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Efficacy and Safety of Combination Therapy With Low Dose of Telmisartan and S-Amlodipine in Patients With Hypertension: A Randomized, Double-Blind, Multicenter, Therapeutic Confirmatory, Phase III Clinical Trial 低剂量替米沙坦和s -氨氯地平联合治疗高血压患者的疗效和安全性:一项随机、双盲、多中心、治疗性验证的III期临床试验
IF 3.6 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2026-03-01 Epub Date: 2026-02-10 DOI: 10.1016/j.clinthera.2026.01.001
Sang Hyun Lee MD, PhD , Kyungil Park MD, PhD , Ki Hong Lee MD, PhD , Yoonhaeng Cho MD, PhD , Dae-Hee Kim MD, PhD , Sungmin Lim MD, PhD , Seong Bo Yoon MD, PhD , Jae-Sik Jang MD, PhD , Hong-Seok Lim MD, PhD , Joon-Hyung Doh MD, PhD , Dae-Young Kim MD , Il Suk Sohn MD, PhD , Dae Young Cheon MD , Myung Hwan Bae MD, PhD , Sung Hea Kim MD, PhD , Yonggu Lee MD, PhD , Sang Hyun Ihm MD, PhD , Rak Kyeong Choi MD, PhD , Hun-Jun Park MD, PhD , Wook Bum Pyun MD, PhD , Jinho Shin MD, PhD

Purpose

This randomized, double-blind, multicenter, phase III clinical trial aimed to evaluate the efficacy and safety of telmisartan 20 mg and s-amlodipine 1.25 mg, a fixed-dose combination (Tel/S-Amlo) versus telmisartan 20 mg single therapy or s-amlodipine 1.25 mg single therapy for initial treatment in patients with hypertension.

Methods

After a wash-out/therapeutic lifestyle change period of ≥4 weeks, a total of 235 eligible patients were randomized and received 1 of 3 treatments for 8 weeks: (1) telmisartan 20 mg/s-amlodipine 1.25 mg (Tel/S-Amlo), (2) telmisartan 20 mg (Tel), or (3) S-amlodipine 1.25 mg (S-Amlo). The primary endpoint was the efficacy evaluation of Tel/S-Amlo by comparing changes in mean sitting systolic blood pressure (msSBP) from baseline after 8 weeks of treatment.

Findings

At 8 weeks, the least square (LS) mean (SE) change in msSBP was −20.04 (1.46) mm Hg in the Tel/S-Amlo group, compared with –16.44 (1.46) mm Hg in the Tel group (between-group difference –3.60 (1.78) mm Hg, P-value = 0.0451). Similarly, the Tel/S-Amlo group showed a change of −21.12 (1.33) mm Hg versus −15.58 (1.32) mm Hg in the S-Amlo group (between-group difference –5.53 (1.61) mm Hg, P-value = 0.0008). There were no statistically significant differences in the incidence of overall AEs and adverse drug reactions among the 3 groups, and no serious adverse events occurred during the study.

Implications

Combination therapy with a low-dose of telmisartan and s-amlodipine may be a promising initial treatment for patients with hypertension.

