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Expert Review of Clinical Pharmacology

Rafael G Dos Santos, José Carlos Bouso, Miguel Ángel Alcázar-Córcoles, Jaime E C Hallak
Mood, anxiety, and substance use disorders are among the most prevalent psychiatric disorders in the population. Although several pharmacological treatments are available, they are not effective for a significant proportion of patients and are associated with several adverse reactions. Therefore, new treatments should be explored. Recent with serotonergic hallucinogens/psychedelics including ayahuasca, psilocybin and lysergic acid diethylamide (LSD) suggest that these drugs have anxiolytic, antidepressive, and antiaddictive effects...
August 13, 2018: Expert Review of Clinical Pharmacology
Keith C Ferdinand, Miyako Igari
No abstract text is available yet for this article.
August 13, 2018: Expert Review of Clinical Pharmacology
Ling Wang, Shaoming Wang, Juan Qi, Rongguo Yu, Jie Zhuang, Boyang Zhuang, Yongming Lou, Junshan Ruan, Hong Ye, Fangfang Lin
BACKGROUND: Dexmedetomidine is a widely used sedative in clinic, which is mainly metabolized by cytochrome P450 2A6 (CYP2A6). Dexmedetomidine was rarely reported for off-label usage of premedication, but lacking relevant pharmacokinetic investigations. Therefore, our study determined the dexmedetomidine pharmacokinetics of CYP2A6*4 allele in Chinese patients pretreated with dexmedetomidine whose mutation frequency of CYP2A6*4 are high, in order to provide clinical references. METHODS: Thirty-one elective surgery patients received premedication with 0...
August 9, 2018: Expert Review of Clinical Pharmacology
Kristina Johnell
No abstract text is available yet for this article.
August 9, 2018: Expert Review of Clinical Pharmacology
Manuel Gorostidi, Alejandro de la Sierra
Hypertension is the leading cause of mortality and disability worldwide. Despite the proven benefits of blood pressure (BP) reduction, lack of BP pressure control continues to be the most important clinical problem in hypertension management. Areas covered: Factors involved in the lack of BP control and strategies to improve such control have been reviewed, with special focus on the usefulness of combination therapies, those types of combination which include a renin-angiotensin system (RAS) blocker, with diuretics, calcium channel blockers, or both...
August 9, 2018: Expert Review of Clinical Pharmacology
Yiliang Li, Hai Liu, Wei Peng, Zhi Song
Introduction Clinical trials concerning the effects of nicorandil in stable coronary artery disease (CAD) remain controversial. This study sought to evaluate the clinical outcomes of nicorandil following elective percutaneous coronary intervention (PCI). Areas covered A meta-analysis including eligible randomized controlled trials (RCTs) with data on the nicorandil in stable CAD from Pubmed, EMBase, and Cochrane library (up to March 2018) was conducted. The primary endpoints were postprocedural incidence of myocardial infarction (MI) and contrast-induced nephropathy (CIN)...
August 6, 2018: Expert Review of Clinical Pharmacology
Maddalena Napolitano, Claudio Marasca, Gabriella Fabbrocini, Cataldo Patruno
Adult atopic dermatitis (AD) is very difficult to manage. Indeed, AD in adults is frequently refractory to topical treatment, especially with regards to the persistent form. Therefore, long-term treatment with oral immunosuppressive therapy is often required to control the burden of the disease, prevent flare-ups and achieve better patient quality of life outcomes. Areas covered: In the last decade the better understanding of AD pathogenesis has been used to improve treatment strategies with many emerging therapeutics options...
August 3, 2018: Expert Review of Clinical Pharmacology
Hugo Geerts, Ronald Gieschke, Richard Peck
The success rate of pharmaceutical Research & Development (R&D) is much lower compared to other industries such as micro-electronics or aeronautics with the probability of a successful clinical development to approval in central nervous system (CNS) disorders hovering in the single digits (7%). Areas covered: Inspired by adjacent engineering-based industries, we argue that quantitative modeling in CNS R&D might improve success rates. We will focus on quantitative techniques in early clinical development, such as PharmacoKinetic-PharmacoDynamic modeling, clinical trial simulation, model-based meta-analysis and the mechanism-based physiology-based pharmacokinetic modeling, and quantitative systems pharmacology...
August 3, 2018: Expert Review of Clinical Pharmacology
Sermsiri Sangroongruangsri, Tanapat Ratanapakorn, Olivia Wu, Thunyarat Anothaisintawee, Usa Chaikledkaew
Anti-vascular endothelial growth factor (VEGF) therapy has become the most commonly used treatment for macular edema secondary to retinal vein occlusion (RVO). Although its superior efficacy as compared to other interventions has been proven, there is a lack of evidence for relative efficacy among anti-VEGF drugs. Areas covered: This work systematically reviewed and compared the efficacy of intravitreal bevacizumab, ranibizumab, and aflibercept for treating macular edema due to RVO. PubMed, EMBASE, and the Cochrane Library were searched from their inception until October 2017...
