Carbamazepine adverse drug reactions.
Authors: Fricke-Galindo I, LLerena A, Jung-Cook H, López-López M Abstract INTRODUCTION: Carbamazepine (CBZ) is used for the treatment of epilepsy and other neurological and psychiatric disorders. The occurrence of adverse reactions (ADRs) to CBZ can negatively impact the quality of life of patients, as well as, increase health care costs. Thus, knowledge of CBZ-induced ADRs is important to achieve safer treatment outcomes. Areas covered. This review describes the clinical features, known mechanisms, and clinical management of the main CBZ-induced ADRs. In addition, pharmacogenetic studies focused on A...
Source: Expert Review of Clinical Pharmacology - June 16, 2018 Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research

Treatment of Sarcoidosis: Grading the evidence.
Authors: James WE, Baughman R Abstract INTRODUCTION: Treatment of sarcoidosis recommendations are often based on clinical experience and expert opinion. However, there are an increasing number of studies which are providing evidence to support decisions regarding treatment. Areas Covered: Several studies have identified factors associated with increased risk for organ failure or death ("danger"). There have been several studies focused on the role of treatment to improve quality of life for the patient. Sarcoidosis treatment often follows a progression, based on response. Corticosteroids remain the initia...
Source: Expert Review of Clinical Pharmacology - June 9, 2018 Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research

Pharmacoperone drugs: targeting misfolded proteins causing lysosomal storage-, ion channels-, and G protein-coupled receptors- associated conformational disorders.
Authors: Hou ZS, Ulloa-Aguirre A, Tao YX Abstract INTRODUCTION: Conformational diseases are caused by structurally abnormal proteins that cannot fold properly and achieve their native conformation. Misfolded proteins frequently originate from genetic mutations that may lead to loss-of-function diseases involving a variety of structurally diverse proteins including enzymes, ion channels, and membrane receptors. Pharmacoperones are small molecules that cross the cell surface plasma membrane and reach their target proteins within the cell, serving as molecular scaffolds to stabilize the native conformation of misfolde...
Source: Expert Review of Clinical Pharmacology - June 2, 2018 Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research

Pharmacological treatment options for severe hypertriglyceridemia and familial chylomicronemia syndrome.
Authors: Chaudry R, Viljoen A, Wierzbicki AS Abstract INTRODUCTION: A spectrum of disorders, ranging from rare severe cases of homozygous null lipoprotein lipase deficiency (LPLD) -familial chylomicronemia syndrome (FCS) to heterozygous missense LPLD or polygenic causes, result in hypertriglyceridemia and pancreatitis. The effects of mutations are exacerbated by environmental factors such as diet, pregnancy and insulin resistance. Areas covered: In this review, authors discuss chronic treatment of FCS by ultra-low fat diets allied with the use of fibrates, omega-3 fatty acids, niacin, statins and insulin-sensitisin...
Source: Expert Review of Clinical Pharmacology - June 1, 2018 Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research

Tailoring tacrolimus therapy in kidney transplantation.
CONCLUSION: tacrolimus-based immunosuppression is still the best immunosuppressive therapy in kidney transplant recipients, and can be tailored according to patients'need. PMID: 29779413 [PubMed - as supplied by publisher] (Source: Expert Review of Clinical Pharmacology)
Source: Expert Review of Clinical Pharmacology - May 23, 2018 Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research

The impact of chronic kidney disease on medication choice and pharmacologic management in patients with heart failure.
Authors: Shah SR, Winchester DE Abstract INTRODUCTION: In the past few years, medical community, including doctors, have become increasingly aware of the fact that chronic kidney disease (CK) and heart failure (HF) have common risk factors which impacts one another in terms of choice of therapy. Areas covered: Management of these two diseases has been a challenge for physicians. The treatment goals for HF patients in CK are very important. They serve as the end-point in using a specific treatment for management and treatment of CK patients hence, decreasing mortality rates. In this review, we discuss the pharmacolo...
Source: Expert Review of Clinical Pharmacology - May 23, 2018 Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research