Clinical trial registration

This study was registered in ClinicalTrials.gov (NCT06121518).
目的:这项随机、双盲、多中心、III期临床试验旨在评估替米沙坦20mg和s-氨氯地平1.25 mg,固定剂量组合(Tel/S-Amlo)与替米沙坦20mg单药或s-氨氯地平1.25 mg单药初始治疗高血压患者的疗效和安全性。方法:在洗脱期/治疗性生活方式改变期≥4周后,共有235例符合条件的患者随机接受3种治疗中的1种,为期8周:(1)替米沙坦20mg /s-氨氯地平1.25 mg (Tel/S-Amlo),(2)替米沙坦20mg (Tel),或(3)s-氨氯地平1.25 mg (S-Amlo)。主要终点是通过比较治疗8周后平均坐位收缩压(msSBP)与基线的变化来评估Tel/S-Amlo的疗效。结果:8周时,Tel/S-Amlo组msSBP的最小二乘(LS)平均(SE)变化为-20.04 (1.46)mm Hg,而Tel组为-16.44 (1.46)mm Hg(组间差异为-3.60 (1.78)mm Hg, p值= 0.0451)。同样,Tel/S-Amlo组的变化为-21.12 (1.33)mm Hg,而S-Amlo组为-15.58 (1.32)mm Hg(组间差异为-5.53 (1.61)mm Hg, p值= 0.0008)。三组患者总不良反应发生率及药物不良反应发生率比较,差异均无统计学意义,研究期间均未发生严重不良事件。意义:低剂量替米沙坦和s-氨氯地平联合治疗可能是高血压患者的一种有希望的初始治疗方法。临床试验注册:本研究已在ClinicalTrials.gov (NCT06121518)注册。
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引用次数: 0
The Use of Ensemble Large Language Models to Predict Patient Nonadherence 使用集成大语言模型预测患者不依从。
IF 3.6 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2026-03-01 Epub Date: 2026-02-17 DOI: 10.1016/j.clinthera.2026.01.011
Jill L. Maron MD, MPH
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引用次数: 0
A Century of Antibiotic War on Neisseria gonorrhoeae: New Hope With New First-in-Class Drug Developments 一个世纪的淋病奈瑟菌抗生素战争:新的一流药物开发带来的新希望。
IF 3.6 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2026-03-01 Epub Date: 2026-02-26 DOI: 10.1016/j.clinthera.2026.01.012
Stephanie Pisciella MD , Nicholas G. Guerina MD, PhD
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引用次数: 0
Profiling of Potential Postmarket Risk Tracking and Pharmacovigilance Data for Avacopan Avacopan潜在上市后风险跟踪和药物警戒数据分析
IF 3.6 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2026-03-01 Epub Date: 2026-01-27 DOI: 10.1016/j.clinthera.2025.12.017
Zhilan Zhou , Lurong Yu , Jiaoni Zheng , Yao He , Lili Xia , Qingyan Jia , Limei Liu

Purpose

Avacopan emerges as a significant therapeutic agent for the condition known as antineutrophil cytoplasmic antibody–associated vasculitis. However, there is a lack of current real-world safety studies with large sample sizes. The objective of this study is to scrutinize avacopan’s postcommercialization safety profile, thereby providing an informed foundation for its clinical application.

Methods

Using 2 methods, including the Bayesian confidence propagation neural network and reporting odds ratio (ROR), we conducted signal mining on all avacopan adverse event reports in the US Food and Drug Administration Adverse Event Reporting System from the third quarter of 2021 to the fourth quarter of 2024 to evaluate the safety profile of avacopan.

Findings

The US Food and Drug Administration Adverse Event Reporting System database recorded 7141 adverse events related to avacopan, involving 3135 patients. The proportion of female patients who experienced adverse events is higher than that of male patients. We found that 225 patients died, with more deaths among those aged 65 years and above and male patients. This signal mining identified 17 systemic organ classifications, including a total of 136 adverse eventsignals, such as antineutrophil cytoplasmic antibody increased (ROR = 357.69; 95% CI, 150.92–847.75; information coefficient = 8.27; lower limit of the CI = 1.60), biopsy kidney (ROR = 106.68; 95% CI, 33.48–339.94; information coefficient = 6.67; lower limit of the CI = 0.47). In addition, we also discovered new adverse events, such as alopecia, sepsis, pulmonary hemorrhage, hypertransaminasemia, deafness, and insomnia.

