Pharmacotherapeutic management of asthma in pregnancy and the effect of sex hormones.
This article reviews recent developments of asthma pharmacotherapy and provides emerging data on the safety of asthma controller medications and biological therapies in pregnancy. The authors highlight the clinical outcomes of asthma during pregnancy, and summarize emerging new data related to the influence of sex hormones and fetal sex on asthma severity. AREAS COVERED: This review of asthma pharmacotherapy during pregnancy examines the recent guidelines and reports the most pertinent publications on safety data and asthma management. EXPERT OPINION: Asthma management during pregnancy follows the same principles a...
Source: Expert Opinion on Pharmacotherapy - September 30, 2020 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Use of octreotide long acting repeatable (LAR) as second-line therapy in advanced neuroendocrine tumors in different clinical settings: an Italian Delphi survey.
CONCLUSIONS: The present statements aim to fill current gaps in treatment guidelines by providing recommendations based on expert consensus in clinical settings in which patients progress following first-line therapy with octreotide LAR. PMID: 32990061 [PubMed - as supplied by publisher] (Source: Expert Opinion on Pharmacotherapy)
Source: Expert Opinion on Pharmacotherapy - September 30, 2020 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Efficacy and safety of saxagliptin for the treatment of type 2 diabetes mellitus.
Authors: Orime K, Terauchi Y Abstract INTRODUCTION: Saxagliptin, a member of the dipeptidyl peptidase-4 inhibitor (DPP-4i) class of drugs, was approved by the FDA for the treatment of type 2 diabetes (T2D) in 2009, and has been in clinical use for more than a decade. Since the drug was first launched, much real-world evidence has also been accumulated. The efficacy and safety of saxagliptin, especially its cardiovascular safety, are of particular interest. AREAS COVERED: This review provides an overview of the safety and efficacy of saxagliptin based on observational studies, pharmacovigilance, and meta-analyse...
Source: Expert Opinion on Pharmacotherapy - September 30, 2020 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Pharmacological treatment of focal epilepsy in adults: an evidence based approach.
PHARMACOLOGICAL TREATMENT OF FOCAL EPILEPSY IN ADULTS: AN EVIDENCE BASED APPROACH. Expert Opin Pharmacother. 2020 Sep 29;: Authors: Mula M Abstract INTRODUCTION: Focal seizures represent the most common seizure type and focal epilepsies the most common epilepsy type. Anti-seizure medications (ASMs) still represent the main form of treatment for epilepsy. AREAS COVERED: The aim of this review article is to provide an overview of available evidence about current and upcoming pharmacological options and strategies for adults with focal epilepsy focusing on the last 5 years. EXPERT OPINION: Sevente...
Source: Expert Opinion on Pharmacotherapy - September 30, 2020 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Current and Emerging Pharmacotherapy for Chronic Spontaneous Urticaria: A Focus on Non-biological Therapeutics.
Authors: Hon KL, Li JTS, Leung AKC, Lee V Abstract INTRODUCTION: Chronic spontaneous urticaria (CSU) refers to urticaria (wheals) or angioedema, which occur for a period of six weeks or longer without an apparent cause. The condition may impair the patient's quality of life. AREAS COVERED: Treatment for CSU is mainly symptomatic. Both AAAAI/ACAAI practice parameters and EAACI/GA2LEN/EDF/WAO guidelines suggest CSU management in a stepwise manner. First-line therapy is with second-generation H1-antihistamines. Treatment should be stepped up along the algorithm if symptoms are not adequately controlled. Increasing...
Source: Expert Opinion on Pharmacotherapy - September 30, 2020 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

State of the art: approved and emerging JAK inhibitors for rheumatoid arthritis.
Authors: El Jammal T, Sève P, Gerfaud-Valentin M, Jamilloux Y Abstract INTRODUCTION: Rheumatoid arthritis (RA) is the most common autoimmune inflammatory arthritis in adults. In the past decade, many treatments have emerged to expand the therapeutic armamentarium of rheumatologists. Among emerging treatments, Janus Kinase inhibitors (JAKi) are promising in treating RA and several other inflammatory conditions, such as psoriatic arthritis (PsA). The JAK/STAT signaling pathway is located downstream certain cytokines receptors that are known to be involved in RA pathogenesis. So far, three JAKi are approved for...
