Alexia Bikou, Foteini Dermiki-Gkana, Michail Penteris, Theodoros K Constantinides, Christos Kontogiorgis
INTRODUCTION: Semaglutide, a glucagon-like peptide-1 receptor agonist, is associated with significant weight loss, yet its impact on lean body mass remains insufficiently understood. This review investigates the effect of semaglutide on lean mass in the context of obesity management. METHODOLOGY: This study investigates through different databases (PubMed, Elsevier, and Google Scholar) from 2016 for randomized control trials (RCTs) or observational studies that assessed the use of semaglutide in overweight or obese patients, regardless of whether they have type 2 diabetes or not...
April 18, 2024: Expert Opinion on Pharmacotherapy
M Ammar Kalas, Irene Sarosiek, Richard W McCallum
INTRODUCTION: Gastroparesis is a chronic disorder characterized by decreased gastric emptying and presents with nausea, vomiting, and abdominal pain which impacts patients' quality of life greatly. The treatment modalities available for gastroparesis have been expanding over the past 2 decades. Currently there are multiple options available for gastroparesis albeit with only one FDA approved medication until June of 2021. AREAS COVERED: We review the different treatments available for gastroparesis and discuss the recently FDA approved intranasal formulation of metoclopramide...
April 17, 2024: Expert Opinion on Pharmacotherapy
Antonella Bruzzese, Enrica Antonia Martino, Caterina Labanca, Francesco Mendicino, Eugenio Lucia, Virginia Olivito, Annamaria Zimbo, Valentina Fragliasso, Antonino Neri, Fortunato Morabito, Ernesto Vigna, Massimo Gentile
INTRODUCTION: Myelofibrosis (MF) is a hematologic disease characterized by bone marrow fibrosis, cytopenias, splenomegaly, and constitutional symptoms. Recent years have seen the emergence of novel therapeutic agents, notably ruxolitinib and fedratinib, which target the Janus kinases (JAK) pathway. However, their myelosuppressive effect coupled with the persistence, and even worsening anemia remains a significant challenge, leading usually to treatment discontinuation. AREAS COVERED: This review focuses on Momelotinib (MMB), a unique JAK inhibitor that has shown promise in MF treatment, particularly in improving anemia...
April 16, 2024: Expert Opinion on Pharmacotherapy
Aditya K Gupta, Avantika Mann, Shruthi Polla Ravi, Tong Wang
INTRODUCTION: The reports of resistance to antifungal agents used for treating onychomycosis and other superficial fungal infections are increasing. This rise in antifungal resistance poses a public health challenge that requires attention. AREAS COVERED: This review explores the prevalence of dermatophytes and the current relationship between dermatophyte species, their minimum inhibitory concentrations (MICs) for terbinafine (an allylamine) and itraconazole (an azole), and various mutations prevalent in these species...
April 16, 2024: Expert Opinion on Pharmacotherapy
Katherine Gunther, David R Lynch
INTRODUCTION: Friedreich ataxia (FRDA) is a rare autosomal recessive disease, marked by loss of coordination as well as impaired neurological, endocrine, orthopedic, and cardiac function. There are many symptomatic medications for FRDA, and many clinical trials have been performed, but only one FDA-approved medication exists. AREAS COVERED: The relative absence of the frataxin protein (FXN) in FRDA causes mitochondrial dysfunction, resulting in clinical manifestations...
April 15, 2024: Expert Opinion on Pharmacotherapy
Paweł Sobczuk, Michał Cholewiński, Piotr Rutkowski
INTRODUCTION: Increasing evidence from preclinical and clinical studies suggests the role of vascular endothelial growth factor (VEGF) signaling in melanoma progression, response to therapy, and overall survival. Moreover, the discovery of the potential involvement of the VEGF pathway in resistance to immunotherapy has led to new clinical trials with VEGFR inhibitors. AREAS COVERED: We have reviewed recent literature, mainly published within the last 5 years, on VEGFR-targeted treatments for advanced melanoma, including mucosal, acral, and uveal melanoma...
April 12, 2024: Expert Opinion on Pharmacotherapy
Parvej Khan, Sparsh Saini, Shadan Hussain, Haya Majid, Sparsh Gupta, Nidhi Agarwal
INTRODUCTION: Ganaxolone has exhibited potential in managing seizures for epilepsy. This systematic review and meta-analysis aim to assess both the safety and efficacy of Ganaxolone for refractory epilepsy. METHODS: A thorough search of electronic databases was conducted to identify relevant randomized controlled trials involving patients with drug-resistant focal epilepsy and CDKL5 deficiency disorder. Efficacy and safety outcomes were extracted from the selected studies...
April 12, 2024: Expert Opinion on Pharmacotherapy
Yuan Zhang, Luo Zhang
No abstract text is available yet for this article.