Implications

This study reveals the potential risks of avacopan use and found significant differences in adverse events between genders and age groups. Further prospective studies are needed to validate the current findings, refine risk warnings and monitoring strategies for different populations, and explore strategies to reduce or prevent adverse reactions.
目的:avacopan是抗中性粒细胞细胞质抗体相关血管炎的重要治疗药物。然而,目前缺乏大样本量的实际安全性研究。本研究的目的是仔细审查avacopan商业化后的安全性概况,从而为其临床应用提供知情基础。方法采用贝叶斯置信传播神经网络和报告优势比(ROR) 2种方法,对美国食品药品监督管理局不良事件报告系统中从2021年第三季度到2024年第四季度的所有avacopan不良事件报告进行信号挖掘,评价avacopan的安全性。美国食品和药物管理局不良事件报告系统数据库记录了7141例与阿伐科泮相关的不良事件,涉及3135例患者。女性患者发生不良事件的比例高于男性患者。我们发现225例患者死亡,其中65岁及以上患者和男性患者死亡较多。该信号挖掘共识别出17个系统器官分类,包括136个不良事件信号,如抗中性粒细胞胞浆抗体升高(ROR = 357.69, 95% CI, 150.92-847.75;信息系数= 8.27,CI下限= 1.60)、肾活检(ROR = 106.68, 95% CI, 33.48-339.94;信息系数= 6.67,CI下限= 0.47)。此外,我们还发现了新的不良事件,如脱发、败血症、肺出血、高转氨酶血症、耳聋和失眠。本研究揭示了avacopan使用的潜在风险,并发现性别和年龄组之间不良事件的显著差异。需要进一步的前瞻性研究来验证当前的发现,完善针对不同人群的风险预警和监测策略,并探索减少或预防不良反应的策略。
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引用次数: 0
Comment on: The Effect of Intermittent Fasting Diet in Comparison With Low-Calorie Diet on Inflammation, Lipid Profile, Glycemic Index, Liver Fibrosis in Patients With Metabolic-Associated Fatty Liver Disease (MAFLD): A Randomized Controlled Trial 评论:与低热量饮食相比,间歇性禁食饮食对代谢性脂肪性肝病(MAFLD)患者炎症、脂质谱、血糖指数、肝纤维化的影响:一项随机对照试验。
IF 3.6 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2026-03-01 Epub Date: 2025-08-26 DOI: 10.1016/j.clinthera.2025.08.002
Hongda Xu , Tuocen Fan , Yiyang Xu , Wenhao Li , Junrui Cui
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引用次数: 0
Unseen but Impactful: Gout as a Neglected Comorbidity in Cardiovascular Care 看不见但有影响:痛风是心血管护理中被忽视的合并症。
IF 3.6 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2026-03-01 Epub Date: 2026-02-19 DOI: 10.1016/j.clinthera.2026.01.006
Zaayneb Sediqi MD , Oliver Buchhave Pedersen MD, PhD , Søren Jepsen PhD , Steen Hylgaard Jørgensen MD, PhD , Claus Rasmussen MD, PhD

Background

Cardiovascular diseases (CVD) affect about 6% of the global population and are a leading cause of death. Gout impacts approximately 3% of the population, and many do not receive adequate urate-lowering therapy to prevent disease progression. Gout is frequent in patients with CVD, and poorly managed gout is associated with cardiovascular complications, warranting proper gout treatment. This study assessed adherence to recommended gout treatment in patients with CVD.

Methods

From a prospective cohort of gout patients confirmed by microscopy-identified urate crystals, we identified those with concomitant CVD (ischemic heart disease, atrial fibrillation, or heart failure). Patients were treated in real-life healthcare settings. The primary outcome was achieving recommended target serum urate levels 2 years postdiagnosis: <0.36 mmol/L for general gout management and <0.30 mmol/L for patients with tophi.

Results

Of 286 gout patients, 117 (41%) had CVD. The median age was 71 years, 76% were male, and most had multiple comorbidities. Recommended urate levels to prevent disease progression were achieved by 59%. However, 45% had tophi at diagnosis, and only 33% of these achieved levels sufficient to dissolve tophi. The mean prescribed dose of allopurinol was 253 mg/day, which was often insufficient to achieve target urate levels.

