Clinical therapeutics最新文献

{"title":"Medical Cannabis Dosing Trajectories of Patients: Evidence From Sales Data","authors":"Alexandra F. Kritikos PhD ,&nbsp;Myfanwy Graham MPharm ,&nbsp;Dominic Hodgkin PhD ,&nbsp;Rosalie Liccardo Pacula PhD","doi":"10.1016/j.clinthera.2024.09.004","DOIUrl":"10.1016/j.clinthera.2024.09.004","url":null,"abstract":"<div><h3>Purpose</h3><div>Medical cannabis use is rising with limited high-quality clinical trial data to guide dosing. This study relies on real-world, longitudinal medical cannabis purchase data to provide information on Δ-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) dosing trends for patients with qualifying medical conditions.</div></div><div><h3>Methods</h3><div>A retrospective study of purchases by 16,727 patients obtaining medical cannabis from dispensaries located in New York between 2016 and 2019, recorded in point-of-sale data. Group-based trajectory modeling was used to identify clusters of patients following similar progressions in dosing of THC and CBD over time. χ² tests were performed to identify which patient characteristics and qualifying medical conditions were associated with membership in each trajectory group.</div></div><div><h3>Findings</h3><div>Six trajectory groups were identified that described different patterns in the THC and CBD doses that patients purchased over the whole time period. For THC, the majority of patients (62.6%) purchased a steady amount but at different levels: consistently low (4.1 mg) or moderate (7.4 mg). Three groups, representing 22.0% together, exhibited doses that either fluctuate or constantly increase over time (5–20 mg). A final group of patients (15.8%) exhibited constant decrease in dose from 11 to 5 mg. For CBD, the data show similar trajectories, but at the generally higher values (4–16 mg). Patients with chronic pain, neuropathy, and cancer were overrepresented in groups where higher doses of THC were purchased over time. Patients with epilepsy had a higher representation in groups with higher doses of CBD across time.</div></div><div><h3>Implications</h3><div>Results suggest heterogeneous dosing patterns and trajectories in the use of medical cannabis by patients with different medical conditions.</div></div>","PeriodicalId":10699,"journal":{"name":"Clinical therapeutics","volume":"48 1","pages":"Pages 5-12"},"PeriodicalIF":3.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380237","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}

{"title":"Experimental Evidence of Dexamethasone in Reversing Endothelial Dysfunction in COVID-19: Therapeutic Insights from Intranasal Administration","authors":"Celeste Trejo-Moreno DSc ,&nbsp;Marisol Méndez-Martínez DSc ,&nbsp;Zimri A. Alvarado-Ojeda MSc ,&nbsp;Sergio Sifontes-Rodríguez PhD ,&nbsp;Jaquelynne Cervantes-Torres DSc ,&nbsp;Raul J. Bobes DSc ,&nbsp;Juan P. Laclette PhD ,&nbsp;Edda Sciutto DSc ,&nbsp;Gladis Fragoso DSc ,&nbsp;Gabriela Rosas-Salgado DSc","doi":"10.1016/j.clinthera.2025.11.005","DOIUrl":"10.1016/j.clinthera.2025.11.005","url":null,"abstract":"<div><h3>Purpose</h3><div>Vascular endothelial dysfunction (ED) plays a critical role in the pathogenesis of severe COVID-19. Intranasal dexamethasone (IN-DXM) has been reported to improve clinical outcomes more efficiently than intravenous (IV-DXM) administration in hospitalized patients. This study compared the efficacy of both regimens in improving ED.</div></div><div><h3>Methods</h3><div>Hospitalized COVID-19 patients from the REVIVAL trial received either intranasal dexamethasone (IN-DXM) via a MAD-Nasal device (0.12 mg/kg for 3 days followed by 0.06 mg/kg for 7 days; <em>n</em> = 10) or intravenous dexamethasone (IV-DXM; 6 mg/day for 10 days; <em>n</em> = 7). Respiratory and inflammatory parameters were analyzed before and 10 days after treatment. Serum levels of IL-6, malondialdehyde (MDA), and nitric oxide (NO) metabolites (nitrites) were quantified, along with their effects on human microvascular endothelial cells (HMEC-1) incubated with patient or control sera.</div></div><div><h3>Findings</h3><div>COVID-19 infection significantly increased IL-6 and MDA and reduced NO levels. Only IN-DXM significantly improved respiratory parameters (FiO₂, SatO₂, pO₂) and reduced serum IL-6. Both regimens decreased peripheral inflammatory markers (C-reactive protein, neutrophil-to-lymphocyte ratio and fibrinogen) and increased NO approaching control levels, improving the vascular function. Notably, only sera from IN-DXM–treated patients normalized IL-6 levels in HMEC-1 supernatants to those of controls. Regardless of the administration route, supernatants from HMEC-1 cells incubated with sera from treated patients showed decreased MDA and increased NO compared with those obtained before treatment.</div></div><div><h3>Implications</h3><div>The IN-DXM regimen produced greater improvement in respiratory and inflammatory parameters than IV-DXM, supporting its potential as a practical and effective alternative for managing severe COVID-19–associated endothelial dysfunction.</div></div>","PeriodicalId":10699,"journal":{"name":"Clinical therapeutics","volume":"48 1","pages":"Pages e10-e15"},"PeriodicalIF":3.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145741408","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}