Gemtuzumab ozogamicin for the treatment of acute myeloid leukemia.
Authors: Baron J, Wang ES Abstract INTRODUCTION: Gemtuzumab ozogamicin (GO) is an antibody-drug conjugate consisting of a monoclonal antibody targeting CD33 linked to a cytotoxic derivative of calicheamicin. Despite the known clinical efficacy in relapsed/refractory acute myeloid leukemia (AML), GO was withdrawn from the market in 2010 due to increased early deaths seen in newly diagnosed AML patients receiving GO + intensive chemotherapy. In 2017, new data on the clinical efficacy and safety of GO administered on a fractionated dosing schedule led to re-approval for newly diagnosed and relapsed/refractory AML. Are...
Source: Expert Review of Clinical Pharmacology - May 23, 2018 Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research

Dolutegravir and rilpivirine for the maintenance treatment of virologically suppressed HIV-1 infection.
Authors: Casado JL, Monsalvo M, Rojo AM, Fontecha M, Rodriguez-Sagrado MA Abstract INTRODUCTION: Triple combinations of antiretroviral (ART) drugs are the standard treatment for HIV infection, but the challenges include long-term side effects, high costs, and adherence. The recent advent of potent and well tolerated ART has renewed the interest for newer ART strategies. A dual regimen with the combination of dolutegravir (DTG) and rilpivirine (RPV), two well tolerated, metabolic-friendly, and potent drugs could offer additional benefits. Areas covered: A review of recent randomized trials and observational cohorts ...
Source: Expert Review of Clinical Pharmacology - May 22, 2018 Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research

A systematic review and combined analysis of therapeutic drug monitoring studies for oral paliperidone.
This article includes a combined analysis of therapeutic drug monitoring (TDM) studies and a review of the marketer's data on pharmacological mechanisms. Areas covered: An article search led to the inclusion of 21 paliperidone studies in the systematic review plus 2 case reports. Paliperidone clearance was calculated from: 1) steady-state studies using concentration/dose (C/D) ratios, and 2) single-dose studies describing 24-hour area under the curve calculations. The marketed extended-release formulation has 28% bioavailability. Calculated mean C/D ratios (ng/ml/mg/d) were: 1) 4.09 in 6 studies of 221 non-Korean and non-g...
Source: Expert Review of Clinical Pharmacology - May 22, 2018 Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research

Enasidenib for the treatment of acute myeloid leukemia.
Authors: Dugan J, Pollyea D Abstract INTRODUCTION: In August 2017 the United States Federal Drug Administration (FDA) approved enasidenib (Idhifa, Celgene/Agios) for adults with relapsed and refractory acute myelogenous leukemia (AML) with an IDH2 mutation. Enasidenib targets cells with mutant copies of isocitrate dehydrogenase-2 (IDH2), inhibiting the oncometabolite 2-hydroxyglutarte (2-HG) formed by the mutant IDH2. Areas covered: We review the studies leading to enasidenib's approval, as well as common side effects and safety issues experienced during the clinical trials. There is a focus on the diagnosis and tr...
Source: Expert Review of Clinical Pharmacology - May 19, 2018 Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research

Seek and destroy: improving PK/PD profiles of anticancer agents with nanoparticles.
Authors: Rodallec A, Fanciullino R, Lacarelle B, Ciccolini J Abstract BACKGROUND: The Pharmacokinetics/pharmacodynamics (PK/PD) relationships with cytotoxics are usually based on a steepening concentration-effect relationship; the greater the drug amount, the greater the effect. The Maximum Tolerated Dose paradigm, finding the balance between efficacy while keeping toxicities at their manageable level, has been the rule of thumb over the last 50-years. Developing nanodrugs is an appealing strategy to help broaden this therapeutic window. The fact that efficacy and toxicity with cytotoxics are intricately linked is ...
Source: Expert Review of Clinical Pharmacology - May 17, 2018 Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research

Placebo effects: the need for a new perspective and conceptualization.
Authors: Benedetti F, Frisaldi E, Shaibani A PMID: 29745259 [PubMed - as supplied by publisher] (Source: Expert Review of Clinical Pharmacology)
Source: Expert Review of Clinical Pharmacology - May 12, 2018 Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research

