首页 > 最新文献

Expert Review of Clinical Pharmacology最新文献

英文 中文
Non-implantable neuromodulation therapies compared to conventional treatments for major depression. 非植入式神经调节疗法与传统治疗重度抑郁症的比较。
IF 3 3区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2026-02-10 DOI: 10.1080/17512433.2026.2626459
Victor Fontenelle Bastos Lima, Valquíria Aparecida Silva, Rebeca Pelosof, Vanessa Malfatti, Eric Cretaz, Kallene Summer Moreira Vidal, André Russowsky Brunoni, Vitor Breseghello Cavenaghi

Introduction: Depression remains a leading cause of disability worldwide. Conventional treatments, such as pharmacotherapy and psychotherapy, are first-line interventions but are limited by partial efficacy, tolerability issues, and delayed onset of action. In this context, non-implantable neuromodulation techniques can be an important tool in clinical practice addressing some of these limitations, and are the scope of this review.

Areas covered: This review synthesizes evidence on non-implantable neuromodulation for major depressive disorder, covering established modalities (ECT, MST, rTMS, tDCS, tACS) and emerging approaches (FUS, PBM, tTIS, PNS and tPEMF). Mechanisms, efficacy, tolerability, and accessibility are discussed. PubMed/MEDLINE was searched from inception to 1 November 2025, prioritizing systematic reviews, randomized trials, major guidelines, and large observational studies, with reference-list screening.

Expert opinion: Non-implantable neuromodulation therapies are evolving from experimental interventions to validated clinical options. Rather than competing with pharmacotherapy, they should be viewed as complementary components within a multimodal framework. The future of depression management likely depends on the integration of pharmacological and neuromodulatory approaches to optimize response, tolerability, and functional recovery.

抑郁症仍然是世界范围内致残的主要原因。常规治疗,如药物治疗和心理治疗,是一线干预措施,但受到部分疗效、耐受性问题和延迟起效的限制。在这种情况下,非植入式神经调节技术可以成为临床实践中解决这些局限性的重要工具,并且是本综述的范围。涵盖领域:本综述综合了非植入式神经调节治疗重度抑郁症的证据,包括已建立的模式(ECT, MST, rTMS, tDCS, tACS)和新兴方法(FUS, PBM, tTIS, PNS和tPEMF)。机制,疗效,耐受性和可及性进行了讨论。检索PubMed/MEDLINE从创建到2025年11月1日,优先考虑系统评价、随机试验、主要指南和大型观察性研究,并进行参考文献筛选。专家意见:非植入式神经调节疗法正在从实验性干预发展到经过验证的临床选择。它们不应与药物治疗竞争,而应被视为多模式框架内的互补组成部分。抑郁症管理的未来可能取决于药理学和神经调节方法的整合,以优化反应、耐受性和功能恢复。
{"title":"Non-implantable neuromodulation therapies compared to conventional treatments for major depression.","authors":"Victor Fontenelle Bastos Lima, Valquíria Aparecida Silva, Rebeca Pelosof, Vanessa Malfatti, Eric Cretaz, Kallene Summer Moreira Vidal, André Russowsky Brunoni, Vitor Breseghello Cavenaghi","doi":"10.1080/17512433.2026.2626459","DOIUrl":"10.1080/17512433.2026.2626459","url":null,"abstract":"<p><strong>Introduction: </strong>Depression remains a leading cause of disability worldwide. Conventional treatments, such as pharmacotherapy and psychotherapy, are first-line interventions but are limited by partial efficacy, tolerability issues, and delayed onset of action. In this context, non-implantable neuromodulation techniques can be an important tool in clinical practice addressing some of these limitations, and are the scope of this review.</p><p><strong>Areas covered: </strong>This review synthesizes evidence on non-implantable neuromodulation for major depressive disorder, covering established modalities (ECT, MST, rTMS, tDCS, tACS) and emerging approaches (FUS, PBM, tTIS, PNS and tPEMF). Mechanisms, efficacy, tolerability, and accessibility are discussed. PubMed/MEDLINE was searched from inception to 1 November 2025, prioritizing systematic reviews, randomized trials, major guidelines, and large observational studies, with reference-list screening.</p><p><strong>Expert opinion: </strong>Non-implantable neuromodulation therapies are evolving from experimental interventions to validated clinical options. Rather than competing with pharmacotherapy, they should be viewed as complementary components within a multimodal framework. The future of depression management likely depends on the integration of pharmacological and neuromodulatory approaches to optimize response, tolerability, and functional recovery.</p>","PeriodicalId":12207,"journal":{"name":"Expert Review of Clinical Pharmacology","volume":" ","pages":"1-15"},"PeriodicalIF":3.0,"publicationDate":"2026-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146112661","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
Evaluation of drug-drug interactions associated with metamizole in clinical practice. 在临床实践中评价与安咪唑相关的药物-药物相互作用。
IF 3 3区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2026-02-10 DOI: 10.1080/17512433.2026.2630755
Tom G Jacobs, Sharon E J D van den Eijnde, Laura Nijboer, Anke Kylstra, Steven B Nicia, David M Burger, Paul D van der Linden, Merel van Nuland

Background: Metamizole, a non-steroidal anti-inflammatory drug and moderate inducer of cytochrome P450 enzymes (CYP3A4, CYP2B6, CYP2C19), has gained increased use in clinical practice. This retrospective study evaluates the number of drug-drug interactions (DDIs) associated with metamizole when prescribed for ≥24 hours.

