PubMed Journal Database | Expert opinion on pharmacotherapy 
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Showing PubMed Articles 1–25 of 223 from Expert opinion on pharmacotherapy
Current treatment options for hyperprolactinemia.
Introduction: Hyperprolactinemia is a prevalent cause of oligo-amenorrhea, and prolactinomas are the most common type of functional pituitary tumor. Untreated hyperprolactinemia can lead to bone loss and impair gonadal function and fertility. Normalization of prolactin improves bone mass and restores gonadal function in a majority of patients. Areas covered: This article contains an overview of hyperprolactinemia with an emphasis on pharmacologic, surgical and radiation treatment options. Discussion focuses...
Introduction: Non-steroidal anti-inflammatory drugs (NSAIDS) are commonly used for acute pain management. Lornoxicam is a nonselective NSAID for oral and intravenous administration. It has been available for human use since two decades and there is a growing body of evidence supporting its efficacy and tolerability for management of acute pain. Areas covered: Public domain literature around the clinical use of lornoxicam for acute pain management has been reviewed. Expert opinion: There are a growing number...
Identifying the challenges of biomarkers that predict response to HER2-directed therapies.
The identification of the human epidermal growth factor receptor 2 (HER2) as a targetable marker of adverse prognosis along with the development of HER2-directed therapies, have significantly improved outcomes for women with HER2-overexpressing breast cancers. However, both resistance to treatment and treatment-related toxicities have contributed to a less-than-ideal effect even as we have access to an increasing number of HER2-directed therapies making treatment selection potentially complex. Therefore, id...
Introduction: Acute lymphoblastic leukemia (ALL) is the most common hematologic malignancy in children. Treatment-related cardiac damage is progressive and often difficult to reverse. Strategies to minimize cardiotoxicity during treatment are crucial to prevent severe lasting effects on health and quality of life. Areas covered: This comprehensive review covers the pathophysiology and various presentations, both clinical and subclinical, of treatment-induced cardiotoxicity and characteristics associated wit...
Icosapent ethyl for the treatment of hypertriglyceridemia.
Introduction: Icosapent ethyl (IPE; Vascepa) is a high-purity prescription form of eicosapentaenoic acid (EPA) ethyl ester recently approved in 2012 to reduce triglyceride (TG) levels in adult patients with severe (≥ 500 mg/dL) hypertriglyceridemia. Elevated TG levels are associated with increased risk for coronary heart disease. Currently available TG-lowering agents (fibrates, niacins, omega-3 fatty acid products containing both EPA and docosahexaenoic acid [DHA]) may be associated with adverse effects...
Peginesatide as a new approach for treating anemia of CKD patient: is it like a falling star?
Any scientific innovation needs to translate into a significant benefit. Peginesatide is noninferior to other erythropoiesis stimulating agents (ESAs) in terms of efficacy, and it shares the advantages of other long-acting ESAs: delayed administration frequency and no changes in dose needs according to the administration route. The molecular structure of peginesatide does not require the use of recombinant DNA technology during the manufacturing process, making its synthesis simpler and likely economically...
Introduction: Phosphodiesterase type 5 inhibitors (PDE5-i) are used for the oral treatment of erectile dysfunction (ED). Since the launch of sildenafil more than 15 years ago, new molecules have become available. At present, in addition to tadalafil and vardenafil, there are three other drugs, udenafil, avanafil and mirodenafil, marketed in some countries which appear to be promising. Areas covered: The clinical pharmacological differences in dosage and side effects of all PDE5-i are evaluated. Expert opini...
Bilastine for the treatment of urticaria.
Introduction: Urticaria is a highly prevalent disease among people. First-choice treatment continues to be centred on the second-generation H1 antihistamines, including a wide group of drugs with a better therapeutic index (or risk:benefit ratio) than the classic ones, even in the high, off-label dosage occasionally required in chronic urticaria. Bilastine is a newly registered H1-antihistamine for treatment of allergic rhinoconjunctivitis and urticaria. With established antihistaminic and antiallergic prop...
