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When is pharmacotherapy necessary for Tourette syndrome? The risks vs reward. 妥瑞特综合症何时需要药物治疗?风险vs回报。
IF 2.7 3区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2026-02-07 DOI: 10.1080/14656566.2026.2629472
Andrea E Cavanna

Introduction: Tourette syndrome is a neurodevelopmental disorder characterized by chronic motor and vocal tics. Both tic severity and co-morbid psychiatric disorders can affect patients' health-related quality of life to an extent that warrants active treatment interventions. Different decisional approaches can be implemented to determine the need for pharmacotherapy.

Areas covered: A critical appraisal of the existing literature on the clinical scenarios where pharmacotherapy for Tourette syndrome is deemed necessary has highlighted three indications: (1) physical discomfort - e.g. pain or injury; (2) emotional or social problems - e.g. depression or isolation; or (3) functional interference - e.g. impairment of academic achievements.

Expert opinion: Pharmacotherapy for tic disorders aims to reduce tic severity enough to improve daily functioning and health-related quality of life rather than to eliminate symptoms. Expert consensus emphasizes patient-centered decision-making that integrates disease-specific quality of life measures with objective tic severity scales. Medications may be prioritized when tics cause significant impairment, pose medical risks, require rapid control, or coexist with treatable co-morbidities. Current guidelines rely largely on limited trials and expert opinion, with dopamine-modulating agents and alpha-2 agonists being most commonly used. Further research should focus on open questions about real-world effectiveness and generalizability of individual pharmacological agents.

图雷特综合征是一种以慢性运动和声音抽搐为特征的神经发育障碍。抽动的严重程度和共病的精神疾病都会影响患者与健康相关的生活质量,因此需要积极的治疗干预。可以采用不同的决策方法来确定是否需要药物治疗。涵盖领域:对图雷特综合征的药物治疗被认为是必要的临床情况的现有文献进行了批判性评估,强调了三个适应症:(1)身体不适-例如疼痛或损伤;(2)情绪或社会问题——例如抑郁或孤立;或(3)功能性干扰——例如学业成绩受损。专家意见:抽动障碍的药物治疗旨在减轻抽动严重程度,以改善日常功能和与健康相关的生活质量,而不是消除症状。专家共识强调以患者为中心的决策,将疾病特异性生活质量测量与客观抽动严重程度量表相结合。当抽动引起严重损害、构成医疗风险、需要快速控制或与可治疗的合并症共存时,可优先用药。目前的指南很大程度上依赖于有限的试验和专家意见,多巴胺调节剂和α -2激动剂是最常用的。进一步的研究应该集中在现实世界的有效性和个体药物的普遍性的开放性问题。
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引用次数: 0
Belzutifan monotherapy and combination therapies in renal cell carcinoma: a clinical trial perspective from the ARON working group. 贝尔祖替芬单药和联合治疗肾细胞癌:来自ARON工作组的临床试验观点。
IF 2.7 3区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2026-02-06 DOI: 10.1080/14656566.2026.2627934
Concetta Calabrò, Francesco Ciccimarra, Alessandro Rizzo, Gerardo Cazzato, Mario Della Mura, Tarek Taha, Maria T Bourlon, Bohuslav Melichar, Hana Studentova, Timothy J Schieber, Patrizia Nardulli, Javier Molina-Cerrillo, Fernando Sabino Marques Monteiro, Andrey Soares, Raffaella Massafra, Veronica Mollica, Francesco Massari, Jakub Kucharz, Matteo Santoni

Introduction: Several studies have identified Hypoxia-Inducible Factor 2-alpha (HIF-2α) as a key oncogenic driver in clear cell renal cell carcinoma (ccRCC). In this context, belzutifan emerges as an oral inhibitor of HIF-2α, that acts by blocking the heterodimerization of HIF-2α with HIF-1β, thereby preventing the transcription of hypoxia-target genes and reducing VEGF-mediated tumor growth. The LITESPARK series of studies recently defined the emerging role of belzutifan in the therapeutic landscape of RCC, and further studies are ongoing.

Areas covered: In the current review, we discuss the role of belzutifan as an innovative and promising therapeutic strategy for targeting a key biological mechanism in ccRCC.

Expert opinion: According to available evidence and data, belzutifan has generally been well tolerated, though anemia is a frequent on-target side effect and, along with hypoxia, necessitates monitoring throughout treatment. As reported, ongoing phase III clinical trials are set to yield potentially practice-changing results, investigating innovative combinatorial strategies including belzutifan. Ongoing advancement of predictive biomarkers and understanding of resistance mechanisms could improve patient selection and identify new drug targets, thereby increasing the clinical efficacy of belzutifan.