Research design and methods: Data were collected from the electronic healthcare records of adult patients prescribed metamizole at Tergooi Medical Center between June 2017 and May 2024. Relevant DDIs with metamizole were identified using the Metamizole DDI Manager developed by Global DDI Solutions. Only clinically relevant, i.e. orange (action may be needed) and red (contra-indicated), DDIs that occurred during or within 7 after discontinuation of metamizole treatment in a hospital setting were considered.

Results: A total of 37,110 unique patients received at least one metamizole prescription of which 2.6% (n = 968) were treated for ≥24 hours. Of these, 98.6% (n = 954) were prescribed at least one interacting medication. In total, 3680 DDIs were identified, corresponding to an average of 3.8 DDIs per metamizole prescription. Of the 98 interacting medications identified, 95% were classified as orange, and 5% as red.

Conclusions: In conclusion, metamizole is associated with a many DDIs in clinical practice. This highlights the need for careful monitoring when prescribed.

背景:Metamizole是一种非甾体抗炎药和细胞色素P450酶(CYP3A4, CYP2B6, CYP2C19)的中度诱导剂,在临床实践中越来越多地使用。这项回顾性研究评估了在处方时间≥24小时时与metamizole相关的药物-药物相互作用(ddi)的数量。研究设计与方法:数据收集于2017年6月至2024年5月在Tergooi医疗中心使用安咪唑的成年患者的电子医疗记录。使用Global DDI Solutions开发的metamizole DDI Manager识别与metamizole相关的DDI。仅考虑与临床相关的ddi,即橙色(可能需要采取行动)和红色(禁忌症),在医院环境中停止metamizole治疗期间或后7年内发生的ddi。结果:共有37,110例患者接受了至少一次甲胺唑处方,其中2.6% (n = 968)的治疗时间≥24小时。其中,98.6% (n = 954)至少服用了一种相互作用的药物。总共确定了3680个ddi,相当于平均每个metamizole处方3.8个ddi。在确定的98种相互作用的药物中,95%被归类为橙色,5%被归类为红色。结论:在临床实践中,metamizole与许多ddi相关。这突出了在规定时进行仔细监测的必要性。
{"title":"Evaluation of drug-drug interactions associated with metamizole in clinical practice.","authors":"Tom G Jacobs, Sharon E J D van den Eijnde, Laura Nijboer, Anke Kylstra, Steven B Nicia, David M Burger, Paul D van der Linden, Merel van Nuland","doi":"10.1080/17512433.2026.2630755","DOIUrl":"https://doi.org/10.1080/17512433.2026.2630755","url":null,"abstract":"<p><strong>Background: </strong>Metamizole, a non-steroidal anti-inflammatory drug and moderate inducer of cytochrome P450 enzymes (CYP3A4, CYP2B6, CYP2C19), has gained increased use in clinical practice. This retrospective study evaluates the number of drug-drug interactions (DDIs) associated with metamizole when prescribed for ≥24 hours.</p><p><strong>Research design and methods: </strong>Data were collected from the electronic healthcare records of adult patients prescribed metamizole at Tergooi Medical Center between June 2017 and May 2024. Relevant DDIs with metamizole were identified using the Metamizole DDI Manager developed by Global DDI Solutions. Only clinically relevant, i.e. orange (action may be needed) and red (contra-indicated), DDIs that occurred during or within 7 after discontinuation of metamizole treatment in a hospital setting were considered.</p><p><strong>Results: </strong>A total of 37,110 unique patients received at least one metamizole prescription of which 2.6% (n = 968) were treated for ≥24 hours. Of these, 98.6% (n = 954) were prescribed at least one interacting medication. In total, 3680 DDIs were identified, corresponding to an average of 3.8 DDIs per metamizole prescription. Of the 98 interacting medications identified, 95% were classified as orange, and 5% as red.</p><p><strong>Conclusions: </strong>In conclusion, metamizole is associated with a many DDIs in clinical practice. This highlights the need for careful monitoring when prescribed.</p>","PeriodicalId":12207,"journal":{"name":"Expert Review of Clinical Pharmacology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146149523","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
Vaping Δ9-Tetrahydrocannabinol (Δ9-THC) in liquid forms: pharmacokinetics, pharmacodynamics, and regulatory implications. 液体形式的电子烟Δ9-Tetrahydrocannabinol (Δ9-THC):药代动力学、药效学和监管意义。
IF 3 3区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2026-02-10 DOI: 10.1080/17512433.2026.2630756
Ashleigh C Block, Danielle M Smith, Maciej L Goniewicz

Introduction: Little is known about the pharmacokinetics (PK) and pharmacodynamics (PD) of Δ9-tetrahydrocannabinol (Δ9-THC) when vaped in liquid formulations. As prevalence of vaping Δ9-THC in liquid forms grows, understanding the factors that influence PK/PD profiles is critical to guide future research and cannabis regulation.