Source: Expert Opinion on Pharmacotherapy - September 26, 2020 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Evaluation of cardiovascular and renal outcomes with ertugliflozin: what is the VERdict from the VERTIS-CV trial?
This article addresses the Evaluation of Ertugliflozin Efficacy and Safety Cardiovascular Outcomes (VERTIS-CV) trial, its background, design, results, and implications. In patients at least 40 years of age with atherosclerotic cardiovascular disease (ASCVD), the VERTIS-CV trial demonstrated ertugliflozin was non-inferior to placebo for major adverse cardiovascular events, though not superior. Ertugliflozin significantly reduced hospitalization for heart failure compared to placebo. The composite renal outcome was not significantly different between groups. Ertugliflozin was generally well tolerated with a safety profi...
Source: Expert Opinion on Pharmacotherapy - September 24, 2020 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

What are the key considerations when prescribing pharmacotherapy for sickle cell anemia?
Authors: Meier ER PMID: 32955945 [PubMed - as supplied by publisher] (Source: Expert Opinion on Pharmacotherapy)
Source: Expert Opinion on Pharmacotherapy - September 23, 2020 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Pharmacotherapeutic options for kidney disease in HIV positive patients.
Authors: Tariq A, Kim H, Abbas H, Lucas GM, Atta MG Abstract INTRODUCTION: Since the developmentof combined antiretroviral therapy (cART), HIV-associated mortality and the incidence of HIV-associated end-stage kidney disease (ESKD) has decreased. However, in the United States, an increase in non-HIV-associated kidney diseases within the HIV-positive population is expected. AREAS COVERED: In this review, the authors highlight the risk factors for kidney disease within an HIV-positive population and provide the current recommendations for risk stratification and for the monitoring of its progression to chronic ki...
Source: Expert Opinion on Pharmacotherapy - September 23, 2020 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Evaluating pitolisant as a narcolepsy treatment option.
Authors: de Biase S, Pellitteri G, Gigli GL, Valente M Abstract INTRODUCTION: Narcolepsy is a chronic sleep disorder characterized by a pentad of excessive daytime sleepiness (EDS), cataplexy, sleep paralysis, hypnagogic/hypnopompic hallucinations, and disturbed nocturnal sleep. Treatment of narcolepsy remains challenging and current therapy is strictly symptomatically based. AREAS COVERED: The present manuscript is based on an extensive Internet and PubMed search from 1990 to 2020. It is focused on the clinical and pharmacological properties of pitolisant in the treatment of narcolepsy. EXPERT OPINION: Cur...
Source: Expert Opinion on Pharmacotherapy - September 19, 2020 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Aspirin for primary prevention of cardiovascular disease: a review of recent literature and updated guideline recommendations.
Authors: Mogul A, E Leppien E, Laughlin E, A Spinler S Abstract INTRODUCTION: Recent clinical trials evaluating the efficacy of aspirin in primary prevention of atherosclerotic cardiovascular disease (ASCVD) have suggested the risk of aspirin may outweigh its benefit in individuals once thought to be candidates for aspirin therapy. These results led to the publication of updated guideline recommendations in 2019 for aspirin use in primary prevention of cardiovascular disease from the American College of Cardiology (ACC) and American Heart Association (AHA). AREAS COVERED: Recent clinical trials and guidelines r...
Source: Expert Opinion on Pharmacotherapy - September 16, 2020 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

An overview of sarecycline for the treatment of moderate-to-severe acne vulgaris.
Authors: Valente Duarte de Sousa IC Abstract INTRODUCTION: Sarecycline is a novel, tetracycline-class antibiotic specifically designed to treat inflammatory acne. It offers a narrow spectrum of activity (mainly against Cutinebacterium acnes), and it shows less in vitro activity than other tetracyclines against enteric Gram-negative bacteria, offering advantages over older tetracyclines by decreasing the disruption of the gastrointestinal microbiome and the likelihood of developing bacterial resistance. AREAS COVERED: The drug's pharmacology, safety profile, and clinical efficacy are discussed. Results of phase ...
Source: Expert Opinion on Pharmacotherapy - September 16, 2020 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Therapeutic options for difficult-to-treat Acinetobacter baumannii infections: a 2020 perspective.