Efficacy and safety of iron chelators in thalassemia and sickle cell disease: A multiple treatment comparison network meta-analysis and trial sequential analysis.
CONCLUSION: Relative estimates between the individual iron chelators have been established. However, this evidence should be considered preliminary and may change with the results of future head-to-head clinical trials. PMID: 29727586 [PubMed - as supplied by publisher] (Source: Expert Review of Clinical Pharmacology)
Source: Expert Review of Clinical Pharmacology - May 7, 2018 Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research

Impact of Total Body Weight on Acute Kidney Injury in Patients with Gram-Negative Bacteremia.
CONCLUSIONS: TBW>80kg was associated with the development of AKI. However, the mechanism for this association is not clear. PMID: 29718754 [PubMed - as supplied by publisher] (Source: Expert Review of Clinical Pharmacology)
Source: Expert Review of Clinical Pharmacology - May 3, 2018 Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research

Response to: Pharmacological treatment of primary membranous nephropathy in 2016.
Authors: Printza N, Georeli I, Stabouli S, Dotis J, Sidira C, Fotios P PMID: 29669425 [PubMed - as supplied by publisher] (Source: Expert Review of Clinical Pharmacology)
Source: Expert Review of Clinical Pharmacology - April 20, 2018 Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research

Intracavitary Therapies for Upper Tract Urothelial Carcinoma.
Authors: Knoedler JJ, Raman JD Abstract INTRODUCTION: While radical nephroureterectomy remains the gold-standard for upper tract urothelial carcinoma (UTUC), there is a growing push for organ-sparing therapy in low-risk disease. Herein we review the use of intracavitary topical therapy for treatment of UTUC. Areas covered:. A PubMed search was performed for studies pertaining to upper tract urothelial carcinoma, with 236 articles reviewed, and distilled for content pertinent to intracavitary therapy for UTUC. Topics discussed include agents used for management of UTUC, most commonly BCG, as well as techniques for a...
Source: Expert Review of Clinical Pharmacology - April 12, 2018 Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research

Treatment and prevention of HIV infection with long-acting antiretrovirals.
Authors: Benítez-Gutiérrez L, Soriano V, Requena S, Arias A, Barreiro P, de Mendoza C Abstract INTRODUCTION: Current antiretroviral therapy allows to achieve and sustain maximal suppression of HIV replication in most treated patients. As result, the life expectancy of HIV-infected persons has improved dramatically and is nowadays similar to that of the HIV-negative population. However, oral antiretrovirals have to be taken daily and indefinitely to avoid resumption of HIV replication and selection of drug resistance. Unfortunately, drug adherence is often suboptimal and tends to decline over time. Are...
Source: Expert Review of Clinical Pharmacology - March 31, 2018 Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research

Pharmacological management of interstitial cystitis/bladder pain syndrome and the role Cyclosporine and other immunomodulating drugs play.
Authors: Ogawa T, Ishizuka O, Ueda T, Tyagi P, Chancellor MB, Yoshimura N Abstract INTRODUCTION: Interstitial cystitis/bladder pain syndrome (IC/BPS) is a symptomatic disorder characterized by pelvic pain and urinary frequency. Immunological responses are considered as one of the possible etiologies of IC/BPS. In this review, we focused on emerging targets, especially on those modulating immunological mechanisms for the treatments of IC/BPS. Area covered: This review was based on the literature search of PubMed/MEDLINE, for which key words following bladder pain syndrome, interstitial cystitis, and/or cyclosporine ...
Source: Expert Review of Clinical Pharmacology - March 27, 2018 Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research

Dupilumab for treatment of atopic dermatitis.
Authors: Seegräber M, Srour J, Walter A, Knop M, Wollenberg A Abstract INTRODUCTION: Dupilumab is a new treatment option for patients with moderate-to-severe atopic dermatitis. It blocks IL-4/IL13-signaling and thereby inhibits receptor signaling downstream the JAK-STAT-pathway. Three of the main disease mechanisms of atopic dermatitis are affected by blocking this pathway; the decrease of skin barrier function, the class switch to IgE and the TH2-differentiation. Areas Covered: Dupilumab showed promising results in clinical trials of phase I-III. Clinical outcome parameters such as SCORAD, EASI, IGA and BSA i...
Source: Expert Review of Clinical Pharmacology - March 21, 2018 Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research