Areas covered: Currently, no human studies have elucidated the PK/PD profile of Δ9-THC from vaped liquids, as confirmed by searches of PubMed and Embase. Using existing research on smoked cannabis and nicotine-containing e-cigarettes, this review examines the potential influence of product potency, vaporization efficiency, consumer use behaviors, aerosol bioavailability, and other constituents on the PK/PD profile of Δ9-THC vaped in liquid forms. Further, we hypothesize whether the PK/PD of Δ9-THC in liquid forms may differ from smoked cannabis and address potential regulatory implications (United States-focused) of novel vaping products.

Expert opinion: While more potent than smoked cannabis, vaped liquid formulations with Δ9-THC may have a similar PK/PD profile through modulation of Δ9-THC delivery by consumer use behaviors. Potential health effects of high-potency vaping products with Δ9-THC in liquid form need to be carefully studied. Lastly, researchers should continue to think creatively about how this important work can progress while restrictions on Δ9-THC continue to hinder research.

介绍:很少知道的药代动力学(PK)和药效学(PD)的Δ9-tetrahydrocannabinol (Δ9-THC),当蒸发在液体制剂。随着液体形式的电子烟Δ9-THC的流行程度越来越高,了解影响PK/PD谱的因素对于指导未来的研究和大麻监管至关重要。涉及领域:目前,通过PubMed和Embase的搜索证实,没有人类研究阐明了电子烟液体中Δ9-THC的PK/PD谱。利用现有的大麻吸食和含尼古丁电子烟的研究,本综述探讨了产品效价、蒸发效率、消费者使用行为、气溶胶生物利用度和其他成分对液体形式的Δ9-THC的PK/PD谱的潜在影响。此外,我们假设液体形式的Δ9-THC的PK/PD是否可能与吸烟大麻不同,并解决新型电子烟产品的潜在监管影响(以美国为重点)。专家意见:虽然含有Δ9-THC的蒸汽液体制剂比吸烟大麻更有效,但通过消费者使用行为调节Δ9-THC的递送,可能具有类似的PK/PD概况。液体形式含有Δ9-THC的高效电子烟产品的潜在健康影响需要仔细研究。最后,研究人员应该继续创造性地思考,在Δ9-THC的限制继续阻碍研究的情况下,这项重要的工作如何取得进展。
{"title":"Vaping Δ<sup>9</sup>-Tetrahydrocannabinol (Δ<sup>9</sup>-THC) in liquid forms: pharmacokinetics, pharmacodynamics, and regulatory implications.","authors":"Ashleigh C Block, Danielle M Smith, Maciej L Goniewicz","doi":"10.1080/17512433.2026.2630756","DOIUrl":"https://doi.org/10.1080/17512433.2026.2630756","url":null,"abstract":"<p><strong>Introduction: </strong>Little is known about the pharmacokinetics (PK) and pharmacodynamics (PD) of Δ<sup>9</sup>-tetrahydrocannabinol (Δ<sup>9</sup>-THC) when vaped in liquid formulations. As prevalence of vaping Δ<sup>9</sup>-THC in liquid forms grows, understanding the factors that influence PK/PD profiles is critical to guide future research and cannabis regulation.</p><p><strong>Areas covered: </strong>Currently, no human studies have elucidated the PK/PD profile of Δ<sup>9</sup>-THC from vaped liquids, as confirmed by searches of PubMed and Embase. Using existing research on smoked cannabis and nicotine-containing e-cigarettes, this review examines the potential influence of product potency, vaporization efficiency, consumer use behaviors, aerosol bioavailability, and other constituents on the PK/PD profile of Δ<sup>9</sup>-THC vaped in liquid forms. Further, we hypothesize whether the PK/PD of Δ<sup>9</sup>-THC in liquid forms may differ from smoked cannabis and address potential regulatory implications (United States-focused) of novel vaping products.</p><p><strong>Expert opinion: </strong>While more potent than smoked cannabis, vaped liquid formulations with Δ<sup>9</sup>-THC may have a similar PK/PD profile through modulation of Δ<sup>9</sup>-THC delivery by consumer use behaviors. Potential health effects of high-potency vaping products with Δ<sup>9</sup>-THC in liquid form need to be carefully studied. Lastly, researchers should continue to think creatively about how this important work can progress while restrictions on Δ<sup>9</sup>-THC continue to hinder research.</p>","PeriodicalId":12207,"journal":{"name":"Expert Review of Clinical Pharmacology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146149561","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
CYP2C19 genotype-guided dosing of proton pump inhibitors: progress in clinical trials and real-world use. CYP2C19基因型引导质子泵抑制剂给药:临床试验和实际应用进展
IF 3 3区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2026-02-08 DOI: 10.1080/17512433.2026.2626454
Han Minh Thuy, Mitsushige Sugimoto, Pham Minh Ngoc Quang, Yoshio Yamaoka

