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Expert Opinion on Pharmacotherapy

Ahmed I El-Sakka
Numerous studies have highlighted the intimate association between erectile dysfunction (ED) and diabetes mellitus (DM). However, the true pathogenesis of ED among diabetic men has not yet been fully discovered. The treatment of ED in diabetic patients remains an interesting area of research. The last two decades have witnessed phenomenal advances in the management of ED with the efficacy of pharmacotherapy for ED in diabetic patients encouraging, especially with introduction of innovative conservative tools for treatment...
August 14, 2018: Expert Opinion on Pharmacotherapy
Udaya Tantry, Rahul Chaudhary, Jacek Kubica, Kevin Bliden, Paul A Gurbel
All oral P2Y12 receptor blockers are associated with some degree of delayed onset and offset of pharmacodynamic (PD) effects in patients with acute coronary syndromes (ACS) undergoing percutaneous coronary intervention (PCI). Although intravenous glycoprotein IIb/IIIa inhibitors are associated with rapid onset of action, they are also associated with delayed offset and other limitations such as elevated bleeding risk and thrombocytopenia. Areas covered: In this review, the authors focus on cangrelor, an intravenous, reversible P2Y12 receptor blocker with fast onset and offset of effects...
August 13, 2018: Expert Opinion on Pharmacotherapy
Samreen Shafiq, Tamara Pringsheim
Antipsychotic use in children has increased over the past two decades. Randomized controlled trials have evaluated the efficacy of antipsychotics in autism spectrum disorder (ASD) and disruptive behavior disorders (DBD). Areas covered: The authors systematically analyze the results of randomized controlled trials of second and third generation antipsychotics for irritability in ASD and aggressive and disruptive behavior in DBD with or without low IQ and ADHD. The aim of the review is to assist healthcare professionals to optimize therapy in this population...
August 13, 2018: Expert Opinion on Pharmacotherapy
Jane C Davies, Isaac Martin
Cystic fibrosis is characterized by bacterial lung infection, a majority of adults being chronically infected with Pseudomonas aeruginosa. Treatment is a major challenge, with frequent courses of antibiotics contributing to antimicrobial resistance. New approaches are clearly required. Over the last few years, a major shift in our approach to treating CF has occurred with the availability of the first drugs targeting the CFTR protein and leading to improvements in lung function, weight gain and frequency of exacerbations...
August 12, 2018: Expert Opinion on Pharmacotherapy
Adrian Wagg
Overactive bladder (OAB) and urgency incontinence are common in older people. Nevertheless, there remains a paucity of prospectively collected data on the efficacy of commonly used drug treatments for the condition. Many trials have included older people, but have seldom reported results stratified by age or reported adverse events of particular relevance to older people in clinical practice. This has partially been rectified with the introduction of more recently introduced antimuscarinic agents, particularly fesoterodine, and the beta-3-agonist, mirabegron...
August 9, 2018: Expert Opinion on Pharmacotherapy
Athanasios E Dellis, Athanasios G Papatsoris
Interstitial cystitis/bladder pain syndrome (IC/BPS) is a painful and debilitating clinical entity which is challenging to diagnose and even more difficult to treat. Unfortunately, none of the existing oral and intravesical medications have been established as effective and therefore relevant research is ongoing. Areas covered: In this review, the authors present established and emerging treatment options for IC/BPS in terms of medication and minimal invasive procedures. Both American and European Urological Association Guidelines recommend multimodal behavioral techniques alongside oral (e...
August 3, 2018: Expert Opinion on Pharmacotherapy
Theodosios Filippatos, Moses Elisaf, George Liamis
Hyponatremia is the most common electrolyte disorder with a prevalence of up to 30% in hospitalized patients. Furthermore, it is associated with increased morbidity and mortality. Areas covered: This review discusses the efficacy and side effects of the currently available treatment options for hyponatremia and the differences in the pharmacological approach between the European and USA guidelines. Additionally, the authors provide their expert perspectives on current treatment strategies and what they expect from this field in the future...
August 2, 2018: Expert Opinion on Pharmacotherapy
Alberto Enrico Maraolo, Ivan Gentile, Biagio Pinchera, Salvatore Nappa, Guglielmo Borgia
Spontaneous bacterial peritonitis (SBP) is the quintessential model of bacterial infection in cirrhotic patients. In these particularly frail subjects, infections clearly worsen prognosis increasing substantially mortality. Furthermore, treatment of SBP has become more challenging because of the growing impact of multidrug-resistant (MDR) bacteria. Areas covered: This review addresses the reasons behind the change in therapeutic recommendations for SBP that have occurred in the past few years, by focusing on the following aspects: the importance of an early appropriate empirical treatment, the difference between nosocomial and non-nosocomial forms and the overall microbiological shift (rise of Gram-positive bacteria and MDR strains) that have affected SBP...
August 2, 2018: Expert Opinion on Pharmacotherapy
Daniela Caldirola, Alessandra Alciati, Alice Riva, Giampaolo Perna
Several effective medications are available for treating panic disorder (PD). However, outcomes are unsatisfactory in a number of patients, suggesting the usefulness of expanding the array of antipanic drugs and improving the quality of response to current recommended treatments. Areas covered: The authors have performed an updated systematic review of pharmacological studies (phase III onwards) to examine whether advances have been made in the last five years. Only four studies were included. D-cycloserine no longer seemed promising as a cognitive-behavioral therapy (CBT) enhancer...