Potential nephrotoxicity of sofosbuvir-based treatment in patients infected with hepatitis C virus: a review on incidence, type and risk factors.
Authors: Dashti-Khavidaki S, Khalili H, Nasiri-Toosi M Abstract INTRODUCTION: There was no report of nephrotoxicity during clinical trials assessed sofosbuvir for treatment of hepatitis C (HCV) infection. This may be due to excluding patients with severe kidney dysfunction, as a main population at risk for drug-induced nephrotoxicity from these studies. There are some reports of acute kidney injury (AKI) possibly related to sofosbuvir-containing treatments from real-life experiences. Areas covered: Available data on epidemiology, type, and possible risk factors for nephrotoxicity of sofosbuvir-containing treatment ...
Source: Expert Review of Clinical Pharmacology - March 14, 2018 Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research

Lateral switch to IFN beta-1a 44 mcg may be effective as escalation switch to fingolimod in selected persons with relapsing remitting multiple sclerosis: a real-world setting experience.
CONCLUSIONS: lateral switch to IFN beta-1a 44 mcg and escalation switch to fingolimod showed same ability in influencing RRMS disease activity at 24 months. PMID: 29521113 [PubMed - as supplied by publisher] (Source: Expert Review of Clinical Pharmacology)
Source: Expert Review of Clinical Pharmacology - March 11, 2018 Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research

Pharmacological management of late-onset hypogonadism.
Authors: Rastrelli G, Maggi M, Corona G Abstract INTRODUCTION: The frequency of late-onset hypogonadism (LOH) ranges between 2 and 15%. Up to 85% of LOH is due to a functional impairment of the hypothalamus-pituitary-testicular axis, mostly secondary to metabolic conditions. Areas covered: This paper provides a comprehensive review of all the available medications for treating LOH, including antiestrogens, gonadotropins and testosterone therapy (TTh). In addition, the evidence on clinical outcomes of these treatments is provided by meta-analyzing the results from the available randomized clinical trials. Expert com...
Source: Expert Review of Clinical Pharmacology - March 7, 2018 Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research

Pharmacokinetics of multiple doses of teicoplanin in Chinese elderly critical patients.
CONCLUSIONS: In Chinese elderly critical patients, t1/2 of teicoplanin was consistent with that of literatures published, however, CL were higher. The pharmacokinetics of teicoplanin at the range of 400~800mg is linear pharmacokinetics, indicating that the dosage regimens for patients were more simply and accurately adjusted according to therapeutic drug monitoring. PMID: 29506414 [PubMed - as supplied by publisher] (Source: Expert Review of Clinical Pharmacology)
Source: Expert Review of Clinical Pharmacology - March 7, 2018 Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research

What prevents cardioprotective drugs from reaching the market?
Authors: Simko F, Adamcova M PMID: 29495886 [PubMed - as supplied by publisher] (Source: Expert Review of Clinical Pharmacology)
Source: Expert Review of Clinical Pharmacology - March 4, 2018 Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research

Treatment of early stage chronic Hepatitis C Virus infection.
Authors: Ponziani FR, Miele L, Tortora A, Furnari M, Bodini G, Pompili M, Gasbarrini A, Giannini EG Abstract INTRODUCTION: Treatment of Hepatitis C Virus (HCV) with direct acting antivirals (DAAs) is able to achieve the cure of infection in almost the totality of patients, independently of patients and virus characteristics, using short treatment schedules, and without the need of ribavirin. The high cost of DAAs is the main limiting factor for universal treatment of HCV. However, there is a strong evidence that treatment of infection at the early stage of disease may be the most rewarding approach. Areas covered: ...
Source: Expert Review of Clinical Pharmacology - March 4, 2018 Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research