Introduction: Proton pump inhibitors (PPIs) are widely used to treat acid-related disorders; however, treatment response varies significantly due to Cytochrome P450 2C19 (CYP2C19) genetic polymorphisms that alter individual drug metabolism. Such variation can lead to insufficient acid suppression, resulting in treatment failure or adverse events. Genotype-guided PPI therapy represents an important step toward personalized gastroenterology by optimizing drug efficacy and safety.

Areas covered: This review summarizes evidence from clinical trials and meta-analyses examining CYP2C19-mediated differences in the pharmacokinetics and pharmacodynamics of PPIs in both adults and children. Relevant literature was identified primarily through PubMed and clinical guidelines, covering publications from 1989 to 2025. The review focuses on outcomes related to gastroesophageal reflux disease (GERD), Helicobacter pylori eradication, and eosinophilic esophagitis. Current trials indicate that genotype-guided, tailored PPI therapy - through dose adjustment, drug selection, or regimen modification - can improve treatment efficacy and control abdominal symptoms without increasing safety risks or costs.

Expert opinion: CYP2C19 genotype-guided therapy constitutes a practical approach to personalized medicine for acid-related disorders. Barriers to widespread implementation include limited test availability, uncertain cost-effectiveness, and insufficient clinician awareness. Future directions include integrating multi-gene pharmacogenomic testing, model-informed dosing, and artificial intelligence-based decision support to advance individualized acid suppression and personalized gastroenterology.

质子泵抑制剂(PPIs)被广泛用于治疗酸相关疾病;然而,由于细胞色素P450 2C19 (CYP2C19)基因多态性改变个体药物代谢,治疗反应差异很大。这种变异可导致酸抑制不足,导致治疗失败或不良事件。基因型引导的PPI治疗通过优化药物疗效和安全性,是迈向个性化胃肠病学的重要一步。涵盖领域:本综述总结了来自临床试验和荟萃分析的证据,这些证据检验了成人和儿童中cyp2c19介导的PPIs药代动力学和药效学差异。相关文献主要通过PubMed和临床指南确定,涵盖1989年至2025年的出版物。综述的重点是与胃食管反流病(GERD)、幽门螺杆菌根除和嗜酸性粒细胞性食管炎相关的结局。目前的试验表明,基因型导向、量身定制的PPI治疗——通过剂量调整、药物选择或方案修改——可以提高治疗效果和控制腹部症状,而不会增加安全风险或成本。专家意见:CYP2C19基因型引导治疗是一种针对酸相关疾病的个体化治疗的实用方法。广泛实施的障碍包括有限的测试可用性、不确定的成本效益和临床医生认识不足。未来的发展方向包括整合多基因药物基因组学测试、模型信息给药和基于人工智能的决策支持,以推进个体化抑酸和个性化胃肠病学。
{"title":"CYP2C19 genotype-guided dosing of proton pump inhibitors: progress in clinical trials and real-world use.","authors":"Han Minh Thuy, Mitsushige Sugimoto, Pham Minh Ngoc Quang, Yoshio Yamaoka","doi":"10.1080/17512433.2026.2626454","DOIUrl":"10.1080/17512433.2026.2626454","url":null,"abstract":"<p><strong>Introduction: </strong>Proton pump inhibitors (PPIs) are widely used to treat acid-related disorders; however, treatment response varies significantly due to Cytochrome P450 2C19 (<i>CYP2C19</i>) genetic polymorphisms that alter individual drug metabolism. Such variation can lead to insufficient acid suppression, resulting in treatment failure or adverse events. Genotype-guided PPI therapy represents an important step toward personalized gastroenterology by optimizing drug efficacy and safety.</p><p><strong>Areas covered: </strong>This review summarizes evidence from clinical trials and meta-analyses examining <i>CYP2C19</i>-mediated differences in the pharmacokinetics and pharmacodynamics of PPIs in both adults and children. Relevant literature was identified primarily through PubMed and clinical guidelines, covering publications from 1989 to 2025. The review focuses on outcomes related to gastroesophageal reflux disease (GERD), <i>Helicobacter pylori</i> eradication, and eosinophilic esophagitis. Current trials indicate that genotype-guided, tailored PPI therapy - through dose adjustment, drug selection, or regimen modification - can improve treatment efficacy and control abdominal symptoms without increasing safety risks or costs.</p><p><strong>Expert opinion: </strong><i>CYP2C19</i> genotype-guided therapy constitutes a practical approach to personalized medicine for acid-related disorders. Barriers to widespread implementation include limited test availability, uncertain cost-effectiveness, and insufficient clinician awareness. Future directions include integrating multi-gene pharmacogenomic testing, model-informed dosing, and artificial intelligence-based decision support to advance individualized acid suppression and personalized gastroenterology.</p>","PeriodicalId":12207,"journal":{"name":"Expert Review of Clinical Pharmacology","volume":" ","pages":"1-18"},"PeriodicalIF":3.0,"publicationDate":"2026-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146092219","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
New and emerging treatments for vitiligo: a narrative review. 新的和新兴的治疗白癜风:叙述回顾。
IF 3 3区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2026-02-06 DOI: 10.1080/17512433.2026.2626458
Carolina Rodrigues Mendonça, Adam Mohamed, Amir Mohamed, Cesar Ferreira, Tiago Torres