Treatment options for esophageal squamous cell carcinoma.
Introduction: The treatment for esophageal squamous cell carcinoma (SCC) depends on its etiology. For mucosal cancer, endoscopic resection is standard; while for locally advanced cancer, esophagectomy is the main treatment. When the tumor is more advanced, neoadjuvant or adjuvant therapy is added. For unresectable cancer, concurrent chemoradiotherapy is the standard therapy. Areas covered: The standard chemotherapy for esophageal SCC is a cisplatin- and 5-fluorouracil (CF)-based regimen. Chemoradiotherapy (...
Pharmacological management of essential thrombocythemia.
Introduction: Two factors have deeply influenced the area of essential thrombocythemia (ET). A gain-of-function mutation in the pseudokinase region of the JAK2 gene, which partly explains the pathophysiology of myeloproliferative neoplasms (MPNs), was discovered in 2005 and is present in 50 - 60% of ET patients. Furthermore, the 2008 WHO MPN classification outlined criteria for the separation of ET and early or prefibrotic primary myelofibrosis (PMF). However, these and other new findings have not yet chang...
Treating myoclonic epilepsy in children: state-of-the-art.
Introduction: Myoclonic seizures can be observed in various clinical settings and different epileptic conditions, including some forms of both diopathic and symptomatic epilepsies. Relatively little has been written on treatment of myoclonic seizures. Some old antiepileptic drugs, such as valproate and some benzodiazepines, are widely used but more treatment options exist today for some newer antiepileptic drugs. Nevertheless, patients can be refractory to drug treatment and some drugs may exacerbate or eve...
Imidafenacin for the treatment of overactive bladder.
Introduction: Imidafenacin (KRP-197/ONO-8025) is the latest antimuscarinic (AM) developed for the treatment of overactive bladder syndrome (OAB) and, at the moment, it is marketed only in Japan. This compound has been developed to improve the tolerability of AM therapy by binding specifically the M3 receptor subtype, thus limiting undesirable adverse events (AEs). Areas covered: This systematic review offers a brief explanation of the mechanism of action and of the pharmacokinetics of imidafenacin and helps...
There is a debate as to whether percutaneous coronary intervention (PCI) with drug-eluting stents or coronary artery bypass surgery (CABG) is the best procedure for subjects with type 2 diabetes and coronary artery disease requiring revascularization. There is some evidence that by following these procedures, there is less further revascularization with CABG than PCI in subjects with diabetes. Two recent studies, namely, the FREEDOM (Future Revascularization Evaluation in patients with Diabetes mellitus: Op...
Perioperative statin therapy: current knowledge and future directions.
Perioperative statin therapy has come to represent a cornerstone of risk reduction for millions of patients who undergo cardiac and noncardiac surgeries. While large-scale, robust, randomized controlled studies support the use of statins in cardiac surgery, their role in noncardiac surgery has become ambiguous following concerns regarding scientific misconduct in many pivotal studies. In this edition of the Expert Opinion on Pharmacotherapy, Irwin et al. comprehensively summarize the evidence for perioperat...
Comment on: Leishmaniasis: an update of current pharmacotherapy.
Introduction: Inhaled antibiotics are probably the safest and most effective therapy for Pseudomonas aeruginosa chronic lung infection in cystic fibrosis (CF) patients. Areas covered: To summarise the available evidence, a systematic review of the three currently available inhaled antibiotics (aztreonam lysine (AZLI), colistin (COL) and tobramycin (TOB)) was performed. The three AZLI placebo-controlled studies showed that the improvements in FEV1 and mean sputum P. aeruginosa density were statistically sign...
Evaluation of everolimus in renal cell cancer.
Introduction: The incidence of renal cell cancer (RCC) has been steadily increasing over the past decade. Advances in understanding the pathophysiology and carcinogenesis RCC have led to the development of novel therapies that target molecular pathways. Everolimus is a synthetic, orally available analogue of rapamycin that inhibits the activation of mTOR. Everolimus extended progression-free survival in RCC patients from 1.9 months (for patients receiving a placebo) to 4.9 months. Grades 3 and 4 adverse eve...