Authors: Bassetti M, Labate L, Russo C, Vena A, Giacobbe DR Abstract INTRODUCTION: Treatment of severe infections due to Acinetobacter baumannii with difficult-to-treat resistance (DTR-AB), which exhibits resistance to all β-lactams, β-lactam/β-lactamases inhibitor combinations, and fluoroquinolones, remains a challenge for clinicians. AREAS COVERED: The present perspective provides a personal view on both current and future agents for the treatment of severe DTR-AB infections. EXPERT OPINION: We currently are in a transition era for the treatment of DTR-AB infections, where in the past 20&nb...
Source: Expert Opinion on Pharmacotherapy - September 13, 2020 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Pharmacological treatment of lower urinary tract symptoms in benign prostatic hyperplasia: consequences on sexual function and possible endocrine effects.
Authors: La Vignera S, Aversa A, Cannarella R, Condorelli RA, Duca Y, Russo GI, Calogero AE Abstract INTRODUCTION: Benign prostate hyperplasia (BPH) is one of the most prevalent diseases in aging men. It may adversely affect quality-of-life due to the presence of low urinary tract symptoms (LUTS) and its effects on sexuality. AREAS COVERED: The impact of α1-blockers, 5α-reductase inhibitors (5-ARI), and phosphodiesterase 5 inhibitors (PDE-5i) on erectile and ejaculatory functions in men with BPH are covered. Endocrinological aspects have also been addressed, including the management of hypogonadism,...
Source: Expert Opinion on Pharmacotherapy - September 10, 2020 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

An evaluation of sodium zirconium cyclosilicate as a treatment option for hyperkalemia.
Authors: Takkar C, Nassar T, Qunibi W Abstract INTRODUCTION: Hyperkalemia, defined as serum potassium level> 5.0 mEq/l, is associated with serious cardiac dysrhythmias, sudden death and increased mortality risk. It is common in patients with chronic kidney disease (CKD), diabetes (DM) and heart failure (HF), particularly in those treated with the renin-angiotensin-aldosterone system (RAAS) inhibitors or potassium-sparing diuretics. Although these drugs have documented renal and cardiac protective benefits, frequent hyperkalemia associated with their use often dictates administration of suboptimal doses or their ...
Source: Expert Opinion on Pharmacotherapy - September 9, 2020 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Indirect treatment comparison of the efficacy of patisiran and inotersen for hereditary transthyretin-mediated amyloidosis with polyneuropathy.
CONCLUSIONS: Patisiran demonstrated greater treatment effects on neuropathy and QOL than inotersen in patients with hATTR amyloidosis with polyneuropathy. PMID: 32892660 [PubMed - as supplied by publisher] (Source: Expert Opinion on Pharmacotherapy)
Source: Expert Opinion on Pharmacotherapy - September 9, 2020 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Pharmacotherapeutic options for prediabetes.
Authors: Rendell M Abstract INTRODUCTION: 'Prediabetes' is a condition of elevated glucose not attaining the established criteria for a diagnosis of diabetes. The United States Diabetes Prevention Program (DPP) began in 1996 and was the iconic study of prediabetes. In that study, after 3 years, the risk of reaching the numerical criteria of diabetes was reduced by 58% by intensive emphasis on diet and exercise whereas treatment with metformin achieved a lesser reduction of 31%. The DPP was widely heralded as suggesting that lifestyle change was superior to pharmacologic therapy in the prediabetes population. T...
Source: Expert Opinion on Pharmacotherapy - September 9, 2020 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

The pharmacotherapeutic management of gastroesophageal reflux disease (GERD).
Authors: Chapelle N, Ben Ghezala I, Barkun A, Bardou M Abstract INTRODUCTION: Gastroesophageal reflux disease (GERD) is a very common worldwide condition, affecting about 15-20% of the whole population, and representing a major burden for health-care systems. Because of its frequency, health physicians - family doctors as well as specialists - should be aware of the different pharmacotherapeutic approaches in managing GERD, according to disease severity. AREAS COVERED: Authors summarize the pharmacological management of GERD in adults, present the different pharmaceutical classes, and review the evidence on eff...
Source: Expert Opinion on Pharmacotherapy - September 9, 2020 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

The pharmacological management of chronic lower back pain.