Introduction: Vitiligo is a chronic autoimmune skin disorder characterized by progressive melanocyte loss, resulting in well-demarcated depigmented patches that significantly impact quality of life. Affecting 0.5-2% of the global population, vitiligo poses both psychosocial and therapeutic challenges. Despite multiple conventional therapies such as corticosteroids, calcineurin inhibitors, and phototherapy, durable repigmentation remains difficult to achieve.

Areas covered: This review summarizes recent advances in understanding the emerging medical treatment of vitiligo. A targeted literature search was conducted using PubMed, Embase, and ClinicalTrials.gov from inception to April 2025. Key clinical trial data are discussed to evaluate efficacy, safety and durability of response across therapeutic classes.

Expert opinion: The approval of topical ruxolitinib marks a pivotal step toward precision therapy in vitiligo. Ongoing studies of combination and maintenance regimens offer promise for sustained repigmentation and disease stabilization. However, optimizing long-term outcomes requires continued translational research to elucidate mechanisms of relapse, improve accessibility of emerging therapies and personalize treatment strategies to individual disease phenotypes.

白癜风是一种慢性自身免疫性皮肤疾病,其特征是黑素细胞进行性损失,导致界限清晰的脱色斑块,严重影响生活质量。白癜风影响全球0.5-2%的人口,给社会心理和治疗带来挑战。尽管有多种常规疗法,如皮质类固醇、钙调磷酸酶抑制剂和光疗,持久的色素沉着仍然难以实现。涵盖领域:本文综述了白癜风新兴医学治疗的最新进展。从成立到2025年4月,使用PubMed、Embase和ClinicalTrials.gov进行有针对性的文献检索。关键的临床试验数据进行讨论,以评估疗效,安全性和反应的持久性在治疗类。专家意见:局部ruxolitinib的批准标志着白癜风精准治疗的关键一步。正在进行的联合和维持方案的研究为持续的色素沉着和疾病稳定提供了希望。然而,优化长期结果需要持续的转化研究,以阐明复发机制,提高新兴疗法的可及性,并针对个体疾病表型制定个性化治疗策略。
{"title":"New and emerging treatments for vitiligo: a narrative review.","authors":"Carolina Rodrigues Mendonça, Adam Mohamed, Amir Mohamed, Cesar Ferreira, Tiago Torres","doi":"10.1080/17512433.2026.2626458","DOIUrl":"https://doi.org/10.1080/17512433.2026.2626458","url":null,"abstract":"<p><strong>Introduction: </strong>Vitiligo is a chronic autoimmune skin disorder characterized by progressive melanocyte loss, resulting in well-demarcated depigmented patches that significantly impact quality of life. Affecting 0.5-2% of the global population, vitiligo poses both psychosocial and therapeutic challenges. Despite multiple conventional therapies such as corticosteroids, calcineurin inhibitors, and phototherapy, durable repigmentation remains difficult to achieve.</p><p><strong>Areas covered: </strong>This review summarizes recent advances in understanding the emerging medical treatment of vitiligo. A targeted literature search was conducted using PubMed, Embase, and ClinicalTrials.gov from inception to April 2025. Key clinical trial data are discussed to evaluate efficacy, safety and durability of response across therapeutic classes.</p><p><strong>Expert opinion: </strong>The approval of topical ruxolitinib marks a pivotal step toward precision therapy in vitiligo. Ongoing studies of combination and maintenance regimens offer promise for sustained repigmentation and disease stabilization. However, optimizing long-term outcomes requires continued translational research to elucidate mechanisms of relapse, improve accessibility of emerging therapies and personalize treatment strategies to individual disease phenotypes.</p>","PeriodicalId":12207,"journal":{"name":"Expert Review of Clinical Pharmacology","volume":" ","pages":"1-16"},"PeriodicalIF":3.0,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146124296","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
Pharmacological interventions for alcohol use disorder: novel insights from recent clinical trials. 酒精使用障碍的药物干预:来自最近临床试验的新见解。
IF 3 3区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2026-02-03 DOI: 10.1080/17512433.2026.2625341
Kaitlin R McManus, Lara A Ray

Introduction: 27.1 million adults in the United States have alcohol use disorder (AUD). However, current medications for AUD have mixed efficacy. As such, a shift in treatment approach and the development of novel pharmacotherapies for AUD is imperative.

