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Expert Opinion on Pharmacotherapy

Fabiola Zakia Mónica, Gilberto De Nucci
In men, lower urinary tract symptoms (LUTS) are primarily attributed to benign prostatic hyperplasia (BPH). Therapeutic options are targeted to relax prostate smooth muscle and/or reduce prostate enlargement. Areas covered: This article reviews the major preclinical and clinical data on PDE5 inhibitors with a specific focus on tadalafil. It includes details of the role of the nitric oxide (NO)-cyclic guanosine monophosphate (cGMP) - PDE5 pathway in the LUT organs (bladder and prostate) in addition to the available data on tadalafil in patients with LUTS secondary to BPH with or without erectile dysfunction (ED)...
March 22, 2019: Expert Opinion on Pharmacotherapy
Eun Lee, Soo-Jong Hong
The social and medical costs of bronchiectasis in children are becoming considerable due to its increasing prevalence. Early identification and intensive treatment of bronchiectasis are needed to decrease the morbidity and mortality associated with bronchiectasis in children. Area covered: This review presents the current pharmacotherapeutic strategies for treating bronchiectasis in children with a focus on non-cystic fibrosis bronchiectasis. Expert opinion: Evidence for the effectiveness of diverse treatment strategies in bronchiectasis is lacking, particularly in children, although the disease burden is substantial for bronchiectasis...
March 21, 2019: Expert Opinion on Pharmacotherapy
Gilbert G G Donders, Kateryna Ruban, Gert Bellen, Svitrigaile Grinceviciene
Despite its frequency, recognition and therapy of vulvovaginal atrophy (VVA) remain suboptimal. Wet mount microscopy, or vaginal pH as a proxy, allows VVA diagnosis in menopause, but also in young contraception users, after breast cancer, or postpartum. Intravaginal low dose estrogen product is the main therapy. Ultra-low-dose vaginal estriol is safe and sufficient in most cases, even in breast cancer patients, while hyaluronic acid can help women who cannot or do not want to use hormones. Areas covered: The authors provide an overview of the current pharmaceutical treatment for vulvovaginal atrophy and provide their expert opinions on its future treatment...
March 21, 2019: Expert Opinion on Pharmacotherapy
Markus Riessland
No abstract text is available yet for this article.
March 20, 2019: Expert Opinion on Pharmacotherapy
Susana Gutt, Silvio Schraier, Maria Florencia González Bagnes, Ming Yu, Claudio Daniel González, Guillermo Di Girolamo
The obesity epidemic continues to grow. Bariatric surgery is part of the arsenal to treat the disease. Surgery results in an effective option for patients with severe obesity but also when obesity is associated with significant comorbidities. Weight regain is frequent after bariatric surgery. Consequently, the addition of anti-obesity drugs to prevent and manage weight regain are commonly recommended even when the quality of the evidence supporting this recommendation is relatively weak. Areas covered: The aim of this review is to summarize the available evidence concerning long-term pharmacotherapy of obesity in patients that have undergone bariatric surgery with a focus on pharmacological prevention and management of weight regain...
March 18, 2019: Expert Opinion on Pharmacotherapy
Evdoxia Kyriazopoulou, Evangelos J Giamarellos-Bourboulis
The last five years, there have been considerable changes in our perception on the pathogenesis of sepsis. This review aims to summarize the current progress of the last five years in the management and research fields of sepsis in a holistic approach. To achieve this, accumulated evidence over the last five years coming from randomized clinical trials (RCTs) and observational studies in adults for the management of sepsis is provided. Areas covered: In this review, the authors discuss available strategies in sepsis, divided into standard-of-care and adjunctive therapies...
March 17, 2019: Expert Opinion on Pharmacotherapy
Hans L Tillmann, Gbeminiyi Samuel
Hepatitis B virus (HBV) infection remains a global challenge with several hundred million infected individuals. Disease activity can be controlled, and adverse outcomes prevented when treatment can be provided. Frequently life-long therapy is required instead of defined treatment periods such as with the case of Hepatitis C Virus (HCV) infection. Areas covered: In this review, the authors provide an overview of current start of the art therapy for HBV and indicate where variation from the current guidelines could be considered...