July 31, 2018: Expert Opinion on Pharmacotherapy
Jacek Wolf, Krzysztof Narkiewicz
No abstract text is available yet for this article.
July 30, 2018: Expert Opinion on Pharmacotherapy
Tomoyuki Nagata, Shinichiro Nakajima, Shunichiro Shinagawa, Yoshihiro Noda, Masaru Mimura
No abstract text is available yet for this article.
July 27, 2018: Expert Opinion on Pharmacotherapy
Sylvère Störmann, Jochen Schopohl
Cushing's disease is a rare systemic and disabling disease due to oversecretion of adrenocorticotrophic hormone (ACTH) resulting in excess cortisol levels. Diagnosis and treatment are difficult; despite the availability of various pharmaceutical treatment options, there is an ongoing, unmet need for even more effective treatment. Areas covered: The present review aims at providing an overview of available drugs and presenting new developments. Focusing on the pituitary as a target, the review covers compounds targeting pituitary cell signaling or cell cycle control such as heat shock protein inhibitors (e...
July 26, 2018: Expert Opinion on Pharmacotherapy
Olivia Cools, Kaat Hebbrecht, Violette Coppens, Laurence Roosens, Andy De Witte, Manuel Morrens, Hugo Neels, Bernard Sabbe
A seasonal affective disorder (SAD) is a subtype of unipolar and bipolar major depressive disorders. It is characterized by its annual recurrence of depressive episodes at a particular season, mostly seen in winter and is responsible for 10-20% of the prevalence of major depressive disorders. Some pathophysiological hypotheses, such as the phase delay and the monoamine depletion hypotheses, have been postulated but the exact cause has not been fully unraveled yet. Studies on treatment for SAD in the last decade are lacking...
July 26, 2018: Expert Opinion on Pharmacotherapy
Terence J Coderre
Neuropathic pain (NP) is a particularly severe and intractable chronic condition that is not well treated by commonly recommended systemic pharmacological therapies, partly due to dose-limiting side effects or adverse events. The use of topical therapeutics for NP is growing and benefits from the reduced potential for adverse effects, as well as the ability to directly target peripheral pathological processes. Areas covered: The current review defines and describes the limitations of various commonly prescribed systemic pharmacological therapies for NP...
July 25, 2018: Expert Opinion on Pharmacotherapy
Miguel A González-Gay, Trinitario Pina, Diana Prieto-Peña, Mónica Calderon-Goercke, Ricardo Blanco, Santos Castañeda
Polymyalgia rheumatica (PMR), a common disease in individuals older than 50 in the western world, is characterized by bilateral inflammatory pain involving the shoulder girdle and less commonly the neck and pelvic girdle. The main goals of the currently available treatment are to induce remission and prevent relapse. Areas covered: This review briefly presents the main epidemiological and clinical features of PMR and discusses in depth both its classical management as well as new therapies used in PMR. Expert opinion: In general, patients with isolated PMR experience a rapid response (in less than seven days) to 12...
July 24, 2018: Expert Opinion on Pharmacotherapy
Philip C Robinson, Nicola Dalbeth
Febuxostat is a potent non-purine selective xanthine oxidase inhibitor approved by the FDA in 2009 for management of hyperuricemia in people with gout. Areas covered: The authors summarize the pre-clinical studies and pivotal randomized controlled trials of febuxostat when used as a treatment for hyperuricaemia in gout Expert opinion: Febuxostat has clinical efficacy in serum urate lowering, and long-term use leads to improved outcomes such as gout flare frequency and tophus burden. Recently published post-approval placebo-controlled trials have demonstrated urate-lowering efficacy and safety of febuxostat in patients with chronic kidney disease, and reduced frequency of gout flares in people with early onset of gout...
July 19, 2018: Expert Opinion on Pharmacotherapy
Shuo Ma, Leonidas C Platanias
No abstract text is available yet for this article.
July 18, 2018: Expert Opinion on Pharmacotherapy
Ken Liu, Geoffrey W McCaughan
No abstract text is available yet for this article.
July 16, 2018: Expert Opinion on Pharmacotherapy
Davide Imberti, Claudio Cimminiello, Marcello Di Nisio, Marco Marietta, Hernan Polo Friz, Walter Ageno
Most of the current clinical guidelines recommend the use of Low-Molecular-Weight Heparins (LMWHs) for cancer-associated thrombosis (CAT). The Hokusai VTE-cancer trial reported the first results of a direct comparison between a direct oral anticoagulant (DOAC), edoxaban, and LMWH in this setting. Areas covered: This review aims to critically appraise the currently available evidence on the efficacy and safety of anticoagulant agents for the long-term treatment of CAT and to provide an expert opinion and guidance in this field...
July 16, 2018: Expert Opinion on Pharmacotherapy
Benjamin Cretin
Alzheimer's disease (AD)-related epileptic comorbidity is now well documented and appears to have been previously underestimated. Prescribing antiepileptic drugs (AEDs) in AD patients aims at preventing seizure-related morbi-mortality and the occurrence of deleterious status epilepticus. At the earlier stages of the disease, some clinicians even expect a disease-modifying effect. Areas covered: In this review, the author provides a brief overview of the epileptic comorbidity in AD, discusses the appropriate AEDs from a syndromic point of view, reviews the effectiveness and cognitive tolerability of the currently available drugs, and considers the influence of the comorbidities and the age of AD patients in the choice of an AED...
July 14, 2018: Expert Opinion on Pharmacotherapy
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