Areas covered: This review addresses novel insights on treating AUD through precision medicine that identifies subgroups of individuals most responsive to existing single or combination pharmacotherapies for AUD. In parallel, this review synthesizes the emergence of pharmacological agents for AUD that are on the treatment horizon. These include glucagon-like peptide 1 receptor agonists, classic psychedelics, ketamine, immune modulators, and cannabinoids. Data reviewed were culled from searches of the PubMed database and clinicaltrials.gov registry.

Expert opinion: Adopting a precision medicine approach and investigating novel compounds for AUD treatment requires a shift in systems of care. Precision medicine navigates away from the traditional 'one size fits all' health care model to emphasize the individual, leading to long-term cost-effectiveness and improved patient outcomes. Moreover, novel pharmacotherapies face challenges in the scale of their distribution throughout healthcare settings. The developments reviewed in this paper elucidate a paradigm shift necessary to facilitate the integration of precision medicine and the adoption of novel pharmacotherapies within the AUD field.

简介:美国有2710万成年人患有酒精使用障碍(AUD)。然而,目前治疗AUD的药物疗效不一。因此,治疗方法的转变和新型药物治疗AUD的发展是必要的。涵盖领域:本综述阐述了通过精确医学治疗AUD的新见解,该医学确定了对现有单一或联合药物治疗AUD最敏感的个体亚组。与此同时,本文综述了新近出现的AUD治疗药物。这些药物包括胰高血糖素样肽1受体激动剂、经典致幻剂、氯胺酮、免疫调节剂和大麻素。审查的数据是从PubMed数据库和clinicaltrials.gov注册表的搜索中挑选出来的。专家意见:采用精准医学方法和研究治疗AUD的新化合物需要医疗系统的转变。精准医疗摆脱了传统的“一刀切”的医疗模式,强调个体,从而带来长期的成本效益,并改善了患者的治疗效果。此外,新型药物疗法在整个医疗保健环境中的分布规模面临挑战。本文回顾的发展阐明了促进精准医学整合和在AUD领域采用新型药物治疗所必需的范式转变。
{"title":"Pharmacological interventions for alcohol use disorder: novel insights from recent clinical trials.","authors":"Kaitlin R McManus, Lara A Ray","doi":"10.1080/17512433.2026.2625341","DOIUrl":"10.1080/17512433.2026.2625341","url":null,"abstract":"<p><strong>Introduction: </strong>27.1 million adults in the United States have alcohol use disorder (AUD). However, current medications for AUD have mixed efficacy. As such, a shift in treatment approach and the development of novel pharmacotherapies for AUD is imperative.</p><p><strong>Areas covered: </strong>This review addresses novel insights on treating AUD through precision medicine that identifies subgroups of individuals most responsive to existing single or combination pharmacotherapies for AUD. In parallel, this review synthesizes the emergence of pharmacological agents for AUD that are on the treatment horizon. These include glucagon-like peptide 1 receptor agonists, classic psychedelics, ketamine, immune modulators, and cannabinoids. Data reviewed were culled from searches of the PubMed database and clinicaltrials.gov registry.</p><p><strong>Expert opinion: </strong>Adopting a precision medicine approach and investigating novel compounds for AUD treatment requires a shift in systems of care. Precision medicine navigates away from the traditional 'one size fits all' health care model to emphasize the individual, leading to long-term cost-effectiveness and improved patient outcomes. Moreover, novel pharmacotherapies face challenges in the scale of their distribution throughout healthcare settings. The developments reviewed in this paper elucidate a paradigm shift necessary to facilitate the integration of precision medicine and the adoption of novel pharmacotherapies within the AUD field.</p>","PeriodicalId":12207,"journal":{"name":"Expert Review of Clinical Pharmacology","volume":" ","pages":"1-11"},"PeriodicalIF":3.0,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146085067","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
Understanding RAMP1's role in hormonal migraine may improve CGRP-targeted therapies. 了解RAMP1在激素偏头痛中的作用可能会改善cgrp靶向治疗。
IF 3 3区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2026-02-02 DOI: 10.1080/17512433.2026.2624476
Lars Edvinsson, Anja Holm
{"title":"Understanding RAMP1's role in hormonal migraine may improve CGRP-targeted therapies.","authors":"Lars Edvinsson, Anja Holm","doi":"10.1080/17512433.2026.2624476","DOIUrl":"10.1080/17512433.2026.2624476","url":null,"abstract":"","PeriodicalId":12207,"journal":{"name":"Expert Review of Clinical Pharmacology","volume":" ","pages":"1-3"},"PeriodicalIF":3.0,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146061078","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
Population pharmacokinetic modeling of piperacillin in critically ill adult patients: consideration of sex-based differences during model development. 危重成人患者哌拉西林的群体药代动力学建模:模型开发过程中基于性别差异的考虑
IF 3 3区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2026-01-30 DOI: 10.1080/17512433.2026.2620530
Ibrahim El-Haffaf, David Williamson, Van Dong Nguyen, Alexandre Duong, Virginie Williams, Marc-André Smith, Martin Albert, Hugues Blain, Nicolas Goettel, Bianca Beloin-Jubinville, François Lamontagne, Amélie Marsot

Background: Piperacillin population pharmacokinetic models reportedly perform poorly for critically ill females compared to males. We aimed to explore potential methods that may better adjust for female data during model development.