March 11, 2019: Expert Opinion on Pharmacotherapy
D Merlotti, A Falchetti, I Chiodini, L Gennari
Osteoporosis is a skeletal disorder characterized by loss of bone mass and strength affecting up to 30-50% of postmenopausal women worldwide. Current therapeutic options include antiresorptives such as aminobisphosphonates or denosumab and osteoanabolic compounds such as teriparatide. Areas covered: In this review, the authors summarize the clinical development, safety and efficacy profile of abaloparatide, a new osteoanabolic agent recently marketed in the US for the treatment of postmenopausal osteoporosis in women who are at high risk for fracture or who fail antiresorptive therapy...
March 11, 2019: Expert Opinion on Pharmacotherapy
Winfried Alsdorf, Christoph Seidel, Carsten Bokemeyer, Christoph Oing
With the implementation of platinum-based chemotherapy, germ cell tumors (GCTs) became a model for a curable solid tumor, with survival rates of 95% in all patients with >80% survival in metastatic stages. Areas covered: Herein, the authors review the current standards of adjuvant chemotherapy for stage I GCTs as well as first-line and salvage treatments for metastatic disease. Novel approaches for refractory disease are also reviewed. Expert opinion: Active surveillance should be considered for all stage I patients and is the preferred approach for stage I seminoma...
March 8, 2019: Expert Opinion on Pharmacotherapy
Isabel Cristina Valente Duarte De Sousa
Acne vulgaris is the most common skin disease worldwide, yet current treatment options, although effective, are associated with unwanted side effects, chronicity, relapses and recurrences. The adequate control of the four pathogenic mechanisms involved in the appearance of acne lesions is key to treatment success. This paper aims to discuss the novel treatment modalities that have surfaced in consequence of new knowledge obtained in acne pathogenesis. Areas covered: Pathogenic pathways are evaluated and discussed throughout the paper in relation to the mechanisms of action of novel molecules being investigated for the treatment of acne vulgaris...
March 8, 2019: Expert Opinion on Pharmacotherapy
Genya Aharon-Hananel, Itamar Raz
Accumulating data from recent studies has altered the gold standard of care for diabetes treatment. In patients with type 2 diabetes (T2D) and established cardiovascular disease (CVD) or those at high risk for CVD, subsequently to lifestyle changes and metformin therapy, the administration of an SGLT-2 inhibitor with established benefits for cardiovascular outcome (CVOT) should be considered. Areas covered: Tofogliflozin is the most selective SGLT-2 inhibitor and has been approved for the treatment of T2D in Japan...
March 5, 2019: Expert Opinion on Pharmacotherapy
Hiroki Murayama, Mitsutoshi Toda, Isao Tsumiyama, Yohei Shinfuku, Tomoko Taniguchi, Yoshio Tanaka, Naotsugu Oyama
BACKGROUND: Vildagliptin is indicated for type 2 diabetes mellitus (T2DM); however, the onset and exacerbation of diabetic complications in Japanese T2DM patients treated with vildagliptin is unknown. RESEARCH DESIGN AND METHODS: This 2-year post-marketing surveillance (PMS) assessed the real-world safety and efficacy of vildagliptin therapy in 19,218 Japanese T2DM patients. The relationship between the incidence of macro- and microvascular complications with patient characteristics and changes in glycemic control (HbA1c) were evaluated...
March 4, 2019: Expert Opinion on Pharmacotherapy
M Ruscica, M Banach, A Sahebkar, A Corsini, C R Sirtori
Tolerability problems in treating hypercholesterolemic patients undergoing statin treatment are of growing concern to physicians and patients, thus underlining the need for an agent with a similar mechanism but minimal side effects. A drug with a somewhat similar mechanism to statins but free of muscular side effects is ETC-1002 (bempedoic acid). It inhibits cholesterol biosynthesis at a step preceding HMG-CoA reductase, i.e. ATP citrate lyase (ACLY). A prodrug, ETC-1002 is converted to the active agent only in liver, not in skeletal muscle, and this may prevent any myotoxic activity...
