resistant HIV.
Authors: Capetti A, Rizzardini G Abstract INTRODUCTION: Despite the potency of current antiretrovirals, some patients continue to struggle with the management of the treatment of HIV due to drug resistance-associated mutations. The underlying causes of these developments are usually drug adherence and drug availability as well as the economic affordability of those potent drugs in low to middle-income countries as well as in some industrialised countries. Viral replication, despite therapy, varies by region from 5 to 28. Non-adherence includes a variety of behaviours with different clinical implications. Addressing...
Source: Expert Opinion on Pharmacotherapy - January 26, 2019 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Current antimicrobial management of community-acquired pneumonia in HIV-infected children.
Authors: Nuttall JJC Abstract INTRODUCTION: Community-acquired pneumonia is a leading cause of morbidity and mortality amongst HIV-infected infants and children. Polymicrobial infection is common and, due to the difficulties in confirming the etiology of pneumonia, empiric broad-spectrum antimicrobial therapy is frequently used. Areas covered: The author based this article on literature identified from PubMed. The author's search terms included: pneumonia, community-acquired pneumonia, HIV, children. The articles reviewed included original studies, recent review articles and current guidelines on the management of ...
Source: Expert Opinion on Pharmacotherapy - January 23, 2019 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Challenges of selecting pharmacotherapy for macular edema the need for better and combination therapies.
Authors: Tolentino MJ, Tolentino AJ PMID: 30657723 [PubMed - as supplied by publisher] (Source: Expert Opinion on Pharmacotherapy)
Source: Expert Opinion on Pharmacotherapy - January 19, 2019 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Capecitabine for the treatment of pancreatic cancer.
Authors: Siddiqui NS, Godara A, Byrne MM, Saif MW Abstract INTRODUCTION: Capecitabine is an oral prodrug of 5-fluorouracil (5-FU) which is converted to 5FU by a series of reactions catalyzed by different enzymes, the last of the enzymes being thymidine phosphorylase (TP). TP is found to be elevated in tumor cells in comparison to normal cells, which consequently tumor-localizes the production of 5-FU, thereby limiting its systemic toxicity. Today, capecitabine is extensively used for the treatment of many solid malignancies, with a particular focus in breast and gastrointestinal tumors, but also in pancreatic cance...
Source: Expert Opinion on Pharmacotherapy - January 18, 2019 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

The role of oxycodone/naloxone in the management of patients with pain and opioid-induced constipation.
Authors: Leppert W, Zajaczkowska R, Wordliczek J Abstract INTRODUCTION: Common opioid adverse effects (AE) of the gastrointestinal tract include opioid-induced constipation (OIC) and opioid-induced bowel dysfunction (OIBD) with traditional laxatives being of limited efficacy, having AEs and not addressing the pathophysiology of OIC or OIBD. Targeted treatment comprises of PAMORA (peripherally acting mu-opioid receptor antagonists) and a combination of an opioid receptor agonist with its antagonist, namely prolonged-release oxycodone with prolonged-release naloxone (OXN) tablets at a fixed ratio of 2:1. Oxycodone pr...
Source: Expert Opinion on Pharmacotherapy - January 10, 2019 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Treating obesity in patients with cardiovascular disease: the pharmacotherapeutic options.
Authors: Andrew CA, Saunders KH, Shukla AP, Aronne LJ Abstract INTRODUCTION: Obesity is a growing health problem that has numerous comorbidities, including cardiovascular disease (CVD). The multi-disciplinary treatment of obesity now includes the use of pharmacotherapy. When treating patients with obesity and CVD, certain medications may be more appropriate than others. Areas covered: Herein, the authors review the most commonly used FDA approved medications for the treatment of obesity, describing their mechanism of action, and the efficacy and safety of the medications as seen in recent studies, particularly in p...
Source: Expert Opinion on Pharmacotherapy - January 9, 2019 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Chemical pharmacotherapy for hospital-acquired pneumonia in the elderly.
This article focuses specifically on HAP, excluding patients afflicted by ventilator-associated pneumonia (VAP). The pathogenesis and clinical features of HAP in the elderly are discussed as well as specific drug pharmacokinetic and pharmacodynamic considerations in elderly patients. The current recommended guidelines for the management of HAP are also discussed. Finally, the authors provide evidence on the empirical therapy used for the treatment of HAP and widely consider specific-pathogen treatment of HAP in elderly patients. Expert opinion: In patients not at risk of MDR organism infection, antibiotics including pipera...