Aclidinium bromide for the treatment of chronic obstructive pulmonary disease.
Introduction: Although there are some challenges with current therapies, the growing evidence that tiotropium bromide is important in the maintenance treatment of chronic obstructive pulmonary disease (COPD) has led to enthusiastic investigation in search of novel muscarinic antagonists which share some of the beneficial characteristics of tiotropium and perhaps improve upon less desirable ones. Areas covered: Aclidinium bromide is a new muscarinic antagonist that has been developed to relieve symptoms in p...
Etravirine for the treatment of HIV/AIDS.
Introduction: Etravirine (TMC125) is an orally administered second-generation non-nucleoside reverse transcriptase inhibitor (NNRTI) that is approved in treatment-experienced patients as addition to an optimized background therapy (OBT). Areas covered: A Medline search was conducted of Phase II - IV clinical trials, as well as a review of abstracts from major HIV and infectious disease conferences from 2010 - 2013, involving etravirine. Expert opinion: Etravirine is a well-tolerated NNRTI with a good safety...
An update on the pharmacotherapy of neovascular age-related macular degeneration.
Introduction: Neovascular age-related macular degeneration (AMD) is currently the most common cause of legal blindness in industrialized countries. The advent of pharmacotherapy with intravitreal VEGF inhibitors has greatly improved outcomes for the treatment of this disease. Areas covered: The present review is divided into two major sections: the period prior to the use of anti-VEGF agents (triamcinolone acetonide, verteporfin photodynamic therapy) and the period following their introduction (pegaptanib s...
Current pharmacotherapeutical options for the prevention of kidney transplant rejection.
Introduction: Advances in immunosuppression and medical care over the past years resulted in better short- and long-term graft survival following kidney transplantation. Novel potent immunosuppressive agents, combinations of proven substances and the steadily expanding knowledge on the pathophysiology of kidney transplant rejection allows the extension of donor and recipient criteria, including the usage of organs from ABO-incompatible and crossmatch-positive donors, to overcome the increasing problem of or...
Current pharmacotherapy of nocturia.
Introduction: Nocturia is a bothersome urologic symptom and is defined as awakening from sleep once or more times to void. The condition is highly prevalent in men and women and increases in prevalence with age. Impact on quality of life is substantial as is the associated morbidity and mortality. Areas covered: A PubMed literature search was undertaken to identify evidence for the currently available and utilized pharmacotherapy options for the treatment of nocturia. Available pharmacologic treatments incl...
Introduction: Helicobacter pylori infection is generally treated with therapies that include a proton pump inhibitor (PPI) and, at least, two antibiotics being clarithromycin one of the most used. Antibiotic resistance, mainly to clarithromycin, seems to be increasing in many geographical areas, and this factor is considered a main cause leading to a treatment failure when the later therapies contain this antibiotic again. As clarithromycin is a key antibiotic in the eradication of H. pylori, the election o...
The acute chest syndrome of sickle cell disease.
Introduction: Acute chest syndrome (ACS), a leading cause of morbidity and mortality in sickle cell disease (SCD), is an acute illness characterized by fever and/or respiratory symptoms, accompanied by a new pulmonary infiltrate on a chest X-ray. There is increasing knowledge regarding the etiology and pathogenesis of ACS in SCD. A high index of suspicion is required for the diagnosis of ACS. Treatment of ACS involves the judicious use of intravenous fluids and analgesics, aggressive incentive spirometer an...
Efficacy and safety of fluoxetine monotherapy in bipolar depression: a systematic review.
Introduction: The treatment of depressive episodes in bipolar disorder (BD) remains a challenge for clinicians and is a hot topic in current psychiatric practice. In the present review, we focused on efficacy and safety of fluoxetine monotherapy in order to identify published randomized double-blind trials and open-label trials, written in English, reporting the outcome of fluoxetine treatment in depressed bipolar patients. Areas covered: We searched Pubmed to identify published randomized double-blind tria...
