首页 > 最新文献

Clinical therapeutics最新文献

英文 中文
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。
{"title":"Profiling of Potential Postmarket Risk Tracking and Pharmacovigilance Data for Avacopan","authors":"Zhilan Zhou ,&nbsp;Lurong Yu ,&nbsp;Jiaoni Zheng ,&nbsp;Yao He ,&nbsp;Lili Xia ,&nbsp;Qingyan Jia ,&nbsp;Limei Liu","doi":"10.1016/j.clinthera.2025.12.017","DOIUrl":"10.1016/j.clinthera.2025.12.017","url":null,"abstract":"<div><h3>Purpose</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Findings</h3><div>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.</div></div><div><h3>Implications</h3><div>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.</div></div>","PeriodicalId":10699,"journal":{"name":"Clinical therapeutics","volume":"48 3","pages":"Pages 247-257"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147453831","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
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
{"title":"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","authors":"Hongda Xu ,&nbsp;Tuocen Fan ,&nbsp;Yiyang Xu ,&nbsp;Wenhao Li ,&nbsp;Junrui Cui","doi":"10.1016/j.clinthera.2025.08.002","DOIUrl":"10.1016/j.clinthera.2025.08.002","url":null,"abstract":"","PeriodicalId":10699,"journal":{"name":"Clinical therapeutics","volume":"48 3","pages":"Pages 289-290"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945706","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
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
{"title":"BLUJEPA (gepotidacin)","authors":"Paul Beninger MD, MBA","doi":"10.1016/j.clinthera.2026.01.009","DOIUrl":"10.1016/j.clinthera.2026.01.009","url":null,"abstract":"","PeriodicalId":10699,"journal":{"name":"Clinical therapeutics","volume":"48 3","pages":"Pages 291-293"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146225802","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
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
{"title":"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].","authors":"Lu-Hsuan Wu, Ching-Lan Cheng, Yea-Huei Kao Yang, Swu-Jane Lin","doi":"10.1016/j.clinthera.2026.01.013","DOIUrl":"https://doi.org/10.1016/j.clinthera.2026.01.013","url":null,"abstract":"","PeriodicalId":10699,"journal":{"name":"Clinical therapeutics","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147303191","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
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
Hereditary Anemias as a Monogenic Etiology for Nonimmune Hydrops Fetalis. 遗传性贫血作为非免疫性水肿胎儿的单基因病因。
IF 3.6 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2026-02-03 DOI: 10.1016/j.clinthera.2026.01.002
Mona M Makhamreh, Stephanie M Rice, Kavya Shivashankar, Casey J Brewer, Rodney A McLaren, Seth I Berger, Huda B Al-Kouatly

Purpose: Hereditary anemias are a cause of nonimmune hydrops fetalis (NIHF). Our objective was to review the spectrum of hereditary anemia genes in NIHF diagnosed by exome sequencing (ES).

Methods: We performed a systematic review of ES studies in NIHF from January 1, 2000 to August 1, 2024 with emphasis on genes causing fetal anemia as a primary phenotype.

Findings: Forty-one ES studies with 207 genetically diagnosed NIHF cases met our inclusion criteria; 6 cases within 6 studies involved NIHF and hereditary anemia. Among the six cases, five had definitive diagnosis or likely diagnosis supported by pathogenic or likely pathogenic variants, while one case harbored only variants of uncertain significance and was classified as a possible diagnosis. The six different hereditary anemia genes included SEC23B, SPTA1, KLF1, RPL11, UNC13D, and RFWD3.

Implications: Overall, ES confirmed the etiology of hereditary anemia in 2.4% (5/207) of genetically diagnosed NIHF cases. Hereditary anemias, therefore, represent a distinct and clinically relevant subset of ES-diagnosed NIHF cases. ES should be considered first line in fetuses with NIHF, as common non-genetic causes such as fetomaternal hemorrhage, infectious etiologies, and alloimmunization are excluded. It is also indicated when fetal anemia is suspected, particularly in the setting of elevated MCA Dopplers with a negative evaluation for common hemoglobinopathies and nongenetic etiologies.