February 27, 2019: Expert Opinion on Pharmacotherapy
Rodney A Gabriel, Matthew W Swisher, Jacklynn F Sztain, Timothy J Furnish, Brian M Ilfeld, Engy T Said
There are various important implications associated with poorly controlled postoperative pain in the adult surgical patient - this includes cardiopulmonary complications, opioid-related side effects, unplanned hospital admissions, prolonged hospital stay, and the subsequent development of chronic pain or opioid addiction. With the ongoing national opioid crisis, it is imperative that perioperative providers implement pathways for surgical patients that reduce opioid requirements and pain-related complications...
February 27, 2019: Expert Opinion on Pharmacotherapy
Rossella E Nappi, Barbara Gardella
No abstract text is available yet for this article.
February 26, 2019: Expert Opinion on Pharmacotherapy
Andrea Chiricozzi, Paolo Gisondi, Giampiero Girolomoni
Psoriasis is a chronic inflammatory skin disease that is increasingly being recognized as a complex disorder affecting multiple systems. Systemic inflammation is considered the pathogenic link between psoriasis and its comorbid conditions that include arthritis, metabolic disorders, depression, and cardiovascular diseases. The presence of comorbid conditions modifies both its clinical management and the therapeutic approach in psoriatic patients. Areas covered: This review describes the clinical, epidemiological, and pathogenic link between psoriasis and obesity...
February 22, 2019: Expert Opinion on Pharmacotherapy
Morohunfolu Akinnusi, Ali A El Solh
Insomnia is among the most reported sleep disturbances in patients with post-traumatic stress disorder (PTSD). The pervasiveness of this disorder among trauma-inflicted civilians and military personnel has been associated with reduced quality of life, impaired psychosocial functioning including cognitive impairments, negative mood swings, cardiovascular complications, and increased utilization of medical services. Areas covered: This review describes the current state of science with respect to the impact of the most dispensed pharmacological interventions for posttraumatic insomnia...
February 22, 2019: Expert Opinion on Pharmacotherapy
Taha Al Juhaishi, Victor Yazbeck
No abstract text is available yet for this article.
February 22, 2019: Expert Opinion on Pharmacotherapy
Daniele Roberto Giacobbe, Silvia Corcione, Antonio Salsano, Filippo Del Puente, Simone Mornese Pinna, Francesco Giuseppe De Rosa, Malgorzata Mikulska, Francesco Santini, Claudio Viscoli
Patients undergoing open-heart surgery may suffer from postoperative complications, including severe infections. Antimicrobials to treat infectious complications in this population should be selected thoughtfully, taking into account three different and fundamental issues: (i) the site of infection; (ii) the suspected or proven causative agent and its susceptibility pattern; and (iii) the risk of suboptimal pharmacokinetic characteristics and potential toxicity of the chosen drug/s. Areas covered: The present narrative review summarizes the current and future antimicrobial options for the treatment of infections developing after open-heart surgery...
February 20, 2019: Expert Opinion on Pharmacotherapy
Jessica L Dempsey, Andrew Johns, Ashley E Rosko, Hillard M Lazarus
Multiple myeloma is a disease predominately affecting older adults. Pivotal to treating older adults is understanding their physiologic differences compared to younger subjects and how the complexity of therapies has an impact upon this patient population. Areas covered: Herein, the authors address the efficacy of chemotherapy regimens, decision-making for older adults, chemotherapy-associated toxicity and the approach to management. This review focuses on the complex treatment of older multiple myeloma patients and management of treatment-related adverse events...
February 20, 2019: Expert Opinion on Pharmacotherapy
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