Research design and methods: Total piperacillin concentrations were used from a prospective observational study in NONMEM v7.5.1. Two models were developed following different approaches: classic stepwise approach and sex-specific approach. Relationship between covariates and estimated parameters were explored by statistically and graphically assessing their performance on males and females separately. Dosing regimen simulations were also performed separately by sex.

Results: A one-compartment model based on data from 70 critically ill patients (49/21 males/females) with 233 concentrations best fit the data with both approaches. Creatinine clearance was the most significant covariate for the classic approach model, while creatinine clearance was best for male patients and estimated glomerular filtration rate was best for female patients with the sex-specific approach. Dosing recommendations were different between male and female patients with the sex-specific model.

Conclusion: This study is the first to consider sex-specific covariates during the modeling process for piperacillin in critically ill patients. This approach may help reduce differences in model predictions between males and females in model-informed precision dosing strategies.

背景:与男性相比,哌拉西林人群药代动力学模型在危重女性患者中表现较差。我们的目标是探索可能在模型开发过程中更好地调整女性数据的潜在方法。研究设计和方法:哌拉西林总浓度采用NONMEM v7.5.1的前瞻性观察性研究。根据不同的方法建立了两个模型:经典逐步方法和性别特异性方法。通过统计和图形分别评估其在男性和女性中的表现,探讨了协变量和估计参数之间的关系。给药方案模拟也按性别分别进行。结果:基于70例危重患者(49/21男/女)233浓度数据的单室模型最适合两种方法的数据。在经典入路模型中,肌酐清除率是最显著的协变量,而在性别特异性入路中,男性患者的肌酐清除率最好,女性患者的肾小球滤过率估计值最好。在性别特异性模型中,男性和女性患者的剂量建议不同。结论:本研究首次在危重患者哌拉西林的建模过程中考虑了性别特异性协变量。这种方法可能有助于减少在模型知情的精确给药策略中男性和女性之间模型预测的差异。
{"title":"Population pharmacokinetic modeling of piperacillin in critically ill adult patients: consideration of sex-based differences during model development.","authors":"Ibrahim El-Haffaf, David Williamson, Van Dong Nguyen, Alexandre Duong, Virginie Williams, Marc-André Smith, Martin Albert, Hugues Blain, Nicolas Goettel, Bianca Beloin-Jubinville, François Lamontagne, Amélie Marsot","doi":"10.1080/17512433.2026.2620530","DOIUrl":"10.1080/17512433.2026.2620530","url":null,"abstract":"<p><strong>Background: </strong>Piperacillin population pharmacokinetic models reportedly perform poorly for critically ill females compared to males. We aimed to explore potential methods that may better adjust for female data during model development.</p><p><strong>Research design and methods: </strong>Total piperacillin concentrations were used from a prospective observational study in NONMEM v7.5.1. Two models were developed following different approaches: classic stepwise approach and sex-specific approach. Relationship between covariates and estimated parameters were explored by statistically and graphically assessing their performance on males and females separately. Dosing regimen simulations were also performed separately by sex.</p><p><strong>Results: </strong>A one-compartment model based on data from 70 critically ill patients (49/21 males/females) with 233 concentrations best fit the data with both approaches. Creatinine clearance was the most significant covariate for the classic approach model, while creatinine clearance was best for male patients and estimated glomerular filtration rate was best for female patients with the sex-specific approach. Dosing recommendations were different between male and female patients with the sex-specific model.</p><p><strong>Conclusion: </strong>This study is the first to consider sex-specific covariates during the modeling process for piperacillin in critically ill patients. This approach may help reduce differences in model predictions between males and females in model-informed precision dosing strategies.</p>","PeriodicalId":12207,"journal":{"name":"Expert Review of Clinical Pharmacology","volume":" ","pages":"1-15"},"PeriodicalIF":3.0,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146009605","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
GLP-1 receptor agonist safety in a perioperative setting: more questions than answers. GLP-1受体激动剂围手术期的安全性:问题多于答案。
IF 3 3区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2026-01-28 DOI: 10.1080/17512433.2026.2621247
Graziella Aquilina, Sarah Valerie Casha, Maria Cordina, Ivan Debono, Anthony Fenech, Janet Mifsud, Vanessa Petroni-Magri, Cesca Vassallo, Janet Sultana
{"title":"GLP-1 receptor agonist safety in a perioperative setting: more questions than answers.","authors":"Graziella Aquilina, Sarah Valerie Casha, Maria Cordina, Ivan Debono, Anthony Fenech, Janet Mifsud, Vanessa Petroni-Magri, Cesca Vassallo, Janet Sultana","doi":"10.1080/17512433.2026.2621247","DOIUrl":"10.1080/17512433.2026.2621247","url":null,"abstract":"","PeriodicalId":12207,"journal":{"name":"Expert Review of Clinical Pharmacology","volume":" ","pages":"1-4"},"PeriodicalIF":3.0,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146017929","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
Risk factors and clinical outcomes associated with mitral annular calcification in hypertrophic obstructive cardiomyopathy: a retrospective analysis. 肥厚性梗阻性心肌病二尖瓣环钙化相关的危险因素和临床结果:回顾性分析。
IF 3 3区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2026-01-16 DOI: 10.1080/17512433.2026.2619131
Bowen Guo, Bangrong Song, Xiaoyu Xu, Haiming Dang, Ran Dong