目的:遗传性贫血是导致非免疫性积水胎儿(NIHF)的原因之一。我们的目的是回顾通过外显子组测序(ES)诊断的NIHF的遗传性贫血基因谱。方法:我们对2000年1月1日至2024年8月1日在NIHF中进行的ES研究进行了系统回顾,重点关注导致胎儿贫血的基因作为主要表型。结果:41项ES研究,207例基因诊断的NIHF病例符合我们的纳入标准;6项研究中有6例涉及NIHF和遗传性贫血。在6例病例中,5例有明确的诊断或可能的诊断,有致病或可能的致病变异支持,而1例只有意义不确定的变异,被归类为可能的诊断。6种不同的遗传性贫血基因包括SEC23B、SPTA1、KLF1、RPL11、UNC13D和RFWD3。意义:总体而言,ES在2.4%(5/207)的遗传诊断NIHF病例中证实了遗传性贫血的病因。因此,遗传性贫血是es诊断的NIHF病例中一个独特且具有临床相关性的子集。由于排除了常见的非遗传原因,如胎母出血、感染性病因和同种异体免疫,因此应将新生儿心力衰竭胎儿的ES考虑在一线。当怀疑胎儿贫血时,特别是在MCA多普勒升高的情况下,对常见血红蛋白病和非遗传病因的评价为阴性。
{"title":"Hereditary Anemias as a Monogenic Etiology for Nonimmune Hydrops Fetalis.","authors":"Mona M Makhamreh, Stephanie M Rice, Kavya Shivashankar, Casey J Brewer, Rodney A McLaren, Seth I Berger, Huda B Al-Kouatly","doi":"10.1016/j.clinthera.2026.01.002","DOIUrl":"https://doi.org/10.1016/j.clinthera.2026.01.002","url":null,"abstract":"<p><strong>Purpose: </strong>Hereditary anemias are a cause of nonimmune hydrops fetalis (NIHF). Our objective was to review the spectrum of hereditary anemia genes in NIHF diagnosed by exome sequencing (ES).</p><p><strong>Methods: </strong>We performed a systematic review of ES studies in NIHF from January 1, 2000 to August 1, 2024 with emphasis on genes causing fetal anemia as a primary phenotype.</p><p><strong>Findings: </strong>Forty-one ES studies with 207 genetically diagnosed NIHF cases met our inclusion criteria; 6 cases within 6 studies involved NIHF and hereditary anemia. Among the six cases, five had definitive diagnosis or likely diagnosis supported by pathogenic or likely pathogenic variants, while one case harbored only variants of uncertain significance and was classified as a possible diagnosis. The six different hereditary anemia genes included SEC23B, SPTA1, KLF1, RPL11, UNC13D, and RFWD3.</p><p><strong>Implications: </strong>Overall, ES confirmed the etiology of hereditary anemia in 2.4% (5/207) of genetically diagnosed NIHF cases. Hereditary anemias, therefore, represent a distinct and clinically relevant subset of ES-diagnosed NIHF cases. ES should be considered first line in fetuses with NIHF, as common non-genetic causes such as fetomaternal hemorrhage, infectious etiologies, and alloimmunization are excluded. It is also indicated when fetal anemia is suspected, particularly in the setting of elevated MCA Dopplers with a negative evaluation for common hemoglobinopathies and nongenetic etiologies.</p>","PeriodicalId":10699,"journal":{"name":"Clinical therapeutics","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146118174","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
Implementing CYP2C19 Pharmacogenetic Testing for Personalized Antiplatelet Therapy: Findings From the QPGx-CARES Initiative 在个性化抗血小板治疗中实施CYP2C19药物遗传学检测:来自QPGx-CARES计划的发现
IF 3.6 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2026-02-01 Epub Date: 2025-12-26 DOI: 10.1016/j.clinthera.2025.12.003
Rania Abdel-latif PhD , Wadha Al Muftah MD , Shaban Mohammed MD , Toka AlHsson BPharmSc , Daoud Al-Badriyeh PhD , Radja Badji PhD , Awad Al-Qahtani MD , Abdul Rahman Arabi MD , Said Ismail PhD , Moza Al Hail BPharmSc , Jassim Al Suwaidi MD

