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Expert Review of Clinical Pharmacology

Nienke Halbmeijer, Michael Groeneweg, Lissy de Ridder
The onset of inflammatory bowel disease (IBD) in children is rising. Current treatment options are based on immunomodulatory therapy. Alternative treatment options are upcoming since they appear to be effective in individual patients. Cannabis might relief IBD symptoms in these cases and improve quality of life. Recent evidence suggests a potential anti-inflammatory effect of cannabis. Areas covered: This review presents an overview of recent literature on the use of cannabis in IBD focussing on pediatric IBD patients...
February 15, 2019: Expert Review of Clinical Pharmacology
Ruba Al-Abdulla, Laura Perez-Silva, Lorena Abete, Marta R Romero, Oscar Briz, Jose J G Marin
Anticancer chemotherapy often faces the problem of intrinsic or acquired drug refractoriness due in part to efficient mechanisms of defense present or developed, respectively, in cancer cells. Owing to their polarity and/or high molecular weight, many cytostatic agents cannot freely cross the plasma membrane by simple diffusion and hence depend on SLC proteins to enter cancer cells. The downregulation of these transporters and the appearance of either inactivating mutations or aberrant splicing, hampers the possibility of anticancer drugs to interact with their intracellular targets...
February 11, 2019: Expert Review of Clinical Pharmacology
Karel Allegaert, Sinno Simons, John van den Anker
Research on medication use aims at assessing how much of current pharmacotherapy is rational. In neonates, this is hampered by extensive off-label drug use and the limited knowledge. Areas covered: We report on medication use research and have conducted a systematic review of observational studies on medication use to provide an updated overview on characteristics, objectives, methods and patterns in hospitalized neonates. Moreover, a review on aspects of medication use for opioids, anti-epileptics, gastric acid related disorders and respiratory stimulants with emphasis on trends and impact of interventions is presented, illustrating how research on medication use can contribute to improved neonatal pharmacotherapy and more focused research...
February 9, 2019: Expert Review of Clinical Pharmacology
Giuseppe Cicala, Maria Antonietta Barbieri, Edoardo Spina, Jose de Leon
This is a comprehensive review of antipsychotic (AP)-induced dysphagia and its complications: choking and pneumonia. Areas covered: Four PubMed searches were completed in 2018. The limited literature includes: 1) 45 case reports of AP-induced dysphagia with pharmacological mechanisms, 2) a systematic review of APs as a risk factor for dysphagia, 3) reviews suggesting adult patients with intellectual disability (ID) and dementia are prone to dysphagia (APs are a risk factor among multiple others), 4) studies of the increased risk of choking in patients with mental illness (APs are a contributing factor), 5) naturalistic pneumonia studies suggesting that pneumonia may contribute to AP-increased death in dementia, and 6) naturalistic studies suggesting that pneumonia may be a major cause of morbidity and mortality in clozapine patients...
January 31, 2019: Expert Review of Clinical Pharmacology
Alessandro Loglio, Simone Segato, Pietro Lampertico
No abstract text is available yet for this article.
January 30, 2019: Expert Review of Clinical Pharmacology
Paula Prieto, Daniel Podzamczer
Although antiretroviral therapy is highly effective, many patients may benefit from switching strategies. Rapid advances in the development of new antiretroviral drugs could enhance the success of these approaches. In this review, we build on a previous review from 2014 and summarize the current options for switching strategies in virologically suppressed HIV-infected patients. Areas covered: We conduct a critical analysis of scientific evidence for various switching strategies used in the modern era of antiretroviral therapy, as well as reasons for these approaches, other considerations to be taken into account, and alternative strategies...