几项研究已经确定缺氧诱导因子2- α (HIF-2α)是透明细胞肾细胞癌(ccRCC)的关键致癌驱动因素。在这种情况下,belzutifan作为一种口服HIF-2α抑制剂出现,通过阻断HIF-2α与HIF-1β的异源二聚化,从而阻止缺氧靶基因的转录,减少vegf介导的肿瘤生长。LITESPARK系列研究最近确定了贝尔祖替芬在RCC治疗领域的新作用,进一步的研究正在进行中。所涵盖的领域:在当前的综述中,我们讨论了贝祖替芬作为一种针对ccRCC关键生物学机制的创新和有前途的治疗策略的作用。专家意见:根据现有的证据和数据,尽管贫血是常见的靶标副作用,并且伴随缺氧,需要在整个治疗过程中进行监测,但贝祖替芬总体上耐受性良好。据报道,正在进行的III期临床试验将产生潜在的改变实践的结果,研究包括贝尔祖替芬在内的创新组合策略。预测生物标志物的不断发展和对耐药机制的了解可以改善患者的选择和确定新的药物靶点,从而提高贝祖替芬的临床疗效。
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引用次数: 0
Corticosteroids in acute asthma care in children: what, why, and when. 皮质类固醇在儿童急性哮喘护理中的作用:什么,为什么,何时。
IF 2.7 3区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2026-01-27 DOI: 10.1080/14656566.2026.2622484
Jose A Castro-Rodriguez
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引用次数: 0
Auditory toxicity of antimalarials in systemic autoimmune diseases: a systematic review and critical appraisal. 抗疟药对全身自身免疫性疾病的听觉毒性:系统回顾和批判性评价
IF 2.7 3区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2026-01-27 DOI: 10.1080/14656566.2026.2621193
Olga Araújo, Alex Yu, Gerard Espinosa, Alberto Codina, Ignasi Rodríguez-Pintó, Andrea Vendola, José Hernández-Rodríguez, Francisco Larrosa, Miguel Caballero

Introduction: Antimalarial agents, particularly hydroxychloroquine and chloroquine, are widely used in systemic autoimmune diseases. While ocular toxicity is well established, the extent and clinical relevance of potential auditory toxicity remain unclear. We conducted a systematic review to evaluate the available evidence on auditory adverse effects associated with antimalarial use in systemic autoimmune diseases.

Methods: A systematic search was performed in PubMed, Scopus, and the Cochrane Library from inception to January 2025. Observational and interventional studies reporting audiological outcomes in patients exposed to antimalarials were included, excluding malaria-related treatments. Risk of bias was assessed according to study design. Due to substantial clinical and methodological heterogeneity, results were synthesized descriptively without meta-analysis.

Results: Sixteen studies encompassing heterogeneous autoimmune populations and audiological methods were included. The reported prevalence of hearing abnormalities varied widely across studies and diagnostic techniques. Associations with antimalarial exposure, dose, or duration were inconsistent. Some studies described subclinical cochlear or brainstem alterations, while others found no significant differences compared with non-exposed patients.

Conclusions: Available evidence is limited and heterogeneous, precluding causal inferences regarding antimalarial-related auditory toxicity. Increased clinical awareness of auditory symptoms may be reasonable, but standardized monitoring is not supported. Prospective controlled studies with standardized audiological assessments are needed.

简介:抗疟药,特别是羟氯喹和氯喹,广泛用于全身自身免疫性疾病。虽然眼毒性已被证实,但潜在听觉毒性的程度和临床相关性仍不清楚。我们进行了一项系统综述,以评估与系统性自身免疫性疾病使用抗疟药相关的听觉不良反应的现有证据。方法:系统检索PubMed、Scopus和Cochrane图书馆自成立至2025年1月的文献。观察性和干预性研究报告了暴露于抗疟疾药物的患者的听力学结果,但不包括与疟疾相关的治疗。根据研究设计评估偏倚风险。由于临床和方法学的异质性,结果是描述性综合的,没有进行meta分析。结果:包括异质自身免疫人群和听力学方法在内的16项研究。不同研究和诊断技术对听力异常患病率的报道差异很大。与抗疟疾暴露、剂量或持续时间的关系不一致。一些研究描述了亚临床的耳蜗或脑干改变,而另一些研究发现与未暴露的患者相比没有显著差异。结论:现有证据有限且异质性,排除了抗疟疾相关听觉毒性的因果推论。提高临床对听觉症状的认识可能是合理的,但不支持标准化监测。需要有标准化听力学评估的前瞻性对照研究。
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引用次数: 0
Investigating vimseltinib in tenosynovial giant cell tumors. 维姆司替尼治疗腱鞘巨细胞瘤的研究。
IF 2.7 3区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2026-01-27 DOI: 10.1080/14656566.2026.2622472
Victoria Wytiaz, Rashmi Chugh