Purpose

CYP2C19 loss-of-function (LoF) alleles are associated with increased cardiovascular risk in clopidogrel-treated percutaneous coronary intervention (PCI) patients. Despite the guidelines recommendation for newer P2Y12 inhibitors, clopidogrel remains widely prescribed. The study the potential impact and feasibility of implementing pharmacogenetics (PGx) testing to guide antiplatelet therapy and develop strategies for its clinical integration to improve patient management.

Methods

A pilot study following a prospective cohort design was conducted within the largest community healthcare provider in Qatar using point-of-care (POC) CYP2C19 genotyping in tailoring antiplatelet therapy for PCI patients. Eligible patients underwent CYP2C19 genotyping, and P2Y12 inhibitor prescriptions were adjusted based on genetic results. The study measured antiplatelet prescribing patterns and identified clinically significant gene-drug interactions.

Findings

Out of 376 patients tested, 283 patients received PGx-guided recommendations for anti-platelet therapy. Actionable CYP2C19 alleles were detected in 22% of those patients, prompting a change in drug therapy. PGx-guided recommendations were adopted at a rate of 80%, and CYP2C19 genotyping was a significant predictor of antiplatelet therapy adjustments. A sub-analysis of the cost impact revealed an estimated reduction of 300 QR (82.41 $) per patient annually for ACS patients who underwent PCI with stent placement.

Implications

This real-world study highlights the feasibility and clinical impact of CYP2C19 genotyping in guiding antiplatelet therapy for ACS and PCI patients, supporting broader PGx testing implementation in routine cardiovascular care.