Authors: Migliorini F, Maffulli N, Eschweiler J, Betsch M, Catalano G, Driessen A, Tingart M, Baroncini A Abstract INTRODUCTION: Treating chronic low back pain (LBP) can be challenging, and the most effective pharmacological therapy is controversial. The present systematic review investigated the efficacy of various pharmacological compounds to achieve pain relief and improve disability in chronic LBP patients. The present study focused on acetaminophen, amoxicillin, flupirtine, baclofen, tryciclic antidepressants (TCAs), duloxetine, topiramate, gabapentinoids, non-steroid anti-inflammatory drugs (NSAIDs) and opioi...
Source: Expert Opinion on Pharmacotherapy - September 6, 2020 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

An evaluation of selexipag for the treatment of pulmonary hypertension.
Authors: Panagiotidou E, Boutou A, Pitsiou G Abstract INTRODUCTION: Selexipag is a first-in-class, oral, long-acting, selective, non-prostanoid agonist of the prostacyclin receptor (IP receptor), indicated for the treatment of symptomatic adult pulmonary arterial hypertension (PAH). It was designed with the objective to surpass the inconveniences associated with standard prostanoid therapy, presenting fewer adverse effects and comparable hemodynamic benefits. AREAS COVERED: This review describes the pharmacologic properties of selexipag and presents the clinical trials that have been completed or are currently ...
Source: Expert Opinion on Pharmacotherapy - September 3, 2020 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Early-start vs delayed-start donepezil against cognitive decline in Parkinson disease: a randomized clinical trial.
Authors: Sawada H, Oeda T, Kohsaka M, Tomita S, Umemura A, Park K, Yamamoto K, Kiyohara K Abstract BACKGROUND: Cholinergic neurotransmission regulates neuroinflammation in Parkinson disease (PD). RESEARCH DESIGN AND METHODS: The authors conducted a delayed-start study of donepezil for cognitive decline in non-demented PD patients. The study consisted of a 96-week randomized placebo-controlled double-blind phase 1, followed by a 24-week donepezil extension phase 2. The primary outcome measure was a change in the Mini-Mental State Examination (MMSE) at week 120. RESULTS: A total of 98 patients were randomly a...
Source: Expert Opinion on Pharmacotherapy - September 3, 2020 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

An evaluation of UGN-101, a sustained-release hydrogel polymer-based formulation containing mitomycin-C, for the treatment of upper urothelial carcinomas.
Authors: Porta C, Giannatempo P, Rizzo M, Lucarelli G, Ditonno P, Battaglia M Abstract INTRODUCTION: The treatment of low-grade upper tract urothelial carcinomas (UTUCs) after either surgery, or nephron-sparing techniques remains an unmet need in Genitourinary (GU) Oncology. UGN-101 is a novel drug in development for the treatment of UTUCs; it is composed of a sustained-release hydrogel polymer-based formulation containing the antitumor antibiotic mitomycin-C (MM-C); cold UGN-101 is liquid, but at body temperature, it becomes a gel, and thus, when administered through a ureteral catheter, it sticks to the upper tra...
Source: Expert Opinion on Pharmacotherapy - September 3, 2020 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Considerations in prescribing pharmacotherapy for localized and metastatic urothelial carcinoma.
Authors: Ravi P, Sonpavde GP PMID: 32866395 [PubMed - as supplied by publisher] (Source: Expert Opinion on Pharmacotherapy)
Source: Expert Opinion on Pharmacotherapy - September 2, 2020 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

State-of-the-art pharmacotherapy for diabetic neuropathy.
Authors: Azmi S, Alam U, Burgess J, Malik RA Abstract INTRODUCTION: The global epidemic of diabetes has led to an epidemic of diabetes complications. Diabetic neuropathy is the most common microvascular complication, of which diabetic peripheral neuropathy (DPN) and autonomic neuropathy (AN) are the most prevalent, affecting ~50% of patients. DPN results in pain with a poor quality of life and a loss of sensation with an increased risk of foot ulceration. Autonomic neuropathy can cause significant morbidity in a minority and is associated with increased mortality. The cornerstone of treatment to prevent or limit th...
Source: Expert Opinion on Pharmacotherapy - September 2, 2020 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Challenges associated with systemic therapy for older patients with inoperable non-small cell lung cancer.
Authors: O'Leary C, McSorley L, Hennessy B, Grogan L, Breathnach O, Morris P Abstract INTRODUCTION: Lung cancer is the most common cancer diagnosed worldwide. Data from several studies fall short to make appropriate conclusions on the management for elderly patients. The discovery of targeted therapy and immunotherapy has allowed these patients access to a wider array of options. AREAS COVERED: The authors review research for treating older patients with lung cancer focusing on research performed in this patient population. Data are presented relating to chemotherapy, immunotherapy, and targeted therapy in the ...