Source: Expert Opinion on Pharmacotherapy - January 9, 2019 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

The benefit of betrixaban for the extended thromboprophylaxis in acutely ill medical patients.
Authors: Scarpa D, Denas G, Babuin L, Pengo V Abstract INTRODUCTION: Patients admitted with acute medical conditions are at prolonged risk for venous thrombosis. The efficacy and safety, and the appropriate duration of thromboprophylaxis have not been clearly determined. In recent years, direct coagulation factor inhibitors have been successfully tested for the prevention and treatment of arterial and venous thromboembolism. Betrixaban is a novel direct inhibitor of factor Xa with a noteworthy pharmacological feature: limited renal clearance. Areas covered: This review focuses on the pharmacological profile of Betr...
Source: Expert Opinion on Pharmacotherapy - January 9, 2019 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Lenalidomide for the treatment of mantle cell lymphoma.
Authors: Morabito F, Skafi M, Recchia AG, Kashkeesh A, Hindiyeh M, Sabatleen A, Morabito L, Alijanazreh H, Hamamreh Y, Gentile M Abstract INTRODUCTION: Although a variety of therapeutic schemes for Mantle Cell Lymphoma (MCL) have been attempted, the clinical outcome of patients continues to be unsatisfactory especially among patients with a very high-risk profile and in the relapsed/refractory setting. For this reason, recent clinical trials have explored novel approaches, either by the use of biological agents in chemotherapy-free schedules or by integrating them with chemoimmunotherapy regimens. Areas covered: Th...
Source: Expert Opinion on Pharmacotherapy - January 6, 2019 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Pharmacotherapeutic options for co-morbid depression and alcohol dependence.
Authors: Hillemacher T, Frieling H Abstract INTRODUCTION: Depression and alcohol dependence are frequently co-morbid and among the most prevalent mental disorders. They are a serious global health problem with social, interpersonal, and legal interpolations. Among pharmacological alternatives, anti-craving compounds as well as antidepressants, antipsychotics, anticonvulsants, benzodiazepines, and beta-blockers have shown efficacy for depression as well as alcohol consumption. The pharmacological treatment of both complex interwoven mental diseases is still challenging given the inconsistent results of open and doub...
Source: Expert Opinion on Pharmacotherapy - January 5, 2019 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

An update on the topical and oral therapy options for treating pediatric atopic dermatitis.
Authors: Glines KR, Stiff KM, Freeze M, Cline A, Strowd LC, Feldman SR Abstract INTRODUCTION: Atopic dermatitis (AD) is one of the most common childhood skin disorders. Multiple mechanisms contribute to the pathology of AD and treatment approaches are directed at these processes. Areas covered: The purpose of this review is to discuss the chemical treatment options for pediatric atopic dermatitis, including immunomodulators and small molecule inhibitors. A systematic literature search was conducted, and publications were reviewed for applicable treatment guidelines. Expert opinion: Topical therapy is first-line for...
Source: Expert Opinion on Pharmacotherapy - January 3, 2019 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Current synthetic pharmacotherapy for treatment resistant colorectal cancer: when urgent action is required.
Authors: Eng C, Rogers JE Abstract INTRODUCTION: Colorectal cancer (CRC) remains a global concern. Fourteen antineoplastics are approved for metastatic CRC (mCRC); however, the 5-year overall survival remains poor for the overwhelming majority of patients. Poor outcomes continue to highlight the critical need for therapeutic advancement. Areas covered: mCRC represents a clinical and molecular complex malignancy with several treatment barriers. Prognostic and predictive factors have and continue to emerge anatomically, molecularly, and via patient-related factors. Herein, the authors review the current understanding...
Source: Expert Opinion on Pharmacotherapy - December 30, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Pharmacotherapeutic strategies for treating pancreatic cancer: advances and challenges.
Authors: Diab M, Azmi A, Mohammad R, Philip PA Abstract INTRODUCTION: Despite many efforts to improve the outcome of pancreatic ductal adenocarcinoma (PDAC), its prognosis remains poor, which is mostly related to late diagnosis and drug resistance. Improving systemic therapy is considered the major challenge in improving the outcome of this disease. Areas covered: This review covers novel chemotherapy and targeted agents in the treatment of PDAC, with a focus on advanced stage disease. Expert opinion: Current frontline therapies used in the treatment of patients with PDAC with favorable performance status are gemci...
