Future Prescriber最新文献

The armentarium of potential therapeutics for rheumatoid arthritis (RA) has grown with the identification of relevant disease molecules. Of these, biologic therapeutics targeting tumour necrosis factor-alpha (TNF-alpha), particularly when used in combination with oral methotrexate, have enjoyed notable success in suppressing inflammation and markedly inhibiting the progression of structural damage previously thought to be an unavoidable characteristic of RA.^1,2 However, despite the unprecedented clinical and commercial successes of TNF inhibitors, their availability is restricted by high costs and the failure of a substantial proportion of patients to demonstrate significant clinical responses. Copyright © 2007 John Wiley & Sons, Ltd.

Efforts to combat the Human Immunodeficiency Virus (HIV) began in earnest in the late 1980s following the identification and isolation of HIV as the pathogen of the Acquired Immunodeficiency Syndrome (AIDS). Multiple-drug therapy, known as highly active antiretroviral therapy (HAART), became available in the 1990s and has become the backbone of HIV medication treatment. Understanding of how to optimise its use and effectiveness continues to grow, and is reflected by the emergence of novel agents and new classes of drugs. Copyright © 2007 Wiley Interface Ltd

A quiet revolution is taking place within the NHS as laboratories grad-ually switch from serum creatinine to estimated glomerular filtration rate (eGFR) as the prime measure of renal function. This change follows recommendations in the National Service Framework for Renal Services,1 but the move will have an impact far beyond the renal com-munity, affecting health profess-ionals and patients throughout primary and secondary care. Copyright © 2006 John Wiley & Sons, Ltd.

Inflammatory bowel disease is a common and complicated disorder that has a great impact on the lives of those affected. This review discusses the properties and uses of the treatments available and possible future advances in therapy. Copyright © 2007 Wiley Interface Ltd

Type 2 diabetes mellitus (T2DM) is a global epidemic with an expected prevalence of 380 million in 2025 worldwide¹ and over 2.5 million by 2010 in the UK.² Diabetes is a progres-sive disease which leads to macro and microvascular complications and reduced life expectancy.² Furthermore, diabetes-related complications have been shown to worsen patients' quality of life.^3,4 Copyright © 2008 John Wiley & Sons, Ltd.

Pulmonary arterial hypertension (PAH) is a rare, severe and progressive disease characterised by raised pressures in the arteries in the lungs leading to right heart failure and, historically, a median life expectancy of 2.8 years with-out targeted treatment.¹ Pathologically, it is characterised by a thickening of the muscular layer of the arteries, dysfunction of the vessel walls, and abnormal growth of supporting cells such as fibroblasts. Copyright © 2007 Wiley Interface Ltd

Gliptins represent an emerging new class of oral agents to treat type 2 diabetes. They act by inhibiting the enzyme dipeptidyl peptidase-4 (DPP-4). This enzyme inactivates the incretin hormones glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP). These hormones are released from the intestine during a meal and act on the pancreas to increase nutrient-stimulated insulin secretion. Thus DPP-4 inhibitors serve as incretin enhancers; they delay inactivation of GLP-1 and GIP, increasing the insulin response to a meal, which improves glycaemic control. This therapeutic approach carries a low risk of interprandial hypoglycaemia and does not cause weight gain. The first gliptin, sitagliptin (Januvia), was introduced in the UK in April 2007 as ‘add-on’ therapy for patients with type 2 diabetes inadequately controlled with metformin or a thiazolidinedione. Other gliptins, notably vildagliptin (Galvus), saxagliptin and alogliptin are advanced in clinical development. Copyright © 2007 John Wiley & Sons, Ltd.