April 11, 2024: Expert Opinion on Pharmacotherapy
Samantha M Ruff, Timothy M Pawlik
INTRODUCTION: Hepatocellular carcinoma (HCC) is a primary liver cancer that commonly arises in the background of chronic liver inflammation and/or cirrhosis. Chronic liver inflammation results in the production of different growth factors, remodeling of the microenvironment architecture into fibrosis, and eventually carcinogenesis. Overexpression of some growth factors has been associated with worse prognosis in patients with HCC. Targeted therapies against growth factors may disrupt cell signaling and the mechanisms that allow for cell survival (e...
April 9, 2024: Expert Opinion on Pharmacotherapy
Benedetto Neri, Roberto Mancone, Mariasofia Fiorillo, Sara Concetta Schiavone, Elena De Cristofaro, Stefano Migliozzi, Livia Biancone
INTRODUCTION: Despite the growing number of highly efficacious biologics and chemical drugs for ulcerative colitis (UC), steroid-free disease control is still difficult to achieve in subgroups of patients due to refractoriness, adverse events, primary or secondary failure. New treatments are therefore still required in order to optimize clinical management of patients with UC. AREAS COVERED: The efficacy and safety of both currently available and newly developed small molecules have been summarized...
April 9, 2024: Expert Opinion on Pharmacotherapy
Tetsuya Taguchi, Hisashi Matsushima, Sho Kodama, Naoki Okubo, Tetsuo Ito, Maja Ludwikowska, Seiji Fukumoto, Toshio Matsumoto
BACKGROUND: Hormone therapy with aromatase inhibitors (AIs) for estrogen receptor-dependent breast cancer may expose patients to an increased osteoporosis risk. This study was performed to estimate fracture risk in women with breast cancer to whom AIs were prescribed in Japan. METHODS: This retrospective study used data from the Japanese Medical Data Vision database. Women with breast cancer prescribed AIs over a 12-month period were identified and matched to women not prescribed AIs using a propensity score...
April 8, 2024: Expert Opinion on Pharmacotherapy
Zandra E Walton, Matthew J Frigault, Marcela V Maus
INTRODUCTION: Chimeric antigen receptor (CAR) T cells have revolutionized treatment of multiple hematologic malignancies. Engineered cellular therapies now offer similar hope to transform management of solid tumors and autoimmune disease. However, toxicities can be serious and often require hospitalization. AREAS COVERED: We review the two chief toxicities of CAR T therapy, cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS), and the rarer immune effector cell-associated hemophagocytic lymphohistiocytosis-like syndrome...
April 8, 2024: Expert Opinion on Pharmacotherapy
Elif Şenocak Taşçı, Yasin Kutlu, Ömer Fatih Ölmez, Arda Ulaş Mutlu, Yasemin Gündoğdu, Mustafa Seyyar, Elif Şahin, Devrim Çabuk, Nargiz Majidova, İrem Uğurlu, Ayşe Demirci, Dinçer Aydın, Eyüp Çavdar, Selami Bayram, Nilgün Yıldırım, Fatih Karataş, Melek Karakurt Eryılmaz, Dilek Çağlayan, Serkan Menekşe, Engin Kut, Hacı Arak, Murat Keser, Veli Sunar, Perihan Perkin, Teoman Şakalar, Başak Oyan, Özlem Sönmez, Leyla Özer, İbrahim Yıldız
BACKGROUND: Triple negative breast cancer (TNBC) is characterized by high rates of recurrence, especially in patients with residual disease after neoadjuvant chemotherapy (NAC). Capecitabine is being used as standard adjuvant treatment in residual TNBC. We aimed to investigate the real-life data regarding the efficacy of capecitabine in residual TNBC. DESIGN AND METHODS: In this retrospective multicenter study, TNBC patients with residual disease were evaluated...
April 3, 2024: Expert Opinion on Pharmacotherapy
Erika Stucchi, Michela Bartolini, Marco Airoldi, Roberta Fazio, Valentina Daprà, Giuseppe Mondello, Maria Giuseppina Prete, Alberto Puccini, Armando Santoro
INTRODUCTION: Available treatments for colorectal cancer are limited. However, in the last few years several advances and new treatment options became available and expanded the continuum of care in metastatic colorectal cancer (mCRC). AREAS COVERED: Fruquintinib, a tyrosine kinase inhibitor, has been shown to be effective in heavily pretreated mCRC progressing to trifluridine-tipiracil (FTD/TPI) or regorafenib or both. Preclinical studies have shown that fruquintinib inhibits with high selectivity VEGFR 1-2-3, leading to a blockade in angiogenesis process, but also acts, with weak inhibition, on RET, FGFR-1, and c-kit kinases...