A New Class of Agents for Estrogen-Receptor-Positive Breast Cancer.
Authors: Ekoue DN, Unni N, Raj GV PMID: 29439601 [PubMed - as supplied by publisher] (Source: Expert Review of Clinical Pharmacology)
Source: Expert Review of Clinical Pharmacology - February 15, 2018 Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research

What is the role of statins in the elderly population?
Authors: Stavropoulos K, Imprialos K, Doumas M, Athyros VG PMID: 29431524 [PubMed - as supplied by publisher] (Source: Expert Review of Clinical Pharmacology)
Source: Expert Review of Clinical Pharmacology - February 14, 2018 Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research

Neoadjuvant and adjuvant treatment in high-risk prostate cancer.
Authors: Bandini M, Fossati N, Gandaglia G, Preisser F, Dell'Oglio P, Zaffuto E, Stabile A, Gallina A, Suardi N, Shariat SF, Montorsi F, Karakiewicz PI, Briganti A Abstract INTRODUCTION: High-risk prostate cancer (HRPCa) represents a heterogeneous disease with potential risk for local and distant progression. In these patients, a multi-modal approach consisting of neoadjuvant and/or adjuvant systemic therapies has been proposed. The aim of this review is to summarize the emerging roles of neoadjuvant and adjuvant therapies in HRPCa patients. Areas covered: This review collects the most relevant phase III randomized...
Source: Expert Review of Clinical Pharmacology - January 23, 2018 Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research

Solving the problem of dose optimisation of children's medicines.
Authors: McWilliam SJ, Hawcutt DB PMID: 29355041 [PubMed - as supplied by publisher] (Source: Expert Review of Clinical Pharmacology)
Source: Expert Review of Clinical Pharmacology - January 23, 2018 Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research

The Pharmacological Management of Metabolic Syndrome.
The objective of present paper was to review the therapeutic options for metabolic syndrome and its components, the available evidence related to their cardiovascular benefits, and to evaluate the extent to which they should influence the guidelines for clinical practice. Areas covered: A Medline literature search was performed to identify clinical trials and meta-analyses related to the therapy of dyslipidemia, arterial hypertension, glucose metabolism and obesity published in the past decade. Expert commentary: Our recommendation for first-line pharmacological are statins for dyslipidemia, renin-angiotensin-aldosteron sy...
Source: Expert Review of Clinical Pharmacology - January 19, 2018 Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research

Efficacy and safety of alpha blockers in medical expulsive therapy for ureteral stones: A mixed treatment network meta-analysis and trial sequential analysis of randomized controlled clinical trials.
Authors: Sridharan K, Sivaramakrishnan G Abstract INTRODUCTION: Alpha blockers (AB) are the main group of drugs used for medical expulsive therapy (MET) in patients with ureteral stones. However, there is no consensus on the relative efficacy and safety of individual AB in MET. Areas covered: The present work is a network meta-analysis of randomized controlled trials comparing AB with either placebo or standard of care in patients with ureteral stones. Electronic databases of Medline, Cochrane CENTRAL and Google Scholar were searched for eligible clinical studies. Inverse variance heterogeneity model was used for m...
Source: Expert Review of Clinical Pharmacology - January 16, 2018 Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research

Lidocaine dose-response effect on postoperative cognitive deficit: Meta-analysis and meta-regression.
Authors: Habibi MR, Habibi V, Habibi A, Soleimani A Abstract INTRODUCTION: The true influence of the perioperative intravenous lidocaine on the development of postoperative cognitive deficit (POCD) in coronary artery bypass grafting (CABG) remains controversial. The principal aim is to undertake a meta-regression to determine whether moderator variables mediate the relationship between lidocaine and POCD. Areas covered: We searched the Web of Science, PubMed database, Scopus and the Cochrane Library database (up to June 2017) and systematically reviewed a list of retrieved articles. Our final review includes only r...
Source: Expert Review of Clinical Pharmacology - January 10, 2018 Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research