{"title":"Recognizing Arthralgia as a Potential Adverse Effect of CFTR Modulators: A Case Report","authors":"Flora Charbonneau Pharm ,&nbsp;Magali Dupuy-Grasset MD ,&nbsp;Jeanne Languepin MD ,&nbsp;Marie-Laure Laroche MD, PhD","doi":"10.1016/j.clinthera.2025.11.007","DOIUrl":"10.1016/j.clinthera.2025.11.007","url":null,"abstract":"","PeriodicalId":10699,"journal":{"name":"Clinical therapeutics","volume":"48 1","pages":"Pages 117-120"},"PeriodicalIF":3.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145696080","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}

{"title":"Exposure to Budesonide, Glycopyrronium, and Formoterol With a Next-Generation Propellant Does Not Exceed Exposure With Hydrofluoroalkane-134a Propellant When Administered Via Pressurized Metered-Dose Inhaler With a Spacer","authors":"Hitesh Pandya MBChB, MD ,&nbsp;Mehul Patel MBBS, PhD, FRCP ,&nbsp;Michael Gillen BS, PhD ,&nbsp;Jitendar Reddy MPharm ,&nbsp;Artur Bednarczyk MD ,&nbsp;Marek Kokot MD, MBA ,&nbsp;Yubo Tan MSc ,&nbsp;Maria Heijer MSc ,&nbsp;Magdalena Andersson MSc, MSBA ,&nbsp;David Petullo MSc ,&nbsp;Mandeep Jassal MD","doi":"10.1016/j.clinthera.2025.10.011","DOIUrl":"10.1016/j.clinthera.2025.10.011","url":null,"abstract":"<div><h3>Purpose</h3><div>Hydrofluoroalkane-134a (HFA-134a), the propellant in the marketed budesonide/glycopyrronium/formoterol fumarate dihydrate (BGF) formulation, has a global warming potential (GWP) that falls above environmental regulation thresholds and therefore will be phased out. With global efforts to minimize carbon emissions, the hydrofluoroolefin-1234ze (HFO-1234ze) propellant, with a &gt;99% lower GWP than HFA-134a, is in development for pressurized metered-dose inhalers (pMDIs). Spacers support drug delivery in patients with poor pMDI inhalation technique, but it is unknown if BGF exposure with HFO-1234ze exceeds that observed with HFA-134a when using a spacer.</div></div><div><h3>Methods</h3><div>This Phase I study assessed systemic BGF component exposure with HFO-1234ze versus HFA-134a when using a spacer, and for HFO-1234ze with and without a spacer. Participants (<em>N</em> = 42) were randomized to BGF with HFA-134a with a spacer (reference), HFO-1234ze with a spacer (test), and HFO-1234ze without a spacer (descriptive treatment) over 3 treatment periods in 1 of 6 sequences. As spacer devices help to increase exposure, the upper limit of the 90% confidence interval (CI) of geometric mean ratios (GMRs) was of interest, and bioequivalence was not included as a study objective.</div></div><div><h3>Findings</h3><div>Analyses demonstrated the upper 90% CI of the GMRs for maximum observed plasma concentration (Cmax) and area under the plasma concentration curve from time zero to the time of the last quantifiable concentration (AUClast) were &lt;125% for all BGF components for HFO-1234ze versus HFA-134a when using a spacer, indicating exposure with HFO-1234ze did not exceed exposure with HFA-134a. Additionally, Cmax was increased for all BGF components with HFO-1234ze when using versus not using a spacer, with the largest increases observed among participants with the lowest exposure when not using a spacer, likely due to poor inhalation technique. No new safety findings, and no deaths or serious adverse events, occurred during the study.</div></div><div><h3>Implications</h3><div>These findings provide evidence that may help to support the future use of HFO-1234ze propellant in BGF pMDIs.</div></div>","PeriodicalId":10699,"journal":{"name":"Clinical therapeutics","volume":"48 1","pages":"Pages 73-80"},"PeriodicalIF":3.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145676351","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}