January 28, 2019: Expert Review of Clinical Pharmacology
Juan Eduardo Megías-Vericat, David Martínez-Cuadrón, Miguel Ángel Sanz, José Luis Poveda, Pau Montesinos
Induction chemotherapy based on anthracyclines and cytarabine (Ara-C) combination remains the standard of care for acute myeloid leukemia (AML) patients who are considered candidate for intensive and curative approaches. However, the toxicity of this regimen is high, with disappointing clinical outcomes among the so-called poor-prognosis AML subsets, which generally refer to patients with adverse cytogenetic risk, secondary AML including therapy-related AML, poor-prognosis mutations, especially FLT3-ITD, and relapse/refractory AML...
January 23, 2019: Expert Review of Clinical Pharmacology
Louise Kuhlmann, Søren S Olesen, Anne E Olesen, Lars Arendt-Nielsen, Asbjørn M Drewes
Introduction Pain is the most common symptom in chronic pancreatitis and treatment remains a challenge. Management of visceral pain in general, is only sparsely documented, and treatment in the clinic is typically based on empirical knowledge from somatic pain conditions. This may be problematic, as many aspects of the neurobiology differ significantly from somatic pain, and organs such as the gut and liver play a major role in tolerability to analgesics. On the other hand, clinical awareness and new methods for quantitative assessment of pain mechanisms, will likely increase our understanding of the visceral pain system and guide more individualized pain management...
January 21, 2019: Expert Review of Clinical Pharmacology
Junyi Yang, Weiliang Gong
Approximately 3-5% of patients with non-small cell lung cancer (NSCLC)belonged to anaplastic lymphoma kinase (ALK)-positive NSCLC. The treatment drugs of ALK-positive NSCLC mainly included crizotinib, ceritinib, alectinib and brigatinib. Although these drugs had some effects, most of them were usually easy to develop drug resistance. Lorlatinib is a new inhibitor of ALK for treating ALK-positive NSCLC,the effect is obvious, and not easy to develop resistance. Areas covered: The main mechanism of action, pharmacokinetics, clinical efficacy and safety of lorlatinib were introduced in this paper...
January 18, 2019: Expert Review of Clinical Pharmacology
Claudia Trojaniello, Lucia Festino, Vito Vanella, Paolo A Ascierto
Combination treatment with a BRAF inhibitor and MEK inhibitor is the standard of care for patients with advanced BRAFV600 mutation-positive melanoma. With the currently available combinations of dabrafenib plus trametinib and vemurafenib plus cobimetinib, median progression-free survival (PFS) of over 12 months has been achieved. However, treatment resistance and disease recurrence remain a clinical challenge. Areas covered: Encorafenib in combination with bimetinib offers a new approach that may offer benefits over existing BRAF/MEK inhibitor combinations...
January 17, 2019: Expert Review of Clinical Pharmacology
Xuesong Song, Dunwei Wang, Xiaoyu Qu, Naifu Dong, Shiyong Teng
Opioid-induced constipation (OIC) is a common adverse effect in patients under long-term opioid therapy. Naldemedine is a novel peripherally acting μ-opioid receptor antagonists being developed for the treatment of OIC without affecting central analgesia. This meta-analysis is to assess the current evidence for efficacy and safety of naldemedine for the treatment of OIC. Areas covered: We searched through MEDLINE, EMBASE, Web of Science and Cochrane Library, "ISRCTN Register" and"ClinicalTrials...
January 17, 2019: Expert Review of Clinical Pharmacology
Lance R McMahon
Green tobacco sickness occurs from transdermal absorption of chemicals from freshly harvested, green tobacco leaves. Signs and symptoms include nausea, vomiting, headache, and abdominal cramps. Prevalence has shifted from the United States and Europe to China, India, and Brazil. Worldwide 8 million individuals are afflicted, including women and children. Areas covered: Mecamylamine (Inversine®, Vecamyl®), a nicotinic acetylcholine receptor (nAChR) antagonist, should be tested as a remedy for green tobacco sickness...