Introduction: Tenosynovial giant cell tumors (TGCTs) are locally aggressive mesenchymal neoplasms that can cause chronic disability. Surgery is a mainstay of treatment but can carry a high risk of morbidity or can confer limited benefit. As such, effective alternative treatment options are needed, including systemic agents. Improved understanding of the pathophysiology of TGCTs has led to such drug development.

Areas covered: Vimseltinib is a switch-control tyrosine kinase inhibitor designed to selectively inhibit CSF1R, which, along with CSF1, is responsible for the synovial inflammation that characterizes TGCTs. In this drug evaluation, we review the mechanism of action, pharmacologic properties, clinical efficacy and current role within the TGCT treatment landscape of vimseltinib.

Expert opinion: Vimseltinib demonstrated a significant response rate as well as meaningful symptomatic improvement in patients with TGCTs. Furthermore, there is an absence of severe toxicities that have arisen with other agents in the TGCT treatment space, specifically liver failure. Vimseltinib is a favorable option for patients with TGCTs and further efforts to determine its place in the sequence of overall management are needed.

简介:腱鞘巨细胞瘤(tgct)是一种局部侵袭性间充质肿瘤,可导致慢性残疾。手术是主要的治疗方法,但有很高的发病风险或获益有限。因此,需要有效的替代治疗方案,包括全身药物。对tgct病理生理学的进一步了解促进了此类药物的开发。涉及领域:Vimseltinib是一种开关控制酪氨酸激酶抑制剂,旨在选择性抑制CSF1R, CSF1R与CSF1一起导致滑膜炎症,这是tgct的特征。本文就维姆司替尼的作用机制、药理学特性、临床疗效及其在TGCT治疗中的作用进行综述。专家意见:Vimseltinib在tgct患者中表现出显著的反应率和有意义的症状改善。此外,TGCT治疗中没有其他药物出现的严重毒性,特别是肝衰竭。Vimseltinib是tgct患者的一个有利选择,需要进一步努力确定其在整体治疗顺序中的位置。
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引用次数: 0
The latest pharmacotherapeutic options for the treatment of IgA nephropathy in the pediatric population. 最新的药物治疗方案的治疗IgA肾病的儿科人群。
IF 2.7 3区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2026-01-24 DOI: 10.1080/14656566.2026.2620099
Jakub Zieg

Introduction: Despite the fact that IgA nephropathy (IgAN) is the most common chronic glomerulonephritis across the age spectrum worldwide, there is a lack of evidence-based treatment recommendations for pediatric patients. Moreover, current treatment options in children are very limited. This review aims to provide a comprehensive overview of current therapeutic strategies for managing IgAN, with a particular focus on new drugs recently evaluated in adult cohorts, as well as novel treatments reported in pediatric case studies.

Areas covered: A literature search was conducted using Pubmed and Scopus, covering the period from January 2013 to June 2025. Studies relevant to topic were included. Currently, there are numerous adult trials studying medications that target fundamental IgAN pathogenetic pathways, with very promising results in terms of proteinuria reduction and stabilization of kidney function.

Expert opinion: The higher disease activity and longer life expectancy in pediatric patients create a critical need for the evaluation of modern therapies in children with IgAN. Thus, it is crucial to prioritize pediatric clinical trials and to focus on removing the barriers that limit their implementation.