Conclusion

Gout in patients with CVD is often inadequately managed, potentially increasing the risk of serious cardiovascular events. These findings reflect typical treatment settings. Optimizing allopurinol dosing and adherence to gout treatment guidelines may improve gout-related outcomes and could potentially have implications for cardiovascular risk. These findings highlight gout as a relevant comorbidity in patients with CVD and suggest that greater attention to gout management in cardiovascular care pathways may be warranted.
背景:心血管疾病(CVD)影响全球约6%的人口,是导致死亡的主要原因之一。痛风影响大约3%的人口,许多人没有接受足够的降尿酸治疗来预防疾病进展。痛风常见于心血管疾病患者,管理不善的痛风与心血管并发症有关,需要适当的痛风治疗。本研究评估了心血管疾病患者对推荐的痛风治疗的依从性。方法:从显微镜下鉴定尿酸盐晶体证实的痛风患者的前瞻性队列中,我们确定了伴有CVD(缺血性心脏病、心房颤动或心力衰竭)的患者。患者在真实的医疗环境中接受治疗。主要结局是诊断后2年达到推荐的血清尿酸水平:结果:286例痛风患者中,117例(41%)患有心血管疾病。中位年龄为71岁,76%为男性,多数有多种合并症。预防疾病进展的推荐尿酸水平达到59%。然而,45%的患者在诊断时含有痛风石,其中只有33%的患者达到了足以溶解痛风石的水平。别嘌呤醇的平均处方剂量为253毫克/天,通常不足以达到目标尿酸水平。结论:CVD患者的痛风往往管理不当,潜在地增加了严重心血管事件的风险。这些发现反映了典型的治疗环境。优化别嘌呤醇剂量和遵守痛风治疗指南可能改善痛风相关结果,并可能对心血管风险有潜在影响。这些发现强调痛风是心血管疾病患者的相关合并症,并建议在心血管护理途径中更多地关注痛风管理是有必要的。
{"title":"Unseen but Impactful: Gout as a Neglected Comorbidity in Cardiovascular Care","authors":"Zaayneb Sediqi MD ,&nbsp;Oliver Buchhave Pedersen MD, PhD ,&nbsp;Søren Jepsen PhD ,&nbsp;Steen Hylgaard Jørgensen MD, PhD ,&nbsp;Claus Rasmussen MD, PhD","doi":"10.1016/j.clinthera.2026.01.006","DOIUrl":"10.1016/j.clinthera.2026.01.006","url":null,"abstract":"<div><h3>Background</h3><div>Cardiovascular diseases (CVD) affect about 6% of the global population and are a leading cause of death. Gout impacts approximately 3% of the population, and many do not receive adequate urate-lowering therapy to prevent disease progression. Gout is frequent in patients with CVD, and poorly managed gout is associated with cardiovascular complications, warranting proper gout treatment. This study assessed adherence to recommended gout treatment in patients with CVD.</div></div><div><h3>Methods</h3><div>From a prospective cohort of gout patients confirmed by microscopy-identified urate crystals, we identified those with concomitant CVD (ischemic heart disease, atrial fibrillation, or heart failure). Patients were treated in real-life healthcare settings. The primary outcome was achieving recommended target serum urate levels 2 years postdiagnosis: &lt;0.36 mmol/L for general gout management and &lt;0.30 mmol/L for patients with tophi.</div></div><div><h3>Results</h3><div>Of 286 gout patients, 117 (41%) had CVD. The median age was 71 years, 76% were male, and most had multiple comorbidities. Recommended urate levels to prevent disease progression were achieved by 59%. However, 45% had tophi at diagnosis, and only 33% of these achieved levels sufficient to dissolve tophi. The mean prescribed dose of allopurinol was 253 mg/day, which was often insufficient to achieve target urate levels.</div></div><div><h3>Conclusion</h3><div>Gout in patients with CVD is often inadequately managed, potentially increasing the risk of serious cardiovascular events. These findings reflect typical treatment settings. Optimizing allopurinol dosing and adherence to gout treatment guidelines may improve gout-related outcomes and could potentially have implications for cardiovascular risk. These findings highlight gout as a relevant comorbidity in patients with CVD and suggest that greater attention to gout management in cardiovascular care pathways may be warranted.</div></div>","PeriodicalId":10699,"journal":{"name":"Clinical therapeutics","volume":"48 3","pages":"Pages 226-231"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146257688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
BLUJEPA (gepotidacin) BLUJEPA (gepotidacin)。
IF 3.6 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2026-03-01 Epub Date: 2026-02-18 DOI: 10.1016/j.clinthera.2026.01.009
Paul Beninger MD, MBA
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引用次数: 0
Corrigendum to "A Nationwide Cohort Study on Antidepressant Use and Stroke Risk in Young Adults Aged 18-44 Years" [Clin Ther. 2025;47:720-728]. “18-44岁年轻人抗抑郁药物使用与卒中风险的全国队列研究”的勘误表[临床医学杂志,2025;47:720-728]。
IF 3.6 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2026-02-24 DOI: 10.1016/j.clinthera.2026.01.013
Lu-Hsuan Wu, Ching-Lan Cheng, Yea-Huei Kao Yang, Swu-Jane Lin
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引用次数: 0
Effects of Etomidate Injection on Succinylcholine-Induced Fasciculation. 依托咪酯注射液对琥珀胆碱诱导的束状反应的影响。
IF 3.6 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2026-02-23 DOI: 10.1016/j.clinthera.2026.01.014
Wei Wang, Jun Guo, Bo Chen, Zhijian Lan, Yongjin Fang

Purpose: To assess the effect of etomidate injection on succinylcholine-induced fasciculations through a randomized controlled trial.

Methods: Intravenous succinylcholine (2 mg/kg) was administered to 100 adult patients undergoing elective vocal cord surgery, with allocation to two groups: immediate group, where succinylcholine was administered immediately, and delayed group, where succinylcholine was administered 15 sec after injection of etomidate 0.2 mg/kg. The two groups were compared in terms of the severity and duration of muscle fasciculation caused by succinylcholine and the incidence of postoperative myalgia.

