Future Prescriber最新文献

Although we have had efficacious medications for both schizophrenia and bipolar disorder for over half a century, there remains a clear need for more effective and better-tolerated treatments for both conditions. Current antipsychotics often have troubling side-effect profiles particularly with respect to weight gain and cardiometabolic parameters. These drawbacks also extend to treatment of mania and there are very few evidence-based treatments for the depressed phases of bipolar disorder. The introduction of a novel treatment with a potentially better risk-to-benefit profile is therefore welcome.

Sunovion Pharmaceuticals Europe is a new name to many in the UK but, as its range of innovative medicines comes to market, it will be an increasingly familiar one. Based in London, the company focuses on innovative medicines for areas of unmet clinical need that call for highly specialised early-stage clinical development.

The mortality associated with HIV has declined since the introduction of combination antiretroviral therapy (cART) and life expectancy for those who begin treatment early enough is now approaching that of the general population. However, key concerns in maintaining long-term control of HIV are side-effects and convenience/adherence. This review will discuss the available and recently introduced treatments, and the potential future therapies currently under investigation.

Rheumatoid arthritis (RA) is a chronic systemic inflammatory condition characterised by an erosive arthropathy and other extraarticular manifestations. It affects approximately 1 per cent of the population1 and the incidence is three times higher in women than men, peaking between the ages of 40 and 70 years. The disease has a significant impact on the quality of life of patients as well as on society at large and effective treatments are highly sought after. Although biologic therapies have transformed the management of RA, there is still scope for newer therapies and treatment strategies continue to evolve. This review will focus on the presently available treatments, the current unmet need and the future therapeutic strategy with a focus on some of newer molecules that show promise.

Canagliflozin is a sodium-glucose transporter protein inhibitor under development for the treatment of type 2 diabetes mellitus; it reduces circulatory glucose by facilitating its urinary excretion. In this Drug profile, Richard Donnelly discusses the need for drugs with a mode of action independent of insulin and considers the efficacy and tolerability of canagliflozin in clinical trials, to date, as well as its potential place in management. Copyright © 2013 John Wiley & Sons, Ltd.

Chronic obstructive pulmonary disease (COPD) is a major public health problem that is projected to be the third leading cause of mortality by 2030. The most common aetiological factor related to the development of COPD is tobacco smoking, but exposure to burning biomass and outdoor air pollution are also major risk factors. The prevalence of COPD is projected to increase due to continued exposure to these risk factors and the aging of the world's population. The molecular mechanisms underlying the pathogenesis of COPD are complex and poorly understood and this has hampered the development of new therapies. Copyright © 2013 John Wiley & Sons, Ltd.

Interest in bariatric surgery has gathered pace with wider awareness of its benefits for weight loss and for important weightrelated diseases, especially type 2 diabetes mellitus (T2DM). BS enables many patients with T2DM to achieve normal blood glucose levels and discontinue medication. This has generated lively debate about the role and cost-effectiveness of BS in treating T2DM and whether BS should be offered more widely. Paradoxically, however, these discussions seldom examine the health service perspective. This article summarises recent evidence and asks whether BS could replace conventional treatment for some people with T2DM. Copyright © 2013 John Wiley & Sons, Ltd.

Ingenol mebutate is a once-daily topical treatment for actinic keratosis (AK) that is applied for only two or three days depending on body site. It has recently been approved by the FDA for the treatment of AK on the face, scalp, trunk and extremities and recommended for approval by the CHMP in September 2012. In this drug profile, the author reviews its mode of action, efficacy and tolerability and comments on the drug's likely place in practice. Copyright © 2013 John Wiley & Sons, Ltd.

Dexmedetomidine is a sedating agent with a pharmacological and therapeutic profile that is unlike those of the most commonly used sedative agents (midazolam and propofol). In this article, we provide an over view of dexmedetomidine in terms of its pharmacokinetics and pharmacodynamics, and describe its place in the management of patients in intensive care. Copyright © 2013 John Wiley & Sons, Ltd.

Ruxolitinib is an orally administered JAK2 inhibitor for the treatment of disease-related splenomegaly or symptoms in primary myelofibrosis or myelofibrosis due to polycythaemia vera or essential thrombocythaemia. In our Drug profile Dr Adam Mead presents the clinical data relating to its efficacy and adverse events and comments on its place in therapy. Copyright © 2013 John Wiley & Sons, Ltd.