尽管IgA肾病(IgAN)是世界范围内最常见的慢性肾小球肾炎,但缺乏针对儿科患者的循证治疗建议。此外,目前儿童的治疗选择非常有限。本综述旨在全面概述当前治疗IgA肾病的策略,特别关注最近在成人队列中评估的新药,以及在儿科病例研究中报道的新治疗方法。覆盖领域:使用Pubmed和Scopus进行文献检索,检索时间为2013年1月至2025年6月。纳入与课题相关的研究。目前,有许多成人试验研究针对IgAN基本发病途径的药物,在减少蛋白尿和稳定肾功能方面取得了非常有希望的结果。专家意见:儿科患者较高的疾病活动性和较长的预期寿命使得对IgAN患儿的现代治疗方法进行评估成为迫切需要。因此,至关重要的是要优先考虑儿科临床试验,并集中精力消除限制其实施的障碍。
{"title":"The latest pharmacotherapeutic options for the treatment of IgA nephropathy in the pediatric population.","authors":"Jakub Zieg","doi":"10.1080/14656566.2026.2620099","DOIUrl":"10.1080/14656566.2026.2620099","url":null,"abstract":"<p><strong>Introduction: </strong>Despite the fact that IgA nephropathy (IgAN) is the most common chronic glomerulonephritis across the age spectrum worldwide, there is a lack of evidence-based treatment recommendations for pediatric patients. Moreover, current treatment options in children are very limited. This review aims to provide a comprehensive overview of current therapeutic strategies for managing IgAN, with a particular focus on new drugs recently evaluated in adult cohorts, as well as novel treatments reported in pediatric case studies.</p><p><strong>Areas covered: </strong>A literature search was conducted using Pubmed and Scopus, covering the period from January 2013 to June 2025. Studies relevant to topic were included. Currently, there are numerous adult trials studying medications that target fundamental IgAN pathogenetic pathways, with very promising results in terms of proteinuria reduction and stabilization of kidney function.</p><p><strong>Expert opinion: </strong>The higher disease activity and longer life expectancy in pediatric patients create a critical need for the evaluation of modern therapies in children with IgAN. Thus, it is crucial to prioritize pediatric clinical trials and to focus on removing the barriers that limit their implementation.</p>","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"1-14"},"PeriodicalIF":2.7,"publicationDate":"2026-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146009451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have potential to transform health outcomes for persons with bipolar disorder, schizophrenia, major depressive disorder and other serious mental illnesses by lengthening healthspan and reducing excess and premature mortality. 胰高血糖素样肽-1受体激动剂(GLP-1 RAs)有可能通过延长健康寿命和减少过量和过早死亡来改变双相情感障碍、精神分裂症、重度抑郁症和其他严重精神疾病患者的健康结果。
IF 2.7 3区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2026-01-23 DOI: 10.1080/14656566.2026.2621191
Roger S McIntyre
{"title":"Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have potential to transform health outcomes for persons with bipolar disorder, schizophrenia, major depressive disorder and other serious mental illnesses by lengthening healthspan and reducing excess and premature mortality.","authors":"Roger S McIntyre","doi":"10.1080/14656566.2026.2621191","DOIUrl":"10.1080/14656566.2026.2621191","url":null,"abstract":"","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"1-3"},"PeriodicalIF":2.7,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146017989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Iberogast in functional dyspepsia: yesterday, today, and tomorrow - a narrative review of a multitarget phytomedicine. 伊比利亚沼虾在功能性消化不良中的作用:昨天,今天和明天——一种多靶点植物药物的叙述性回顾。
IF 2.7 3区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2025-12-01 Epub Date: 2025-12-07 DOI: 10.1080/14656566.2025.2597281
Christian Lambiase, Paolo Usai Satta, Gabrio Bassotti, Luca Giacomelli, Nicola de Bortoli, Massimo Bellini

Introduction: Functional dyspepsia (FD) is a highly prevalent disorder of gut - brain interaction, characterized by heterogeneous symptoms, overlapping pathophysiology, and limited treatment efficacy. Iberogast®, a multi-herbal phytomedicine available for more than five decades, has emerged as a promising therapeutic option by addressing multiple mechanisms simultaneously.

Areas covered: This narrative review summarizes the pharmacological rationale, mechanisms of action, and clinical evidence supporting Iberogast's role in FD and related conditions. Literature was identified through searches of PubMed, Scopus, and Web of Science, complemented by reference screening, with the last update on 19 August 2025. Particular attention is given to the original nine-component formulation (STW 5) and the refined six-component version (STW 5-II). Evidence from randomized controlled trials, meta-analyses, mechanistic studies, and real-world data is synthesized to provide an integrated appraisal of efficacy, safety, and therapeutic positioning.

Expert opinion: Iberogast remains an evidence-based phytomedicine with a favorable safety profile, filling therapeutic gaps in FD by targeting motility, hypersensitivity, inflammation, and barrier function. Future research should include trials comparing Iberogast with established drugs, evaluating cyclic therapy in real-world settings, and exploring new indications such as irritable bowel syndrome, inflammatory bowel disease, use in pediatrics, and overlapping dyspepsia - reflux phenotypes.