Source: Expert Opinion on Pharmacotherapy - December 30, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Important decisions in choosing the pharmacotherapy for narcoleptics.
Authors: de Biase S, Gigli GL, Valente M PMID: 30592648 [PubMed - as supplied by publisher] (Source: Expert Opinion on Pharmacotherapy)
Source: Expert Opinion on Pharmacotherapy - December 30, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Pharmacotherapeutic strategies for standard treatment-resistant psoriasis.
Authors: Heath MS, Kolli SS, Dowling JR, Cline A, Feldman SR Abstract INTRODUCTION: Psoriasis management includes a variety of treatments including localized therapies and systemic treatments; however, many patients report inadequate clinical response and resistance to therapy. Currently there is no treatment algorithm that incorporates effective strategies to tackle the various barriers leading to resistance. Areas covered: The authors evaluate the scope of resistance, the reasons it occurs, and provide the reader with strategies for overcoming resistance in both localized and systemic therapies for psoriasis. Exp...
Source: Expert Opinion on Pharmacotherapy - December 29, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Is there an appropriate strategy for treating co-morbid irritable bowel syndrome and bladder pain syndrome?
Authors: Dellis AE, Mozaffari S, Nikfar S, Papatsoris AG, Abdollahi M Abstract INTRODUCTION: Two of the most frequent components of chronic pelvic pain syndrome (CPPS) are irritable bowel syndrome (IBS) and bladder pain syndrome (BPS), characterized by considerable overlapping symptoms and pathophysiology. Currently, its management is challenging meaning there is high the demand for novel efficient therapeutics to aid patient care and to tackle the socioeconomic burden of IBS and BPS. As there are presently no sufficient treatment strategies, identifying the mechanisms that result in their main symptoms is the oppo...
Source: Expert Opinion on Pharmacotherapy - December 29, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

An evaluation of elvitegravir plus cobicistat plus tenofovir alafenamide plus emtricitabine as a single-tablet regimen for the treatment of HIV in children and adolescents.
This article evaluates E/C/FTC/TAF as a treatment option. Expert opinion: E/C/FTC/TAF was well tolerated, and the antiretroviral activity and tolerability data of this combination support the use in children and adolescents. However, the studies regarding E/C/FTC/TAF in children and adolescents are scant. Consequently, additional studies investigating its safety and efficacy in children are paramount. PMID: 30586314 [PubMed - as supplied by publisher] (Source: Expert Opinion on Pharmacotherapy)
Source: Expert Opinion on Pharmacotherapy - December 27, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Is pharmacotherapy enough for urgent weight loss in severely obese patients?
Authors: Gargallo-Vaamonde J, Perdomo CM, de la Higuera M, Frühbeck G, Salvador J PMID: 30576254 [PubMed - as supplied by publisher] (Source: Expert Opinion on Pharmacotherapy)
Source: Expert Opinion on Pharmacotherapy - December 24, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Efficacy and safety of alisporivir for the treatment of hepatitis C infection.
This article reviews the therapeutic efficacy and safety of ALV for the treatment of HCV infection. Expert opinion: Direct-acting antivirals (DAAs) have revolutionized the HCV antiviral treatment paradigm with success rates well above 95% for all HCV genotypes. However, challenges still remain in certain patient populations such as those who have developed resistance and have experienced multi-DAA failure. To cure HCV infection, a treatment regimen must combine antiviral potency and a high barrier to resistance. ALV fulfills this need as shown by the studies evaluating its clinical efficacy. Nevertheless, ALV missed the ch...
Source: Expert Opinion on Pharmacotherapy - December 24, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

The use of polymyxins to treat carbapenem resistant infections in neonates and children.
Authors: Thomas R, Velaphi S, Ellis S, Walker AS, Standing JF, Heath P, Sharland M, Dona' D Abstract INTRODUCTION: The incidence of healthcare-associated multidrug resistant bacterial infections, particularly due to carbapenem resistant organisms, has been on the rise globally. Among these are the carbapenem resistant Acinetobacter baumannii and Enterobacteriaceae, which have been responsible for numerous outbreaks in neonatal units. The polymyxins (colistin and polymyxin B) are considered to be the last resort antibiotics for treating such infections. However, pharmacokinetic and pharmacodynamic data on the use of...