{"title":"Medical Cannabis Formulations, Administration Routes, and Dosing: Perspectives of Patients With Cancer Who Consume","authors":"Manan M. Nayak PhD, MA ,&nbsp;Peter R. Chai MD, MS ,&nbsp;Stephanie Tung MD ,&nbsp;Anna Revette PhD ,&nbsp;Ilana M. Braun MD","doi":"10.1016/j.clinthera.2025.11.004","DOIUrl":"10.1016/j.clinthera.2025.11.004","url":null,"abstract":"<div><h3>Purpose</h3><div>Medical cannabis (MC) is used by 1 in 3 patients with cancer. Scientific work suggests a disconnect between patients’ cannabis therapeutics practices and oncologists’ clinical preferences. This qualitative study explores the preferences of patients with cancer as they relate to MC formulations, administration routes, and dosing.</div></div><div><h3>Methods</h3><div>Semistructured interviews were conducted with patients with cancer consuming MC in 8 states and examined using thematic analysis.</div></div><div><h3>Findings</h3><div>Among study participants (N = 24), the mean age was 54 years, 67% were female, and 51% had metastatic disease. A powerful theme identified across interviews was of myriad MC dispensary product formulations, triggering astonishment and burden. Common strategies among participants included purchasing and sampling multiple store-bought formulations, modifying dispensary products, and altering intended routes of administration. Preferred dispensary products were not consistently available. Top-cited modes of administration included oral, followed by topical, sublingual, vaporization, combustion, and rectal suppository. Three-quarters of participants alternated between modes. Medical cannabis dosing imprecision represented another powerful theme due to the lack of dispensary quality assurance and accuracy in home measurements.</div></div><div><h3>Implications</h3><div>This investigation suggests that MC preparations, dosing, and administration routes vary among patients with cancer, and that common consumption patterns (for instance, reliance on multiple routes of cannabis administration) are not rooted in science. Although these findings should be further interrogated, they suggest a need for lay-facing cannabis therapeutics education and standardization of dispensary products to strengthen cannabis-related care.</div></div>","PeriodicalId":10699,"journal":{"name":"Clinical therapeutics","volume":"48 1","pages":"Pages 51-56"},"PeriodicalIF":3.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145741435","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}

{"title":"Letter to The Editor, Regarding “Indirect Comparison of Maralixibat and Odevixibat for the Treatment of Progressive Familial Intrahepatic Cholestasis” Recently Published by Lacey and Colleagues","authors":"Emmanuelle Kaltenbach PharmD, MSc ,&nbsp;Virginie Jacquemin PhD ,&nbsp;Luis Briseño-Roa PhD ,&nbsp;Andres Gomez-Lievano PhD ,&nbsp;Marie-Cécile Fournier PhD ,&nbsp;Fatine Elaraki MD","doi":"10.1016/j.clinthera.2025.10.014","DOIUrl":"10.1016/j.clinthera.2025.10.014","url":null,"abstract":"","PeriodicalId":10699,"journal":{"name":"Clinical therapeutics","volume":"48 1","pages":"Pages 127-128"},"PeriodicalIF":3.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145631082","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}