Source: Expert Opinion on Pharmacotherapy - September 2, 2020 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Intramuscular Midazolam for treatment of Status Epilepticus.
Authors: Riva A, Iapadre G, Grasso EA, Balagura G, Striano P, Verrotti A Abstract INTRODUCTION: Status epilepticus (SE) is a common neurological and medical emergency. It has high mortality and morbidity rates, which typically correlate with seizure semiology and duration; therefore, prompt and proper pharmacological intervention is paramount. In a pre-hospital setting, establishing venous access can be difficult, so other routes of drug administration should be considered. AREAS COVERED: The paper summarizes the data from the literature and provides an evaluation of the efficacy and safety of intramuscular mid...
Source: Expert Opinion on Pharmacotherapy - August 27, 2020 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Real-world data on the use of insulin glargine 300 U/mL in Japanese patients with type 1 diabetes: twelve-month results from a post-marketing surveillance study (X-STAR study).
Authors: Matsuhisa M, Odawara M, Hirose T, Koshida R, Senda M, Tanaka Y, Terauchi Y Abstract BACKGROUND: With limited real-world insulin glargine 300 U/mL (Gla-300) data among Japanese patients with type 1 diabetes mellitus (T1DM) available, the authors describe its effectiveness and safety in Japanese T1DM patients switching to Gla-300. RESEARCH DESIGN AND METHODS: X-STAR was a 12-month prospective, observational, post-marketing study in Japanese patients with diabetes mellitus from 2015 to 2018: insulin-experienced T1DM patients initiating Gla-300 were analyzed. RESULTS: Of 774 patients, mean (&plusm...
Source: Expert Opinion on Pharmacotherapy - August 27, 2020 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

How effective are antibiotics for the treatment of irritable bowel syndrome?
Authors: Black CJ, Ford AC PMID: 32835541 [PubMed - as supplied by publisher] (Source: Expert Opinion on Pharmacotherapy)
Source: Expert Opinion on Pharmacotherapy - August 25, 2020 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Balancing treatments for patients with systemic hypertension and glaucoma.
This report offers background on various common therapies and considerations to minimize undesirable systemic and ophthalmic outcomes. AREAS COVERED: Key considerations relating to medical treatments for systemic hypertension and glaucoma chosen from a review of the literature are included. The historic safety of ophthalmic beta blockers and sub-types as well as combination agents are described. The potential role of ocular perfusion pressure in the pathogenesis of glaucoma is reviewed with a discussion of landmark studies, including the Barbados Eye Study and the Early Manifest Glaucoma Trial, with implications for me...
Source: Expert Opinion on Pharmacotherapy - August 25, 2020 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Evaluating imipenem + cilastatin + relebactam for the treatment of complicated urinary tract infections.
Authors: Kuiper SG, Leegwater E, Wilms EB, van Nieuwkoop C Abstract INTRODUCTION: The addition of the β-lactamase inhibitor relebactam to imipenem restores the antibacterial activity against the majority of multidrug resistant Gram-negative bacteria. Complicated urinary tract infections (UTIs) are predominantly caused by Gram-negative uropathogens. The rise in antibiotic resistance, including to carbapenems, is an increasing challenge in daily practice. AREAS COVERED: In the current review, the use of imipenem/relebactam in complicated UTI is evaluated by discussing its chemistry, pharmacokinetics/dynamics...
Source: Expert Opinion on Pharmacotherapy - August 23, 2020 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Cenobamate for the treatment of focal epilepsies.
This article reviews animal studies, pharmacokinetics, pharmacodynamics, and the phase 1 to 3 trials and open-label extension data on cenobamate. EXPERT OPINION: Cenobamate has the potential to perform as an important ASD because trial data are indicative of remarkable responder and seizure freedom rates so far not seen with other ASDs. Cenobamate demonstrated significant efficacy at a dosage between 100 and 400 mg per day. The side-effect profile of this drug is comparable to other ASDs and is mainly CNS related; in particular, somnolence, dizziness, headache, diplopia, and nystagmus. However, slow titration is m...