Source: Expert Opinion on Pharmacotherapy - December 24, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Correction.
Authors: PMID: 30561243 [PubMed - as supplied by publisher] (Source: Expert Opinion on Pharmacotherapy)
Source: Expert Opinion on Pharmacotherapy - December 20, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Pharmacotherapy for metastatic esophageal cancer: where do we need to improve?
Authors: Lee S, Cohen DJ Abstract INTRODUCTION: Esophageal cancer is a heterogeneous cancer comprised of differing cells of origin, molecular changes, and immune microenvironments. To date, most advances have been made in chemotherapy regimens where a one-size-fits-all approach is used. As a result, there remains a lack of tailored treatment options for such a heterogeneous cancer. This paper highlights the current standard of care treatment options as well as active areas of clinical research. Areas covered: The authors review the key trials that have led to current standard of care treatment including pivotal che...
Source: Expert Opinion on Pharmacotherapy - December 13, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Therapeutic strategies for treating epilepsy during pregnancy.
Authors: Whelehan A, Delanty N Abstract INTRODUCTION: Counseling for women with epilepsy of childbearing potential surrounding pregnancy issues is of the utmost importance and should be done when antiepileptic medications are prescribed and reviewed regularly at clinic visits. Physicians must be familiar with risks associated with antiepileptic medication, and endeavor to minimize risks to a fetus while selecting best medications for epilepsy type. Areas covered: The authors discuss the role of folic acid, updated evidence relating to the occurrence of major congenital malformations and neurocognitive risks associa...
Source: Expert Opinion on Pharmacotherapy - December 13, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Correction.
Authors: PMID: 30526153 [PubMed - as supplied by publisher] (Source: Expert Opinion on Pharmacotherapy)
Source: Expert Opinion on Pharmacotherapy - December 13, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Pharmacotherapy for acute migraines in children and adolescents.
Authors: Barbanti P, Grazzi L, Egeo G Abstract INTRODUCTION: Migraine is increasingly recognized as an extremely burdensome and disabling disorder in both children and adolescents. A proper treatment plan is needed to improve the quality of life of both children and families as well as to minimize the risk of disease progression. Areas covered: This review focuses on the current pharmacotherapy for acute migraine in pediatric populations, taking into account specific considerations for those drugs tested in randomized, placebo-controlled trials (RCTs). Expert opinion: A large number of RCTs have documented the effi...
Source: Expert Opinion on Pharmacotherapy - December 13, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Mipomersen and its use in familial hypercholesterolemia.
Authors: Parham JS, Goldberg AC Abstract INTRODUCTION: Familial Hypercholesterolemia (FH) is an inherited disorder characterized by a defect in the binding and internalization of low-density lipoprotein (LDL) particles, resulting in markedly elevated LDL levels and premature atherosclerosis. It is one of the most common inherited disorders of lipid metabolism. Many FH patients, especially those with homozygous FH do not reach LDL goals with traditional LDL therapies and may require additional, less often used, therapies. Areas covered: Mipomersen is an anti-sense oligonucleotide that prevents production of apolipop...
Source: Expert Opinion on Pharmacotherapy - December 13, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Siponimod for the treatment of secondary progressive multiple sclerosis.
Authors: Dumitrescu L, Constantinescu CS, Tanasescu R Abstract INTRODUCTION: Multiple sclerosis (MS) is a chronic central nervous system immune-mediated disease with an important inflammatory component associated with focal demyelination and widespread neurodegeneration. In most cases, the clinical presentation is relapsing-remitting, followed by a secondary progressive phase, characterized by disability accrual unrelated to relapses. In a minority, the phenotype is progressive from the beginning. Major therapeutic achievements have been made concerning the relapsing phase but modifying the evolution of progressive...
Source: Expert Opinion on Pharmacotherapy - December 7, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Novel pharmacotherapy for burn wounds: what are the advancements.