January 16, 2019: Expert Review of Clinical Pharmacology
Junyi Yang
Hereditary transthyretin-mediated amyloidosis is caused by a mutation in transthyretin (TTR) gene resulting in misfolded TTR protein accumulating as amyloid fibrils. Patisiran is a lipid nanoparticle formulation of ribonucleic acid interference (RNAi), which can reduce the production of TTR. Areas covered: In this review, the chemical property, mechanism of action, pharmacokinetics, clinical efficacy, safety of patisiran were introduced. Expert Commentary: Patisiran offers a new treatment option for patients with hereditary transthyretin-mediated amyloidosis...
January 15, 2019: Expert Review of Clinical Pharmacology
Wojciech Jurczak, Monika Długosz-Danecka, Michael Wang
Although advances in mantle cell lymphoma (MCL) therapy have improved overall survival (OS), managing relapsed/refractory (R/R) cases remains a great challenge. Bruton tyrosine kinase (BTK) inhibitors have broadened therapeutic options in MCL and became the backbone of second-line strategies. Areas covered: Ibrutinib, the first-in-class BTK inhibitor registered for MCL therapy, is efficient, with clear benefits of its use. However, ibrutinib-related adverse events due to off-target inhibition of other kinases led to the development of more selective molecules with comparable efficacy and better safety profiles...
January 14, 2019: Expert Review of Clinical Pharmacology
Lung-Yi Mak, Wai-Kay Seto, James Fung, Man-Fung Yuen
Chronic hepatitis B (CHB) infection causes considerable morbidity and mortality and hence should be a target for global elimination. In recent years, advances have been made in understanding the disease pathophysiology and the relationship to clinical outcome. Novel treatment targets are actively being sought in the hope of improving the treatment outlook. Areas covered: We discussed the cascade of cure of CHB with respect to the degree of persistence of viral genome and proteins. Several novel antiviral agents either targeting the virus or the host are in different clinical phases of development...
January 8, 2019: Expert Review of Clinical Pharmacology
(no author information available yet)
No abstract text is available yet for this article.
December 29, 2018: Expert Review of Clinical Pharmacology
Jordan M Cloyd, Bhavana Konda, Manisha H Shah, Timothy M Pawlik
Gastroenteropancreatic (GEP) neuroendocrine tumors (NETs) are a unique and complex neoplasm, exhibiting a wide spectrum of diverse clinical behaviors. The contemporary management of well-differentiated GEP-NETs is marked by the availability of a wide range of targeted therapies. Areas Covered: For patients with localized or oligometastatic disease, surgical resection remains the preferred approach and is associated with excellent long-term outcomes. For patients with unresectable but isolated liver metastases, multiple liver-directed therapies, including hepatic arterial based therapies and ablative techniques, exist...
December 24, 2018: Expert Review of Clinical Pharmacology
Andrea Giacomelli, Sonia de Rose, Stefano Rusconi
Introduction Combined antiretroviral therapy (cART) has transformed an inexorably fatal disease into a chronic pathology, shifting the focus of research from the control of viral replication to the possibility of HIV cure. Areas covered The present review assesses the principal pharmacological strategies that have been tested for an HIV cure starting from the in vitro proof of concept and the potential rationale of their in vivo applicability. We evaluated the possible pharmacological procedures employed during the early-stage HIV infection and the possibility of cART-free remission...
December 20, 2018: Expert Review of Clinical Pharmacology
Giovanni Targher, Stefano Bonapace, Christopher D Byrne
No abstract text is available yet for this article.
December 20, 2018: Expert Review of Clinical Pharmacology
Uffe Ravnskov, Michel de Lorgeril, David M Diamond, Rokuro Hama, Tomohito Hamazaki, Björn Hammarskjöld, Niamh Hynes, Malcolm Kendrick, Peter H Langsjoen, Luca Mascitelli, Kilmer S McCully, Harumi Okuyama, Paul J Rosch, Tore Schersten, Sherif Sultan, Ralf Sundberg
No abstract text is available yet for this article.
December 18, 2018: Expert Review of Clinical Pharmacology
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