{"title":"Corrigendum to “Multicenter, Randomized, Double-Blind, Parallel, Phase 2 Clinical Trial to Compare and Evaluate the Efficacy and Safety of SPC1001 and Monotherapy in Patients With Essential Hypertension” (Clin Ther. 2025 Oct 28. [Epub ahead of print])","authors":"Jinho Shin MD, PhD ,&nbsp;Seong Hwan Kim MD, PhD ,&nbsp;Ki Hoon Han MD, PhD ,&nbsp;Moo Hyun Kim MD, PhD ,&nbsp;Young Keun Ahn MD, PhD ,&nbsp;Il Suk Sohn MD, PhD ,&nbsp;Kwang Il Kim MD, PhD ,&nbsp;Dong Hun Cha MD, PhD ,&nbsp;Soon Jun Hong MD, PhD ,&nbsp;Eun Joo Cho MD, PhD ,&nbsp;Hae Young Lee MD, PhD ,&nbsp;Wook Bum Pyun MD, PhD ,&nbsp;Ho Joong Youn MD, PhD ,&nbsp;Woo Shik Kim MD, PhD ,&nbsp;Moo Yong Rhee MD, PhD ,&nbsp;Jun Hee Lee MD, PhD ,&nbsp;Jong Won Ha MD, PhD ,&nbsp;Ji Yong Choi MD, PhD ,&nbsp;Byung Su Yoo MD, PhD ,&nbsp;Jin Ok Jeong MD, PhD ,&nbsp;Chong Jin Kim MD, PhD","doi":"10.1016/j.clinthera.2025.11.011","DOIUrl":"10.1016/j.clinthera.2025.11.011","url":null,"abstract":"","PeriodicalId":10699,"journal":{"name":"Clinical therapeutics","volume":"48 1","pages":"Page 131"},"PeriodicalIF":3.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145767421","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}

{"title":"Corrigendum to “Evaluating the Clinical and Economic Impact of Ceramide-Infused Skin Barriers in Patients With Intestinal and Urinary Stomas: A Systematic Review and Meta-Analysis” [Clin Ther. 2025;47:e21–e32]","authors":"Rosario Caruso PhD, RN, FESNO, FAAN,&nbsp;Silvia Belloni PhD, RN,&nbsp;Beniamino Schiavone MD,&nbsp;Gianluca Conte PhD, RN,&nbsp;Cristina Di Pasquale RN,&nbsp;Arianna Magon PhD, RN,&nbsp;Cristina Arrigoni RN, MSc,&nbsp;Giuseppe Candilio MD,&nbsp;Francesco Stanzione MD,&nbsp;Alessandro Stievano PhD, MSN, MEd, FAAN, FEANS, FESNO, FFNMRCSI, FTNSS,&nbsp;Gennaro Rocco PhD, RN, FFNMRCSI, FESNO, FAAN,&nbsp;Maddalena De Maria PhD, RN, FESNO","doi":"10.1016/j.clinthera.2025.12.004","DOIUrl":"10.1016/j.clinthera.2025.12.004","url":null,"abstract":"","PeriodicalId":10699,"journal":{"name":"Clinical therapeutics","volume":"48 1","pages":"Pages 132-133"},"PeriodicalIF":3.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800057","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}

{"title":"Evaluation of the Application of Antimicrobial Stewardship on the Rational Use of Antibiotics and Overcoming Antimicrobial Resistance in Tertiary Hospitals: A Point Prevalence Survey","authors":"Sara Youssif Ibrahim PhD ,&nbsp;Yara Ali BSc ,&nbsp;Zohra Abdelfattah BSc ,&nbsp;Amany Gad BSc ,&nbsp;Nada Mohamed BSc ,&nbsp;Nancy Mortada BSc ,&nbsp;Omar Ahmed BSc ,&nbsp;Ahmed Nabil BSc ,&nbsp;Mahmoud Refay BSc ,&nbsp;Ahmed Mohamed BSc ,&nbsp;Mohamed Goda BSc ,&nbsp;Ahmed Essam Abou Warda PhD ,&nbsp;Salwa Selim Abougalambou PhD ,&nbsp;Hadeer Ehab Barakat PhD","doi":"10.1016/j.clinthera.2025.10.008","DOIUrl":"10.1016/j.clinthera.2025.10.008","url":null,"abstract":"<div><h3>Purpose</h3><div>Multidrug-resistant (MDR) microorganisms has emerged as a significant global health crisis leading to higher rates of morbidity. Antimicrobial resistance (AMR) presents a serious challenge in intensive care units (ICUs), where infections caused by MDR pathogens are common. Thus, implementation of antimicrobial stewardship programs (ASPs) ensures prudent antibiotic use and decreases AMR. Therefore, the current study evaluates the impact of ASP applications on empirical antibiotic prescribing practices and AMR through a Point Prevalence Survey (PPS) in ICU settings.</div></div><div><h3>Methods</h3><div>A prospective, multicentric, quasi-experimental study was conducted in various departments over a period of 12 weeks. Inpatients receiving antibiotics were surveyed before and after the implementation of ASP. These interventions included customizing ASP guidelines, training healthcare team, and auditing prescribing behaviors. Data was analyzed using SPSS, and outcomes evaluated included adherence to guidelines, prevalence of antibiotic use, and appropriateness of prescriptions.</div></div><div><h3>Results</h3><div>Of the 174 patients were surveyed across PPS. <em>Escherichia coli</em> showed the highest prevalence in PPS-1 (26%), while <em>Klebsiella pneumoniae</em> and <em>Staphylococcus aureus</em> showed the highest in PPS-2 (18%). Carbapenem-resistant Enterobacteriaceae decreased from 25% in PPS-1 to 8% in PPS-2. Guideline-inappropriate prescriptions and missing documentation of preparation or administration method declined from 27.3% to 5.2% (<em>P</em> = 0.000042) and from 78.5% to 56.2% (<em>P</em> = 0.002) respectively, reflecting improved prescribing quality and record-keeping. Although the proportion of prescriptions with improper antibiotic duration increased from 32.1% to 42.7% (<em>P</em> = 0.145), this trend may reflect evolving clinical decision-making rather than a decline in care quality.</div></div><div><h3>Conclusion</h3><div>The study suggests that ASP interventions were associated with improved antibiotic prescribing practices and adherence to guidelines in ICU settings, contributing to the fight against AMR. Given the study design and sample size, findings are exploratory and suggestive. Future work includes expanding ASP monitoring and education strategies with solutions focusing on antibiotic duration.</div></div>","PeriodicalId":10699,"journal":{"name":"Clinical therapeutics","volume":"48 1","pages":"Pages e1-e9"},"PeriodicalIF":3.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145602763","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}