Defibrotide sodium for the treatment of hepatic veno-occlusive disease/sinusoidal obstruction syndrome.
Authors: Richardson PG, Triplett BM, Ho VT, Chao N, Dignan FL, Maglio M, Mohty M Abstract INTRODUCTION: Hepatic veno-occlusive disease/sinusoidal obstruction syndrome (VOD/SOS) is an unpredictable condition associated with endothelial-cell damage due to conditioning for hematopoietic stem-cell transplantation (HSCT) or chemotherapy without HSCT. Mortality in patients with VOD/SOS and multi-organ dysfunction (MOD) may be>80%. Areas covered: Defibrotide is the only approved drug for the treatment of severe hepatic VOD/SOS after HSCT in the European Union and hepatic VOD/SOS with renal or pulmonary dysfunction in t...
Source: Expert Review of Clinical Pharmacology - January 6, 2018 Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research

Dyslipidaemia in the elderly: to treat or not to treat?
Authors: Katsiki N, Kolovou G, Perez-Martinez P, Mikhailidis DP Abstract INTRODUCTION: The elderly population (i.e. aged ≥ 65 years) is increasing worldwide. Ageing is associated with a higher incidence and prevalence of cardiovascular disease (CVD). Areas covered: The prevalence of CVD risk factors including type 2 diabetes mellitus, hypertension and dyslipidaemia also increases with advancing age, contributing to the higher absolute CVD risk observed in the elderly. The present narrative review comments on the associations of dyslipidaemia with CVD as well as the effects of lifestyle measures and lipid-lowerin...
Source: Expert Review of Clinical Pharmacology - January 6, 2018 Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research

Eslicarbazepine acetate in epilepsies with focal and secondary generalised seizures: systematic review of current evidence.
Authors: Willems LM, Zöllner JP, Paule E, Schubert-Bast S, Rosenow F, Strzelczyk A Abstract INTRODUCTION: Eslicarbazepine acetate (ESL) is a third-generation antiepileptic drug (AED) approved for adjunctive treatment in adults, children, and adolescents with focal-onset seizures. Recently ESL was approved for initial monotherapy in adults. The intention of this article is to review current evidence for ESL and to summarise its pharmacological profile in comparison to other AEDs of the dibenzazepine group. Areas covered: We performed a systematic literature search in electronic databases (MEDLINE database, Coch...
Source: Expert Review of Clinical Pharmacology - December 31, 2017 Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research

Challenges of using new and repurposed drugs for the treatment of multidrug-resistant tuberculosis in children.
Authors: Schaaf HS, Garcia-Prats AJ, McKenna L, Seddon JA Abstract INTRODUCTION: New and repurposed antituberculosis drugs are urgently needed to more safely and effectively treat multidrug-resistant (MDR) tuberculosis (TB) in children. Multiple challenges limit timely access to new MDR-TB treatments in children. Areas covered: Diagnosis of MDR-TB in children remains a barrier, with few children with MDR-TB diagnosed and treated. Other barriers to timely access to new and repurposed drugs are discussed, and include delayed initiation of paediatric trials, limited funding for paediatric drug development, fragmented ...
Source: Expert Review of Clinical Pharmacology - December 28, 2017 Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research

The pharmacological treatment of bronchiectasis.
Authors: Melani AS, Lanzarone N, Rottoli P Abstract INTRODUCTION: Until recently considered as a minor health problem, the role of bronchiectasis is now increasingly recognized. New specific drugs are being approved for treatment of bronchiectasis. Possibly they will offer better perspectives to bronchiectatic subjects with evolving course. Areas covered: We provide an overview of aetiopathogenesis, clinics and non-pharmacological management, extending the topic of pharmacological treatment. Present therapies are extrapolated from other chronic lung diseases, but newer promising specific drugs are being awaited. Th...
Source: Expert Review of Clinical Pharmacology - December 24, 2017 Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research