Trail registration

HMC-IRB Registration: IRB-HMC-2021-011, IRB-MoPH Assurance: IRB-A-HMC-2019-0014. ISRCTN registration: ISRCTN15110009, https://www.isrctn.com/ISRCTN15110009.
目的:CYP2C19功能丧失(LoF)等位基因与氯吡格雷治疗的经皮冠状动脉介入治疗(PCI)患者心血管风险增加相关。尽管指南推荐使用较新的P2Y12抑制剂,但氯吡格雷仍被广泛使用。研究实施药物遗传学(PGx)检测指导抗血小板治疗的潜在影响和可行性,并制定其临床整合策略,以改善患者管理。方法:在卡塔尔最大的社区医疗保健提供者中进行了一项前瞻性队列设计的试点研究,使用即时护理(POC) CYP2C19基因分型为PCI患者量身定制抗血小板治疗。符合条件的患者进行CYP2C19基因分型,并根据遗传结果调整P2Y12抑制剂处方。该研究测量了抗血小板处方模式,并确定了具有临床意义的基因-药物相互作用。结果:在376名患者中,283名患者接受了pgx指导的抗血小板治疗建议。22%的患者检测到可作用的CYP2C19等位基因,促使药物治疗发生变化。采用pgx指导建议的比例为80%,CYP2C19基因分型是抗血小板治疗调整的重要预测因子。成本影响的亚分析显示,ACS患者接受PCI支架置入术后,每位患者每年可减少约300 QR(82.41美元)。意义:这项现实世界的研究强调了CYP2C19基因分型在指导ACS和PCI患者抗血小板治疗中的可行性和临床影响,支持在常规心血管护理中更广泛地实施PGx检测。试验注册:HMC-IRB注册:IRB-HMC-2021-011, IRB-MoPH保证:IRB-A-HMC-2019-0014。ISRCTN注册号:ISRCTN15110009, https://www.isrctn.com/ISRCTN15110009。
{"title":"Implementing CYP2C19 Pharmacogenetic Testing for Personalized Antiplatelet Therapy: Findings From the QPGx-CARES Initiative","authors":"Rania Abdel-latif PhD ,&nbsp;Wadha Al Muftah MD ,&nbsp;Shaban Mohammed MD ,&nbsp;Toka AlHsson BPharmSc ,&nbsp;Daoud Al-Badriyeh PhD ,&nbsp;Radja Badji PhD ,&nbsp;Awad Al-Qahtani MD ,&nbsp;Abdul Rahman Arabi MD ,&nbsp;Said Ismail PhD ,&nbsp;Moza Al Hail BPharmSc ,&nbsp;Jassim Al Suwaidi MD","doi":"10.1016/j.clinthera.2025.12.003","DOIUrl":"10.1016/j.clinthera.2025.12.003","url":null,"abstract":"<div><h3>Purpose</h3><div>CYP2C19 loss-of-function (LoF) alleles are associated with increased cardiovascular risk in clopidogrel-treated percutaneous coronary intervention (PCI) patients. Despite the guidelines recommendation for newer P2Y12 inhibitors, clopidogrel remains widely prescribed. The study the potential impact and feasibility of implementing pharmacogenetics (PGx) testing to guide antiplatelet therapy and develop strategies for its clinical integration to improve patient management.</div></div><div><h3>Methods</h3><div>A pilot study following a prospective cohort design was conducted within the largest community healthcare provider in Qatar using point-of-care (POC) CYP2C19 genotyping in tailoring antiplatelet therapy for PCI patients. Eligible patients underwent CYP2C19 genotyping, and P2Y12 inhibitor prescriptions were adjusted based on genetic results. The study measured antiplatelet prescribing patterns and identified clinically significant gene-drug interactions.</div></div><div><h3>Findings</h3><div>Out of 376 patients tested, 283 patients received PGx-guided recommendations for anti-platelet therapy. Actionable CYP2C19 alleles were detected in 22% of those patients, prompting a change in drug therapy. PGx-guided recommendations were adopted at a rate of 80%, and CYP2C19 genotyping was a significant predictor of antiplatelet therapy adjustments. A sub-analysis of the cost impact revealed an estimated reduction of 300 QR (82.41 $) per patient annually for ACS patients who underwent PCI with stent placement.</div></div><div><h3>Implications</h3><div>This real-world study highlights the feasibility and clinical impact of CYP2C19 genotyping in guiding antiplatelet therapy for ACS and PCI patients, supporting broader PGx testing implementation in routine cardiovascular care.</div></div><div><h3>Trail registration</h3><div>HMC-IRB Registration: IRB-HMC-2021-011, IRB-MoPH Assurance: IRB-A-HMC-2019-0014. ISRCTN registration: ISRCTN15110009, <span><span>https://www.isrctn.com/ISRCTN15110009</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":10699,"journal":{"name":"Clinical therapeutics","volume":"48 2","pages":"Pages 170-178"},"PeriodicalIF":3.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145846586","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
LYNKUET® (elinzanetant) LYNKUET®(elinzanetant) .
IF 3.6 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2026-02-01 Epub Date: 2025-12-27 DOI: 10.1016/j.clinthera.2025.12.006
Paul Beninger MD, MBA
{"title":"LYNKUET® (elinzanetant)","authors":"Paul Beninger MD, MBA","doi":"10.1016/j.clinthera.2025.12.006","DOIUrl":"10.1016/j.clinthera.2025.12.006","url":null,"abstract":"","PeriodicalId":10699,"journal":{"name":"Clinical therapeutics","volume":"48 2","pages":"Pages 208-209"},"PeriodicalIF":3.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145849042","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
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1