Source: Expert Opinion on Pharmacotherapy - August 21, 2020 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Fixed-dose combination therapy for Parkinson's disease with a spotlight on entacapone in the past 20 years: a reduced pill burden and a simplified dosing regime.
Authors: Salamon A, Zádori D, Szpisjak L, Klivényi P, Vécsei L Abstract INTRODUCTION: Parkinson's disease (PD) is a progressive, chronic neurodegenerative disorder. The main neuropathological cause of the disease is the death of dopaminergic neurons in the substantia nigra. Unfortunately, there is no curative treatment yet. The gold-standard of the treatment is levodopa (LD). During the course of the disease, motor complications develop, which postulates the addition of entacapone (ENT) to the dopaminergic medication. Previous studies have suggested that patients have a better quality of life w...
Source: Expert Opinion on Pharmacotherapy - August 20, 2020 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Current and emerging pharmacotherapy for pediatric allergic rhinitis.
Authors: Tomazic PV, Lang-Loidolt D Abstract INTRODUCTION: Allergic rhinitis (AR) is a global health problem in adults as well as the younger population, continuously increasing and posing a significant problem for patients, health care systems and economies. For the younger population, some aspects differ from treatment of adults, namely, prevention, compliance and adherence. AREAS COVERED: This narrative review summarizes all the pharmacotherapeutic options with special focus on the pediatric population. Moreover, it elucidates prevention strategies as well as future developments of AR treatment. Currently, s...
Source: Expert Opinion on Pharmacotherapy - August 20, 2020 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Pharmacotherapeutic management of bronchial infections in adults: non-cystic fibrosis bronchiectasis and chronic obstructive pulmonary disease.
Authors: Di Pasquale M, Aliberti S, Mantero M, Gramegna A, Blasi F Abstract INTRODUCTION: Effective management of both acute and chronic bronchial infections is mandatory due to their high frequency rate, the relevant morbidity and mortality and the significant burden to health care systems, especially with the aging of population. Bacteria are the main causative pathogens, followed by viruses, and less commonly by fungi. The clinical evaluation of new therapeutic associations is mandatory to cope with the increases in resistance, in association with better infection control and antimicrobial policies. AREAS CO...
Source: Expert Opinion on Pharmacotherapy - August 20, 2020 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Advances with glucocorticoids in the treatment of asthma: state of the art.
Authors: Ora J, Calzetta L, Matera MG, Cazzola M, Rogliani P Abstract INTRODUCTION: Asthma is one of the most frequent chronic diseases all over the world. Glucocorticoids (GCs), both inhaled (ICSs) and oral (OCSs), are the most effective treatment in asthma because they control symptoms and prevent exacerbations. AREAS COVERED: The present article reviews the new therapeutic indications of GCs for the treatment of asthma and focuses on new molecules and safety issues. EXPERT OPINION: Most patients with asthma benefit from corticosteroid-based treatments. Side effects are mainly due to prolonged use of oral...
Source: Expert Opinion on Pharmacotherapy - August 20, 2020 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Pharmacological management of human respiratory syncytial virus infection.
Authors: Kalergis AM, Soto JA, Gálvez NMS, Andrade CA, Fernandez A, Bohmwald K, Bueno SM Abstract INTRODUCTION: Human respiratory syncytial virus (hRSV) is the primary viral cause of respiratory diseases, leading to bronchiolitis and pneumonia in vulnerable populations. The only current treatment against this virus is palliative, and no efficient and specific vaccine against this pathogen is available. AREAS COVERED: The authors describe the disease symptoms caused by hRSV, the economic and social impact of this infection worldwide, and how this infection can be modulated using pharmacological treatments...
Source: Expert Opinion on Pharmacotherapy - August 20, 2020 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Evaluating ivosidenib for the treatment of acute myeloid leukemia.
Authors: Donker ML, Ossenkoppele GJ Abstract INTRODUCTION: Acute myeloid leukemia (AML) is the most common type of acute leukemia in adults, but the results for patients with AML are still unsatisfactory. The discovery of new mutations in AML, including IDH mutations, has opened the door for treatment with targeted agents. Ivosidenib is a selective, potent inhibitor of the IDH1 mutant protein. AREAS COVERED: This review summarizes the mechanism of action, safety profile and efficacy of ivosidenib for patients with IDH1-mutated AML. The authors then provide their expert perspectives on the use of the drug includ...