{"title":"Impact of CRRT Timing on Mortality in Oliguric Sepsis-Associated Acute Kidney Injury: A Propensity Score Matching Cohort Study","authors":"Jing Li MM ,&nbsp;Caiyun Xu MM ,&nbsp;Zhe Huang MM ,&nbsp;Lan Yao MM ,&nbsp;Huayun Liu MM ,&nbsp;Fuxing Deng MD ,&nbsp;Can Zhu MM ,&nbsp;Qinjuan Jiang MM","doi":"10.1016/j.clinthera.2025.10.012","DOIUrl":"10.1016/j.clinthera.2025.10.012","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aims to evaluate how the timing of continuous renal replacement therapy (CRRT) initiation influences survival outcomes in oliguric patients with sepsis-associated acute kidney injury (S-AKI) admitted to the intensive care unit (ICU).</div></div><div><h3>Methods</h3><div>Using the MIMIC-IV database, we conducted a retrospective analysis of 2,131 ICU patients with oliguric S-AKI who had CRRT records. Patients were categorized into 2 groups according to the timing of CRRT initiation: early initiation within 48 hours (<em>n</em> = 1,222) and delayed initiation after 48 hours (<em>n</em> = 909) following the onset of oliguria. Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were applied to adjust for confounding factors. Baseline characteristics, physiological parameters, and laboratory findings were compared between the 2 groups. Survival outcomes were analyzed using Kaplan-Meier curves and log-rank tests, with a primary focus on 90-day mortality.</div></div><div><h3>Findings</h3><div>Patients who initiated CRRT more than 48 hours after oliguria onset had significantly longer ICU stays compared to those who received early CRRT (17.6 vs. 11.5 days, <em>P</em> &lt; 0.001) and exhibited higher SOFA scores (11.5 vs. 9.14, <em>P</em> &lt; 0.001). After PSM, delayed CRRT was associated with decreased 90-day survival among patients with oliguria, as demonstrated by Kaplan-Meier analysis (<em>P</em> &lt; 0.05). Causal inference showed a 10% increase in the 90-day mortality rate for patients who started CRRT after 48 hours (ATE 0.11, 95% CI: 0.02 - 0.19, <em>P</em> = 0.01).</div></div><div><h3>Implications</h3><div>Early initiation of CRRT, within 48 hours of oliguria onset, in S-AKI patients is associated with improved 90-day survival. These findings suggest that earlier CRRT initiation may be beneficial for improving survival outcomes in this patient population.</div></div>","PeriodicalId":10699,"journal":{"name":"Clinical therapeutics","volume":"48 1","pages":"Pages 65-72"},"PeriodicalIF":3.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145573429","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}