Authors: Hamblin MR Abstract INTRODUCTION: The prognosis for severe burns has improved significantly over the past 50 years. Meanwhile, burns have become an affliction mainly affecting the less well-developed regions of the world. Early excision and skin grafting has led to major improvements in therapeutic outcomes. Areas covered: The purpose of this article is to survey the use of pharmacotherapy to treat different pathophysiological complications of burn injury. The author, herein, discusses the use of drug treatments for a number of systemic metabolic disturbances including hyperglycemia, elevated cataboli...
Source: Expert Opinion on Pharmacotherapy - December 7, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Clinical management of community-acquired pneumonia in young children.
Authors: Nascimento-Carvalho AC, Nascimento-Carvalho CM Abstract INTRODUCTION: Community-acquired pneumonia (CAP) is the leading cause of mortality among children under 5 years worldwide. However, the choices of chemical therapy for the empirical treatment of CAP are frequently debated. Areas covered: The authors provide an update on the chemical management recommendations for childhood CAP. The authors have performed a MEDLINE literature search, using the keywords 'guidelines,' 'community-acquired pneumonia,' AND 'children.' Articles published in English, providing consensual recommendations on management of ...
Source: Expert Opinion on Pharmacotherapy - December 7, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Choosing an ideal pharmacotherapeutic strategy for dyslipidemia in children.
Authors: Nikolic D, Corina A, Toth PP, Hammad L, Rizzo M PMID: 30521406 [PubMed - as supplied by publisher] (Source: Expert Opinion on Pharmacotherapy)
Source: Expert Opinion on Pharmacotherapy - December 7, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Insight into the perioperative management of direct oral anticoagulants: concerns and considerations.
Authors: Ibrahim A, Walsh LG, Algaali M, Satti Z, Kiernan TJ, Yan BP Abstract INTRODUCTION: Direct oral anticoagulants (DOACs) have gained momentum in recent years in patients requiring anticoagulation for the prevention and management of venous thromboembolism and thromboembolic events caused by atrial fibrillation. The use of these agents involves potential bleeding complications, particularly during invasive procedures. With increasing use of DOACs, adequate knowledge regarding the perioperative management of patients on DOACs has become indispensable. Areas covered: This review covers the indications, mechanism...
Source: Expert Opinion on Pharmacotherapy - December 7, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Pharmacotherapeutic strategies for the treatment of attention-deficit hyperactivity (ADHD) disorder with comorbid substance-use disorder (SUD).
Authors: Perugi G, Pallucchini A, Rizzato S, De Rossi P, Sani G, Maremmani A, Pinzone V, Maremmani I Abstract INTRODUCTION: Substance use disorder (SUD) is very common amongst patients with attention deficit hyperactivity disorder (ADHD). The two disorders share partially overlapping features and SUD in ADHD is characterized by an early age of onset, high likelihood of poly-substance use, increased risk of suicide attempts, more hospitalizations, and scarce treatment adherence. Areas covered: This paper reviews randomized active comparator-controlled or placebo-controlled trials evaluating the use of pharmacotherap...
Source: Expert Opinion on Pharmacotherapy - December 6, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Bivalirudin during percutaneous coronary intervention in acute coronary syndromes.
Authors: Laine M, Gilles L, Dabry T, Panagides V, Michael P, Paganelli F, Bonello L Abstract INTRODUCTION: Anticoagulant therapy is critical to prevent ischemic recurrences and complications in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI). Unfractionated heparin (UFH), an injectable anticoagulant has several limitations: lack of predictability of its biological efficacy, platelets activation, heparin-induced thrombopenia and bleedings. Bivalirudin, a synthetic direct thrombin inhibitor has biological properties that promised better clinical outcome in ACS patients under...
Source: Expert Opinion on Pharmacotherapy - December 6, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Advances with extended and controlled release formulations of antiepileptics in the elderly.
Authors: Banach M, Miziak B, Borowicz-Reutt KK, Czuczwar SJ Abstract INTRODUCTION: As a matter of course, elderly people are more sensitive to both the pharmacological and toxicological effects of pharmacotherapy. A senior's treatment, therefore, requires more attention compared to younger adults. Extended release (ER) formulations of anti-epileptic drugs (AEDs) have been developed to improve safety, efficacy and long-term adherence. In senior patients, ER AEDs are used to treat epilepsy, psychiatric conditions, and neuropathic pain. However, very limited clinical evidence is available on the use of these ER AEDs i...
Source: Expert Opinion on Pharmacotherapy - December 2, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research