Source: Expert Opinion on Pharmacotherapy - August 20, 2020 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Ponesimod for the treatment of relapsing multiple sclerosis.
Authors: Baldin E, Lugaresi A Abstract INTRODUCTION: Multiple Sclerosis (MS) is an immune-mediated, complex, chronic inflammatory, and neurodegenerative disease of the central nervous system. Among the several therapeutic options developed over the last decade for relapsing MS (RMS), fingolimod, a sphingosine 1-phosphate receptor (S1PR) modulator, was the first oral treatment. The adverse events associated with fingolimod have limited its use in certain populations, thus further stimulating the search for other S1PR modulators. AREAS COVERED: The authors reviewed the English-published literature on ponesimod us...
Source: Expert Opinion on Pharmacotherapy - August 20, 2020 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

An update on the use of non-ergot dopamine agonists for the treatment of Parkinson's disease.
Authors: Cerri S, Blandini F Abstract INTRODUCTION: Long-term treatment of Parkinson's disease (PD) with levodopa is hampered by motor complications related to the inability of residual nigrostriatal neurons to convert levodopa to dopamine (DA) and use it appropriately. This generated a tendency to postpone levodopa, favoring the initial use of DA agonists, which directly stimulate striatal dopaminergic receptors. Use of DA agonists, however, is associated with multiple side effects and their efficacy is limited by suboptimal bioavailability. AREAS COVERED: This paper reviewed the latest preclinical and clinica...
Source: Expert Opinion on Pharmacotherapy - August 18, 2020 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Pharmacological management of adult patients with acute respiratory distress syndrome.
Authors: Matera MG, Rogliani P, Bianco A, Cazzola M Abstract INTRODUCTION: There is still no definite drug for acute respiratory distress syndrome (ARDS) that is capable of reducing either short-term or long-term mortality. Therefore, great efforts are being made to identify a pharmacological approach that can be really effective. AREAS COVERED: This review focuses on current challenges and future directions in the pharmacological management of ARDS, regardless of anti-infective treatments. The authors have excluded small randomized controlled trials (RCTs) with less than 60 patients because those studies do no...
Source: Expert Opinion on Pharmacotherapy - August 15, 2020 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Enzalutamide for the treatment of nonmetastatic castration-resistant prostate cancer.
Authors: Altavilla A, Casadei C, Lolli C, Menna C, Ravaglia G, Gurioli G, Farolfi A, Brighi N, Conteduca V, Burgio SL, Schepisi G, Rossi L, Gargiulo S, Lisotti I, De Giorgi U Abstract Introduction Enzalutamide is the first characterized second-generation nonsteroidal androgen receptor inhibitor (ARi). Its efficacy has been established in several clinical trials evaluating its role in different settings of prostate cancer. Recently, enzalutamide has been approved for the treatment of nonmetastatic castration-resistant prostate cancer (nmCRPC). Areas covered In this paper, the authors describe the chemical structure ...
Source: Expert Opinion on Pharmacotherapy - August 15, 2020 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Advances with pharmacotherapy for peritoneal metastasis.
This article provides a systematic overview of PM from various cancers including gastric, colorectal, small bowel, appendiceal cancer, and mesothelioma. It also includes all the essential aspects of therapy. EXPERT OPINION: CRS plus perioperative intraperitoneal chemotherapy is safe with acceptable morbidity and mortality. It is justified as a standard treatment to improve the long-term survival of patients with PM and is now performed with curative intent for PM from various malignancies. PMID: 32783786 [PubMed - as supplied by publisher] (Source: Expert Opinion on Pharmacotherapy)
Source: Expert Opinion on Pharmacotherapy - August 15, 2020 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Antithrombotic therapy for stroke prevention in patients with atrial fibrillation in Japan.
Authors: Maruhashi T, Higashi Y Abstract INTRODUCTION: Stroke remains one of the major public health problems in Japan. The number of patients with atrial fibrillation (AF) has been steadily increasing with the aging of the Japanese population. Appropriate oral antithrombotic therapy is necessary to prevent AF-related stroke and bleeding complications. AREAS COVERED: The authors summarize the Japanese guidelines for antithrombotic therapy, as well as the current status of antithrombotic therapy, and future perspectives for antithrombotic therapy for patients with AF in Japan. EXPERT OPINION: Further improve...