August 2, 2018: Expert Review of Clinical Pharmacology
Junyi Yang
Type 2 diabetes mellitus (T2DM) is a growing and serious global health problem. Inhibition of the sodium--glucosecotransporter-2 (SGLT2) can increase urinary glucose excretion and decrease plasma glucose levels in an insulin-independent manner. Ertugliflozin is a highly selective inhibitor of SGLT2, and was approved in the US for the treatment of adults with T2DM. Areas covered: In this paper, the mechanism of action, pharmacokinetics, clinical efficacy, safety, etc., of ertugliflozin have been introduced. Expert commentary: Ertugliflozin offers a novel, therapeutic approach to T2DM...
July 31, 2018: Expert Review of Clinical Pharmacology
Atibordee Meesing, Raymund R Razonable
Cytomegalovirus (CMV) is a common opportunistic infection that causes significant morbidity and preventable mortality after solid-organ and allogeneic hematopoietic stem cell transplantation. Areas covered: Current strategies of pharmacological treatment of CMV in solid-organ and hematologic stem cell transplantation are reviewed. The role of the newly approved drug, letermovir, and other novel investigational compounds is discussed. The complementary role of viral and immunologic monitoring in guiding the optimal role of pharmacologic agents on the management of CMV after transplantation is highlighted...
July 26, 2018: Expert Review of Clinical Pharmacology
Silvano Bertelloni, Cristina Mucaria, Giampiero I Baroncelli, Diego Peroni
Triptorelin depot is largely used to treat central precocious puberty (CPP) in children. Areas covered: This review updates triptorelin depot treatment of CPP, focusing on trials that compared 3.75 mg/28 day treated and untreated children till the adult height (AH). Efficacy of the new 11.25 mg/90 days or 22.5 mg/6 month formulations in suppressing pituitary-gonadal axis in short-term trials is also addressed. Short- and long-term safety was summarized. Expert commentary: Long experience on triptorelin depot use in children with CPP is available...
July 26, 2018: Expert Review of Clinical Pharmacology
Elena Fountzilas, Apostolia M Tsimberidou
Introduction In recent years, the therapeutic management of selected patients with cancer has shifted towards the 'Precision Medicine" approach based on patient's mechanisms of tumorigenesis, and their baseline characteristics and comorbidities. Complete tumor and cell-free DNA profiling using next-generation sequencing, proteomic and RNA analysis, and immune mechanisms should to be taken into consideration and accurate bioinformatic analysis is essential to optimize patient's treatment. Areas covered The challenges and opportunities of conducting clinical trials in precision oncology are summarized...
July 25, 2018: Expert Review of Clinical Pharmacology
Sherifa A Hamed, Tarek A Rageh, Amany O Mohamad, Suzan M Abou Elnour
OBJECTIVES: Clinical and subclinical laboratory evidence of renal proximal tubular dysfunction had been reported in children with epilepsy as an adverse effect of some antiepileptic drugs (AEDs). This study aimed to determine kidney function in adult patients with monosymptomatic epilepsy of unknown etiology and treated with valproate (VPA) or carbamazepine (CBZ). METHODS: This study included 60 patients [mean age of 33.97 ± 6.70 years and treated with VPA (n = 24) or CBZ (n = 36) for mean duration of treatment of 6...
July 25, 2018: Expert Review of Clinical Pharmacology
James Dugan, Daniel Pollyea
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...
July 24, 2018: Expert Review of Clinical Pharmacology
Barbara Błaszczyk, Barbara Miziak, Piotr Czuczwar, Ewa Wierzchowska-Cioch, Ryszard Pluta, Stanisław J Czuczwar
Considering that there are around 30% of patients with epilepsy resistant to monotherapy, the use of synergistic combinations of antiepileptic drugs is of particular importance. This review shows most beneficial as well as irrational combined treatments both from an experimental and clinical point of view. Areas covered: Preferably, experimental data derived from studies evaluating synergy, additivity, or antagonism by relevant methods, in terms of anticonvulsant or neurotoxic effects and pharmacokinetic data have been considered...
July 23, 2018: Expert Review of Clinical Pharmacology
Sebastiano Mercadante
No abstract text is available yet for this article.
July 23, 2018: Expert Review of Clinical Pharmacology
Ashish Correa, Yogita Rochlani, Mohammed Hassan Khan, Wilbert S Aronow
Cardiovascular disease is a leading cause of mortality in the elderly. Hypertension is an important modifiable risk factor that contributes to cardiovascular morbidity and mortality. The prevalence of hypertension is known to increase with age, and hypertension has been associated with an increase in risk for cardiovascular disease in the elderly. There is a wealth of evidence that supports aggressive control of blood pressure to lower cardiovascular risk in the general population. However, there are limited data to guide management of hypertension in the elderly and frail patient subgroups...
July 23, 2018: Expert Review of Clinical Pharmacology
Thomas M Polasek, Sepehr Shakib, Amin Rostami-Hodjegan
No abstract text is available yet for this article.
July 20, 2018: Expert Review of Clinical Pharmacology
Farnaz Foolad, Samuel L Aitken, Roy F Chemaly
Allogeneic hematopoietic cell transplants (allo-HCT) recipients are at high-risk of reactivation of cytomegalovirus (CMV), and reactivation is associated with significant morbidity and mortality. Although available anti-CMV therapies may be effective for prevention of CMV, they are plagued by unacceptable toxicities that prohibit their use in the post-transplant period. Recently studied CMV-active agents, such as maribavir and brincidofovir, failed to reduce the incidence of CMV infection in HCT recipients...
July 13, 2018: Expert Review of Clinical Pharmacology
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