功能性消化不良(FD)是一种非常普遍的肠脑相互作用疾病,其特点是症状异质性,病理生理重叠,治疗效果有限。Iberogast®是一种多草药植物药,已有50多年的历史,已成为一种有希望的治疗选择,同时解决多种机制。涵盖领域:这篇叙述性综述总结了支持伊比利亚鳕鱼在FD和相关疾病中的作用的药理学原理、作用机制和临床证据。文献通过PubMed、Scopus和Web of Science检索确定,并辅以参考文献筛选,最后一次更新于2025年8月19日。特别注意原始的九组分配方(STW 5)和精炼的六组分版本(STW 5- ii)。来自随机对照试验、荟萃分析、机制研究和真实世界数据的证据被综合起来,以提供疗效、安全性和治疗定位的综合评估。专家意见:Iberogast仍然是一种基于证据的植物药物,具有良好的安全性,通过靶向运动、过敏、炎症和屏障功能来填补FD的治疗空白。未来的研究应包括比较Iberogast与现有药物的试验,在现实环境中评估循环治疗,探索新的适应症,如肠易激综合征、炎症性肠病、儿科应用和重叠消化不良-反流表型。
{"title":"Iberogast in functional dyspepsia: yesterday, today, and tomorrow - a narrative review of a multitarget phytomedicine.","authors":"Christian Lambiase, Paolo Usai Satta, Gabrio Bassotti, Luca Giacomelli, Nicola de Bortoli, Massimo Bellini","doi":"10.1080/14656566.2025.2597281","DOIUrl":"10.1080/14656566.2025.2597281","url":null,"abstract":"<p><strong>Introduction: </strong>Functional dyspepsia (FD) is a highly prevalent disorder of gut - brain interaction, characterized by heterogeneous symptoms, overlapping pathophysiology, and limited treatment efficacy. Iberogast®, a multi-herbal phytomedicine available for more than five decades, has emerged as a promising therapeutic option by addressing multiple mechanisms simultaneously.</p><p><strong>Areas covered: </strong>This narrative review summarizes the pharmacological rationale, mechanisms of action, and clinical evidence supporting Iberogast's role in FD and related conditions. Literature was identified through searches of PubMed, Scopus, and Web of Science, complemented by reference screening, with the last update on 19 August 2025. Particular attention is given to the original nine-component formulation (STW 5) and the refined six-component version (STW 5-II). Evidence from randomized controlled trials, meta-analyses, mechanistic studies, and real-world data is synthesized to provide an integrated appraisal of efficacy, safety, and therapeutic positioning.</p><p><strong>Expert opinion: </strong>Iberogast remains an evidence-based phytomedicine with a favorable safety profile, filling therapeutic gaps in FD by targeting motility, hypersensitivity, inflammation, and barrier function. Future research should include trials comparing Iberogast with established drugs, evaluating cyclic therapy in real-world settings, and exploring new indications such as irritable bowel syndrome, inflammatory bowel disease, use in pediatrics, and overlapping dyspepsia - reflux phenotypes.</p>","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":" ","pages":"1867-1876"},"PeriodicalIF":2.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145630436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Expanding indications and developmental landscape of HER2-targeted therapies in breast cancer: a pharmacotherapeutic perspective. 乳腺癌her2靶向治疗的适应症和发展前景:药物治疗的观点。
IF 2.7 3区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2025-12-01 Epub Date: 2025-11-19 DOI: 10.1080/14656566.2025.2591813
Hikari Sano, Hideyuki Hayashi, Naomi Nakao, Hiroko Hosoi, Shunsuke Kondo

Introduction: This review provides an updated overview of the evolving pharmacologic landscape of human epidermal growth factor receptor 2 (HER2)-targeted therapies in breast cancer, highlighting key clinical trial data, recent indication expansions, resistance mechanisms, and emerging therapeutic agents in development.

Areas covered: This review draws on a comprehensive literature search of published studies and major oncology conference proceedings, focusing primarily on data from key phase III clinical trials of HER2-targeted therapies. Studies published within the past decade that have influenced current standards of care were prioritized.

Expert opinion: The treatment paradigm for HER2-expressing breast cancer is evolving rapidly. Trastuzumab deruxtecan has redefined management for both HER2-positive and the newly recognized HER2-low subgroups, while tucatinib offers a critical systemic option for central nervous system metastases. Optimal sequencing and resistance management remain critical challenges in this dynamic field. Nonetheless, HER2-targeted pharmacotherapy continues to advance rapidly, driven by innovative drug designs and strategic clinical developments.