Source: Expert Opinion on Pharmacotherapy - August 13, 2020 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Inclisiran, the billion-dollar drug, to lower LDL cholesterol - is it worth it?
Authors: Doggrell SA Abstract INTRODUCTION: If statins are unsuccessful at achieving the LDL cholesterol level goal in subjects with hypercholesterolemia, non-statin therapy should be added to reduce cardiovascular morbidity and mortality. The first inhibitors of proprotein convertase substilisin-kexin type 9 (PCSK9) were human monoclonal antibodies and these reduced LDL cholesterol and cardiovascular events. Inclisiran is a small interfering RNA molecule (siRNAs) directed against PCSK9. AREAS COVERED: This key paper evaluation focuses on Phase 3 trials that assess inclisiran in the treatment of hypercholestero...
Source: Expert Opinion on Pharmacotherapy - August 13, 2020 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

A look at the clinical, economic, and societal impact of antimicrobial resistance in 2020.
Authors: Bassetti M, Giacobbe DR PMID: 32749893 [PubMed - as supplied by publisher] (Source: Expert Opinion on Pharmacotherapy)
Source: Expert Opinion on Pharmacotherapy - August 13, 2020 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

The trade-off dilemma in pharmacotherapy of COVID-19: systematic review, meta-analysis, and implications.
Authors: Khan S, Gionfriddo MR, Cortes-Penfield N, Thunga G, Rashid M Abstract INTRODUCTION: The coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected millions of people worldwide and has contributed to over 650,000 deaths. This review synthesizes the literature on COVID-19 pharmacotherapy to inform practice and policymaking. AREAS COVERED: The authors systematically review the published literature on COVID-19 therapeutics, grouping candidate treatments into repurposed, adjunct, and experimental agents. They conducted meta-analysis where appr...
Source: Expert Opinion on Pharmacotherapy - August 13, 2020 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Letter to the Editor concerning the pharmacological management of behavioural disturbances in patients with Alzheimer's disease.
Authors: Scicutella A PMID: 32772597 [PubMed - as supplied by publisher] (Source: Expert Opinion on Pharmacotherapy)
Source: Expert Opinion on Pharmacotherapy - August 13, 2020 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Quizartinib for the treatment of acute myeloid leukemia.
This article reviews the mechanism of action, pharmacology, clinical efficacy, and safety of quizartinib, a FLT3 inhibitor, for the treatment of acute myeloid leukemia. EXPERT OPINION: . Quizartinib yielded an improvement in OS and complete remission (CR) rates in a phase 3 trial for relapsed/refractory FLT3-mutated AML. The toxicities are manageable; however, it is associated with significant QTc prolongation and myelosuppression. The FDA and EMA did not grant drug approval to quizartinib in the relapsed/refractory setting due to the lack of a significant benefit - to-risk ratio, safety concerns and concerns with cred...
Source: Expert Opinion on Pharmacotherapy - August 13, 2020 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Oral pharmacotherapeutics for the management of peripheral neuropathic pain conditions - a review of clinical trials.
Authors: Knezevic NN, Jovanovic F, Candido KD, Knezevic I Abstract INTRODUCTION: Epidemiological studies have shown that 6.9-10% of people suffer from neuropathic pain, a complex painful condition which is often undertreated. Data regarding the effectiveness of treatment options for patients with neuropathic pain is inconsistent, and there is no single treatment option that shows cost-effectiveness across studies. AREAS COVERED: In this narrative review, the authors present the results of different prospective, randomized controlled trials, systematic reviews and meta-analyses assessing the effects of different...
Source: Expert Opinion on Pharmacotherapy - August 13, 2020 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Efficacy and safety of add on therapies in patients with hypercholesterolemia undergoing statin therapy.
Authors: Tomlinson B, Chan P, Zhang Y, Lam CWK Abstract INTRODUCTION: Statins are the first-line treatment to reduce cardiovascular (CV) events, mainly by reducing low-density-lipoprotein cholesterol (LDL-C), but many patients need additional treatments to reach the current lipid goals. AREAS COVERED: Herein, the authors review the published literature on the efficacy and safety of the therapies that are most often added to statins to achieve lipid targets. EXPERT OPINION: Ezetimibe is usually the first additional treatment to achieve LDL-C targets. It reduces LDL-C by about a further 20% and has an excelle...
Source: Expert Opinion on Pharmacotherapy - August 13, 2020 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research