Objective: This study aimed to identify risk factors associated with mitral annular calcification (MAC) in patients with hypertrophic obstructive cardiomyopathy (HOCM) and to evaluate its relationship with clinical outcomes.

Methods: A total of 310 patients with HOCM who underwent interventricular septal myectomy were retrospectively analyzed. Patients were divided into a MAC group (n = 24) and a non-MAC group (n = 286). Demographic characteristics, echocardiographic parameters, and clinical data were compared between groups. Major adverse cardiovascular and cerebrovascular event (MACCE) and circulating levels of brain natriuretic peptide, Apelin, and Galectin-3 were analyzed.

Results: Patients with MAC were older and showed higher prevalence of aortic annular calcification, mitral leaflet thickening, and moderate-to-severe tricuspid regurgitation (P < 0.05). Multivariate analysis identified gender, age, aortic annular calcification, moderate-to-severe tricuspid regurgitation, and mitral leaflet thickening as independent risk factors for MAC. Patients with MAC showed larger left ventricular end-diastolic volume, reduced left ventricular ejection fraction, and greater left atrium mass, and a higher incidence of MACCE than those without MAC (P < 0.05).

Conclusion: In HOCM undergoing septal myectomy, MAC is associated with adverse cardiac remodeling and unfavorable clinical outcomes. Identification of related factors may aid risk stratification and perioperative management.

目的:本研究旨在确定肥厚性阻塞性心肌病(HOCM)患者二尖瓣环钙化(MAC)的相关危险因素,并评估其与临床预后的关系。方法:对310例房间隔肌切除术的HOCM患者进行回顾性分析。患者分为MAC组(n = 24)和非MAC组(n = 286)。比较两组患者的人口学特征、超声心动图参数及临床资料。分析主要心脑血管不良事件(MACCE)及循环脑利钠肽、Apelin、半乳糖凝集素-3水平。结果:MAC患者年龄较大,主动脉环钙化、二尖瓣小叶增厚、中重度三尖瓣反流发生率较高(P)。结论:在行间隔肌切除术的HOCM中,MAC与不良的心脏重构和不良的临床结果相关。识别相关因素有助于风险分层和围手术期管理。
{"title":"Risk factors and clinical outcomes associated with mitral annular calcification in hypertrophic obstructive cardiomyopathy: a retrospective analysis.","authors":"Bowen Guo, Bangrong Song, Xiaoyu Xu, Haiming Dang, Ran Dong","doi":"10.1080/17512433.2026.2619131","DOIUrl":"https://doi.org/10.1080/17512433.2026.2619131","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to identify risk factors associated with mitral annular calcification (MAC) in patients with hypertrophic obstructive cardiomyopathy (HOCM) and to evaluate its relationship with clinical outcomes.</p><p><strong>Methods: </strong>A total of 310 patients with HOCM who underwent interventricular septal myectomy were retrospectively analyzed. Patients were divided into a MAC group (n = 24) and a non-MAC group (n = 286). Demographic characteristics, echocardiographic parameters, and clinical data were compared between groups. Major adverse cardiovascular and cerebrovascular event (MACCE) and circulating levels of brain natriuretic peptide, Apelin, and Galectin-3 were analyzed.</p><p><strong>Results: </strong>Patients with MAC were older and showed higher prevalence of aortic annular calcification, mitral leaflet thickening, and moderate-to-severe tricuspid regurgitation (P < 0.05). Multivariate analysis identified gender, age, aortic annular calcification, moderate-to-severe tricuspid regurgitation, and mitral leaflet thickening as independent risk factors for MAC. Patients with MAC showed larger left ventricular end-diastolic volume, reduced left ventricular ejection fraction, and greater left atrium mass, and a higher incidence of MACCE than those without MAC (P < 0.05).</p><p><strong>Conclusion: </strong>In HOCM undergoing septal myectomy, MAC is associated with adverse cardiac remodeling and unfavorable clinical outcomes. Identification of related factors may aid risk stratification and perioperative management.</p>","PeriodicalId":12207,"journal":{"name":"Expert Review of Clinical Pharmacology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145988908","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
期刊
Expert Review of Clinical Pharmacology
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