Home Oxygen Therapy: re-thinking the role of devices.
Authors: Melani AS, Sestini P, Rottoli P Abstract INTRODUCTION: A range of devices are available for delivering and monitoring Home Oxygen Therapy (HOT). Guidelines do not give indications for the choice of the delivery device but recommend the use of an ambulatory system in subjects on HOT whilst walking. Areas covered: We provide a clinical overview of HOT and review traditional and newer delivery and monitoring devices for HOT. Despite relevant technology advancements, clinicians, faced with many challenges when they prescribe oxygen therapy, often remain familiar to traditional devices and continuous flow deliv...
Source: Expert Review of Clinical Pharmacology - December 24, 2017 Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research

Pharmacological management of cystic fibrosis related diabetes.
Authors: Moheet A, Moran A Abstract INTRODUCTION: There are limited data from randomized clinical trials to guide optimal options for pharmacological treatment of cystic fibrosis related diabetes (CFRD). Current guidelines recommend insulin as the only treatment option for CFRD. Areas covered: Current guidelines for screening, diagnosis and pharmacological agents for treatment of impaired glucose tolerance and CFRD in patients with cystic fibrosis are reviewed. Insights from clinical studies examining the role of insulin therapy in CFRD are presented. Expert commentary: CFRD is the most common extra pulmonary compl...
Source: Expert Review of Clinical Pharmacology - December 23, 2017 Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research

The importance of the initial response to cancer treatment in predicting longer overall survival.
Authors: McCoach CE, Doebele RC PMID: 29251525 [PubMed - as supplied by publisher] (Source: Expert Review of Clinical Pharmacology)
Source: Expert Review of Clinical Pharmacology - December 20, 2017 Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research

Novel Psychotherapeutics - A Cautiously Optimistic Focus on Hallucinogens.
Authors: Sherwood AM, Prisinzano TE PMID: 29224406 [PubMed - as supplied by publisher] (Source: Expert Review of Clinical Pharmacology)
Source: Expert Review of Clinical Pharmacology - December 13, 2017 Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research

Non-oncotic properties of albumin. A multidisciplinary vision about the implications for critically ill patients.
Authors: Ferrer R, Mateu X, Maseda E, Yébenes JC, Aldecoa C, De Haro C, Ruiz-Rodriguez JC, Garnacho-Montero J Abstract INTRODUCTION: Effective resuscitation with human albumin solutions is achieved with less fluid than with crystalloid solutions. However, the role of albumin in today's critical care unit is also linked to its multiple pharmacological effects. Areas covered: The potential clinical benefits of albumin in select populations of critically ill patients like sepsis seem related to immunomodulatory and anti-inflammatory effects, antibiotic transportation and endothelial stabilization. Albumin trans...
Source: Expert Review of Clinical Pharmacology - December 10, 2017 Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research

Pharmacological treatments available for the management of underactive bladder in neurological conditions.
Authors: Ladi-Seyedian SS, Nabavizadeh B, Sharifi-Rad L, Kajbafzadeh AM Abstract INTRODUCTION: Underactive bladder (UAB) is a common cause of lower urinary tract dysfunction which has an increasing incidence with aging. It is characterized as an incompetent detrusor contraction with reduced strength and/or duration to completely empty the bladder. UAB is observed in both men and women. The exact definition, classification, and pathophysiological mechanism responsible for UAB is still debatable, however neurologic, myogenic, and iatrogenic causes are explained. The symptom complex related to UAB includes hesitancy, ...
Source: Expert Review of Clinical Pharmacology - December 7, 2017 Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research

Continuous flow technology vs. the batch-by-batch approach to produce pharmaceutical compounds.
Authors: Cole KP, Johnson MD Abstract INTRODUCTION: For the manufacture of small molecule drugs, many pharmaceutical innovator companies have recently invested in continuous processing, which can offer significant technical and economic advantages over traditional batch methodology. This Expert Review will describe the reasons for this interest as well as many considerations and challenges that exist today concerning continuous manufacturing. Areas Covered: Continuous processing is defined and many reasons for its adoption are described. The current state of continuous drug substance manufacturing within the pharma...
Source: Expert Review of Clinical Pharmacology - December 7, 2017 Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research