Findings: The severity of fasciculations graded on a 4-point scale was considered the primary outcome. Compared with the delayed group, the immediate group exhibited substantially reduced fasciculation severity scores (P = 0.005). A lower incidence of postoperative myalgia was observed in the immediate group than in the delayed group (P = 0.031). Furthermore, in the delayed group, the heart rate after intervention decreased more significantly (P = 0.014). No differences in other adverse effects were observed.

Implications: The severity of succinylcholine-induced fasciculations and the incidence of postoperative myalgia were significantly reduced without adversely affecting intubation conditions or hemodynamics by injecting a 0.2 mg/kg dose of etomidate immediately before administering 2 mg/kg succinylcholine.

目的:通过一项随机对照试验,评价依托咪酯注射液对琥珀胆碱诱导的束状反应的影响。方法:对100例择期声带手术患者静脉注射琥珀胆碱(2 mg/kg),分为两组:立即给药组和延迟给药组,分别在注射依托咪酯0.2 mg/kg后15秒给予琥珀胆碱。比较两组琥珀胆碱引起的肌束收缩的严重程度和持续时间以及术后肌痛的发生率。结果:以4分制分级的束控严重程度被认为是主要结局。与延迟组相比,立即组的束状纹严重程度评分明显降低(P = 0.005)。术后肌痛发生率即刻组低于延迟组(P = 0.031)。延迟组干预后心率下降更明显(P = 0.014)。其他不良反应未见差异。意义:在给予2 mg/kg琥珀胆碱之前立即注射0.2 mg/kg剂量的依托咪酯,可以显著降低琥珀胆碱诱导的束状反应的严重程度和术后肌痛的发生率,而不会对插管条件或血流动力学产生不利影响。
{"title":"Effects of Etomidate Injection on Succinylcholine-Induced Fasciculation.","authors":"Wei Wang, Jun Guo, Bo Chen, Zhijian Lan, Yongjin Fang","doi":"10.1016/j.clinthera.2026.01.014","DOIUrl":"https://doi.org/10.1016/j.clinthera.2026.01.014","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the effect of etomidate injection on succinylcholine-induced fasciculations through a randomized controlled trial.</p><p><strong>Methods: </strong>Intravenous succinylcholine (2 mg/kg) was administered to 100 adult patients undergoing elective vocal cord surgery, with allocation to two groups: immediate group, where succinylcholine was administered immediately, and delayed group, where succinylcholine was administered 15 sec after injection of etomidate 0.2 mg/kg. The two groups were compared in terms of the severity and duration of muscle fasciculation caused by succinylcholine and the incidence of postoperative myalgia.</p><p><strong>Findings: </strong>The severity of fasciculations graded on a 4-point scale was considered the primary outcome. Compared with the delayed group, the immediate group exhibited substantially reduced fasciculation severity scores (P = 0.005). A lower incidence of postoperative myalgia was observed in the immediate group than in the delayed group (P = 0.031). Furthermore, in the delayed group, the heart rate after intervention decreased more significantly (P = 0.014). No differences in other adverse effects were observed.</p><p><strong>Implications: </strong>The severity of succinylcholine-induced fasciculations and the incidence of postoperative myalgia were significantly reduced without adversely affecting intubation conditions or hemodynamics by injecting a 0.2 mg/kg dose of etomidate immediately before administering 2 mg/kg succinylcholine.</p>","PeriodicalId":10699,"journal":{"name":"Clinical therapeutics","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147282691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Letter to the Editor: Commending the Feasibility of CYP2C19 Pharmacogenetic Testing in Personalized Antiplatelet Therapy-Insights and Perspectives. 致编辑的信:推荐CYP2C19药物遗传学检测在个性化抗血小板治疗中的可行性——见解和观点。
IF 3.6 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2026-02-14 DOI: 10.1016/j.clinthera.2026.01.008
Yi Cai
{"title":"Letter to the Editor: Commending the Feasibility of CYP2C19 Pharmacogenetic Testing in Personalized Antiplatelet Therapy-Insights and Perspectives.","authors":"Yi Cai","doi":"10.1016/j.clinthera.2026.01.008","DOIUrl":"https://doi.org/10.1016/j.clinthera.2026.01.008","url":null,"abstract":"","PeriodicalId":10699,"journal":{"name":"Clinical therapeutics","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146200472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Clinical therapeutics
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