April 3, 2024: Expert Opinion on Pharmacotherapy
Houssein Safa, Chiara Mercinelli, Philippe E Spiess, Andrea Necchi, Jad Chahoud
INTRODUCTION: Penile squamous cell carcinoma (PSCC), a rare genitourinary cancer, is associated with poor outcomes due to limited treatment effectiveness, especially in advanced stages. AREAS COVERED: While chemotherapy and/or surgery remain the standard of care, emerging therapies like immunotherapy, targeted therapy, and human papillomavirus (HPV) directed therapies show promise. Key to advancing treatment is understanding the immune microenvironment to gain insights into tumor resistance mechanisms and potential therapeutic targets...
March 29, 2024: Expert Opinion on Pharmacotherapy
Fotios Barkas, Kausik Ray
INTRODUCTION: The burden of atherosclerotic cardiovascular disease (ASCVD) persists globally, demanding innovative therapeutic strategies. This manuscript provides an expert opinion on the significance of managing low-density lipoprotein cholesterol in ASCVD prevention and introduces inclisiran, a novel small interfering RNA targeting proprotein convertase subtilisin/kexin type 9 (PCSK9). AREAS COVERED: This work delves into the intricate mechanism of inclisiran, highlighting its unique approach of hepatic intracellular PCSK9 inhibition, its precision and low off-target effects risk...
March 28, 2024: Expert Opinion on Pharmacotherapy
Sanem Pinar Uysal, John A Morren
INTRODUCTION: Myasthenia gravis (MG) is an autoimmune condition targeting the neuromuscular junction, which manifests with neuromuscular symptoms of varying severity and significant morbidity. The mainstay of treatment in MG is mitigation of the immune cascade with steroids and non-steroidal immunosuppressive therapies. The therapeutic strategies in MG are transitioning from broad and indiscriminate immunosuppression to novel agents targeting key steps in MG pathogenesis, including T cell activation, B cell proliferation, complement activation, maintenance of pathogenic antibody production, and proinflammatory cytokine production...
March 25, 2024: Expert Opinion on Pharmacotherapy
Georgios D Kotzalidis, Federica Fiaschè, Alessandro Alcibiade, Laura Monti, Federica Di Segni, Marianna Mazza, Gabriele Sani
INTRODUCTION: Suicidal behavior is relatively frequent in patients with bipolar disorder (BD) and constitutes their most frequent cause of death. Suicide rates remain high in patients with BD despite adherence to guidelines recommending lithium as first line, and/or antidepressants, antipsychotics, psychotherapy, psychosocial interventions, and electroconvulsive therapy. Hence the need to identify more effective and rapid anti-suicide interventions. AREAS COVERED: To tackle the unmet needs of pharmacotherapy, we investigated the PubMed database on 24-25 January 2024 using strategies like ('acute suicid*'[ti] OR 'suicide crisis syndrome' OR 'acute suicidal affective disturbance') AND (lithium[ti] OR clozapine[ti]), which obtained 3 results, and ('acute suicid*'[ti] OR 'suicide crisis syndrome' OR 'acute suicidal affective disturbance') AND (ketamine[ti] OR esketamine[ti] OR NMDA[ti] OR glutamat*[ti]), which yielded 14 results...
March 22, 2024: Expert Opinion on Pharmacotherapy
Alexia Leber, Ranuk Ramachandra, Felicia Ceban, Angela T H Kwan, Taeho Greg Rhee, Jie Wu, Bing Cao, Muhammad Youshay Jawad, Kayla M Teopiz, Roger Ho, Gia Han Le, Diluk Ramachandra, Roger S McIntyre
INTRODUCTION: We systematically reviewed extant studies evaluating the efficacy and tolerability of xanomeline and xanomeline-trospium (KarXT) for treatment of adults with schizophrenia. METHODS: In accordance with PRISMA guidelines, articles were systematically searched for in databases and clinical trial registries. RESULTS: A total of 4 preclinical trials and 3 randomized controlled trials (RCTs) were included in this review. A 4-week RCT observed a difference of 24...
March 21, 2024: Expert Opinion on Pharmacotherapy
Axel Dignass, Philip Esters, Cathrin Flauaus
INTRODUCTION: The small molecule and oral selective and reversible Janus kinase (JAK) inhibitor upadacitinib has been approved for the treatment of moderate to severe active Crohn's disease (CD) in adult patients since April 2023 by EMA/FDA. AREAS COVERED: The approval is based on the two induction studies a maintenance study showing that upadacitinib induction and maintenance therapy was superior to placebo. The approval of upadacitinib in CD expands the therapeutic armamentarium for the management of inflammatory bowel diseases (IBD)...
March 21, 2024: Expert Opinion on Pharmacotherapy
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