The role of gut microbiota in the modulation of drug action: A focus on some clinically significant issues.
Authors: Currò D Abstract INTRODUCTION: A healthy gut microbiota is necessary for the normal operation of several body functions, including gastrointestinal sensitivity and motility, lipid and glucid metabolism, immune surveillance, and host behavior. In addition, intestinal bacteria contribute to determining the pharmacological properties of several drugs by producing different drug metabolizing enzymes. Areas covered: Four enzymatic processes are discussed: prodrug activation; drug inactivation; drug deconjugation; and hydrolysis of natural glycosides with further metabolism of released aglycones. For each...
Source: Expert Review of Clinical Pharmacology - December 7, 2017 Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research

Dosing strategies to optimize currently available anti-MRSA treatment options (Part 2: PO options).
Authors: Payne KD, Das A, Ndiulor M, Hall RG Abstract INTRODUCTION: Methicillin-resistant Staphylococcus aureus (MRSA) is a problematic pathogen in both outpatient and inpatient settings. Research to optimize the dosing of these agents is needed to slow the development of antimicrobial resistance and to decrease the likelihood of clinical failure. Areas covered: This review summarizes the available data for orally administered antimicrobials routinely used as monotherapy for MRSA infections. We make recommendations and highlight the current gaps in the literature. A PubMed (1966 - Present) search was performed to i...
Source: Expert Review of Clinical Pharmacology - December 1, 2017 Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research

The pharmacological treatment of acute HIV infections in neonates.
Authors: Kuhn L, Shiau S Abstract INTRODUCTION: Recent goals of antiretroviral treatment of neonates have expanded from reducing morbidity and mortality to also aiming to facilitate HIV remission. Areas covered: In this review, we present and discuss the rationale and evidence-bases for each of these distinct goals. Next we discuss the challenges of how to identify HIV-infected neonates. Finally, we discuss the specific antiretroviral drugs that are preferred for this group, making distinctions between the use of these agents in prevention and treatment. Expert commentary: The clinical and scientific challenges of ...
Source: Expert Review of Clinical Pharmacology - November 4, 2017 Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research

Pharmacology and Pharmacokinetics of Imatinib in Pediatric Patients.
Authors: Suttorp M, Bornhäuser M, Metzler M, Millot F, Schleyer E Abstract INTRODUCTION: The tyrosine kinase inhibitor (TKI) imatinib was rationally designed to target BCR-ABL1 which is constitutively activated in chronic myeloid leukemia (CML). Following the tremendous success in adults, imatinib also became licensed for treatment of CML in minors. The rarity of pediatric CML hampers the conduction of formal trials. Thus, imatinib is still the single TKI approved for CML treatment in childhood. Areas covered: This review attempts to provide an overview of the literature on pharmacology, pharmacokinetic, and p...
Source: Expert Review of Clinical Pharmacology - October 28, 2017 Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research

Tolerability and Efficacy of Colestipol Hydrochloride for Accelerated Elimination of Teriflunomide.
CONCLUSIONS: The administration of colestipol HCl for 15 days was sufficient to reduce plasma teriflunomide concentrations by greater than 96%. Although colestipol HCl did not completely eliminate teriflunomide with the same effectiveness as cholestyramine, it may offer an alternative method for accelerated elimination of teriflunomide with potentially improved tolerability and more favorable dosing and administration options. PMID: 29064296 [PubMed - as supplied by publisher] (Source: Expert Review of Clinical Pharmacology)
Source: Expert Review of Clinical Pharmacology - October 25, 2017 Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research

Darunavir for Use in Pregnant Women with HIV.
Authors: Pope R, Kashuba A Abstract INTRODUCTION: Combination antiretroviral therapy is recommended during pregnancy to decrease the rate of HIV transmission to the baby and reduce morbidity in the mother. More than 50% of women are prescribed a protease inhibitor-based regimen during pregnancy. Darunavir was recently reclassified as a first-line protease inhibitor for use in pregnancy in the US Department of Health and Human Services Perinatal Guidelines. Areas covered: This is a brief review of the use of protease inhibitor therapy during pregnancy, and a discussion of darunavir's utility in this area. Clinical p...
Source: Expert Review of Clinical Pharmacology - October 11, 2017 Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research