引言:本文综述了人表皮生长因子受体2 (HER2)靶向治疗乳腺癌的最新药理学进展,重点介绍了关键的临床试验数据、近期适应症扩展、耐药机制和正在开发的新治疗剂。涵盖领域:本综述对已发表的研究和主要肿瘤学会议记录进行了全面的文献检索,主要关注her2靶向治疗的关键III期临床试验数据。在过去十年中发表的影响当前护理标准的研究被优先考虑。专家意见:her2表达乳腺癌的治疗模式正在迅速发展。曲妥珠单抗德鲁西替康重新定义了her2阳性和新发现的her2低亚组的治疗方法,而图卡替尼为中枢神经系统转移提供了一个关键的系统性选择。优化测序和耐药性管理仍然是这一动态领域的关键挑战。尽管如此,在创新药物设计和战略性临床发展的推动下,her2靶向药物治疗继续快速发展。
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引用次数: 0
The role of pharmacotherapy in the treatment of endometriosis: an update. 药物治疗在子宫内膜异位症治疗中的作用:最新进展。
IF 2.7 3区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2025-12-01 Epub Date: 2025-12-07 DOI: 10.1080/14656566.2025.2597272
Marisa Imbroane, Parker Bussies, Cara Schachter, Lexi Frankel, Allison Bosch, Julia Santarosa, Tommaso Falcone, Elliott G Richards

Introduction: Endometriosis is a chronic inflammatory condition affecting ~10% of reproductive-age individuals and contributing significantly to infertility, pain, and reduced quality of life. Since our 2020 review, new pharmacologic strategies, updated guidelines, and advances in clinical trial evidence have reshaped the therapeutic landscape. Effective, patient-centered management is essential to lessen the burden of disease.

Areas covered: This review synthesizes current evidence-based pharmacotherapy for endometriosis, integrating 2022 European Society of Human Reproduction and Embryology recommendations and including a literature review of PubMed, with an emphasis on articles published after 2020. First-line therapies, including NSAIDs, combined oral contraceptives, and progestins such as dienogest, remain central, while GnRH agonists/antagonists and aromatase inhibitors are considered in refractory cases. Recent data highlight add-back therapy to reduce hypoestrogenic side effects. We also review postoperative regimens, fertility-preserving strategies, management in post-hysterectomy and postmenopausal populations, and therapies under investigation - including anti-inflammatory, antifibrotic, angiogenesis-modulating, and microbiome-targeting approaches.

Expert opinion: Hormonal suppression remains the cornerstone of treatment, but novel nonhormonal strategies and advances in precision medicine hold promise for more durable and individualized care. Ongoing clinical trials, artificial intelligence - assisted diagnostics, and fertility-focused pharmacotherapies represent exciting frontiers. Multimodal, patient-tailored approaches will be key to optimizing long-term outcomes in endometriosis management.

简介:子宫内膜异位症是一种慢性炎症性疾病,影响约10%的育龄个体,并显著导致不孕、疼痛和生活质量下降。自2020年审查以来,新的药理学策略、更新的指南和临床试验证据的进展重塑了治疗前景。有效的、以患者为中心的管理对于减轻疾病负担至关重要。涵盖领域:本综述综合了目前子宫内膜异位症的循证药物治疗,整合了2022年欧洲人类生殖与胚胎学会的建议,并包括PubMed的文献综述,重点是2020年以后发表的文章。一线治疗,包括非甾体抗炎药、联合口服避孕药和孕激素(如dienogest),仍然是中心,而GnRH激动剂/拮抗剂和芳香化酶抑制剂在难治性病例中被考虑。最近的数据强调补充治疗可以减少雌激素水平低下的副作用。我们还回顾了术后治疗方案、保留生育能力的策略、子宫切除术后和绝经后人群的管理,以及正在研究的治疗方法,包括抗炎、抗纤维化、血管生成调节和微生物组靶向方法。专家意见:激素抑制仍然是治疗的基石,但新的非激素策略和精准医学的进步为更持久和个性化的治疗带来了希望。正在进行的临床试验、人工智能辅助诊断和以生育为重点的药物治疗代表了令人兴奋的前沿。多模式,患者量身定制的方法将是优化子宫内膜异位症管理的长期结果的关键。
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引用次数: 0
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