Current Drug Research Reviews最新文献

Background: Neuropathic pain (NP) presents a significant actual public health challenge. Traditional treatments primarily involve medications, but these approaches frequently yield unsatisfactory results, highlighting the need to explore alternative therapies, such as platelet-rich plasma (PRP), an autologous plasma derivative enriched with platelets.

Objective: This article aims to systematically review the literature and provide an updated assessment of the efficacy and safety of PRP treatment for NP.

Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched databases, including Web of Science, Embase, PubMed, Scopus, and Cochrane Library. We assessed bias risk using the Cochrane Risk of Bias 2 tool (RoB2).

Results: Among 1230 studies identified, 12 randomized trials meeting eligibility criteria were included. Due to substantial heterogeneity, pairwise meta-analysis and intervention ranking were found to be unfeasible. Most trials suggest PRP is effective in relieving NP, with no reported serious complications or significant PRP-related adverse effects. However, these findings were compromised by methodological heterogeneity and study inconsistency.

Conclusion: PRP has shown to be promising as a safe therapeutic option for managing NP. Future studies should prioritize improved rigor and reproducibility for more stringent conclusions.

Introduction: Breast milk is the preferred source of nutrition for premature infants. Galactagogues are used in initiation, induction, and maintenance of lactation. This study examined the effectiveness of fenugreek on prolactin levels and milk volume (primary outcomes), neonatal weight gain, breastfeeding satisfaction, and side effects (secondary outcomes).

Methods: This triple-blind randomized controlled trial was conducted on 68 mothers with preterm newborns less than 32 weeks in Al-Zahra and Taleghani hospitals in Tabriz-Iran. Participants were randomly allocated into fenugreek and placebo groups. About 500 mg of fenugreek and placebo capsules were administered to the participants three times a day, from the fifth day after delivery to the 14th day. Breast milk volume was measured on the fourth day after delivery (one day before the intervention), the seventh day, and the fifteenth day after the intervention. Prolactin levels were measured in the morning before and after the intervention.

Results: On the seventh day of the intervention, milk volume was significantly higher in the fenugreek group than in the placebo group (p =0.017). Nevertheless, no statistically significant difference was observed between groups in milk volume (p =0.073) and prolactin level (p =0.324) on day 15. Moreover, no statistically significant difference was observed between groups regarding newborn weight after intervention (p =0.172) or satisfaction with breastfeeding (p =0.484). None of the participants reported any side effects.

Conclusions: Fenugreek increases milk volume but has no significant effect on prolactin levels. Further trials with larger sample sizes should be performed to obtain conclusive results.

Clinical trial registration number: IRCT20120718010324N62.

Cyclophosphamide is a drug derived from nitrogenous mustards and is mainly indicated for the anti-neoplastic clinic. When it is metabolized in the liver, it produces acrolein, a cytotoxic metabolite capable of generating damage to the body. The oxidative, nitrative and nitrosative stress are responsible for mediating this side effect since the toxicity of the drug induces the production of reactive species of oxygen (ROS) and nitrogen (RNS). These radicals are unstable and react with other molecules that can result in cellular lesions such as lipid peroxidation, enzymatic inactivation, and excessive activation of pro-inflammatory genes, producing molecules such as malonaldehyde (MDA) and nitric oxide (NO), representing oxidative stress markers. One of the consequences of these mechanisms is nephrotoxicity. In contrast, some compounds have direct or indirect antioxidante action, which are the objects of this study: gallic acid, aminoguanidine, chrysin, hesperidine, naringin, morin-5'-sulfonic acid sodium salt and spirulina. All of them are responsible for the nephroprotective activity when administered during experiments in vitro or in vivo. Thus, this observational bibliographic research is characterized as qualitative descriptive and explanatory, since it focuses on analyzing the antioxidant properties of compounds with possible potentials to inhibit the nephrotoxicity induced by cyclophosphamide and describe the results, in addition to clarifying the biochemical activities involved in the process.

Background: Pancreatic neoplasm is one of the types of cancer with a high incidence and case-fatality rate.

Objectives: This study was designed to investigate the relationship between statin intake and the risk of pancreatic cancer with a systematic review and meta-analysis approach.

Methods: This study was a systematic review and meta-analysis of studies published before 2023 in Cochrane Library, Web of Science (WOS), PubMed, Google Scholar, ScienceDirect, Scopus, and Embase databases. The statistical analyses were conducted using Stata software, version 15. The significance level for this study was set at 0.05.

Results: This meta-analysis included 32 studies and a total of 5,849,814 participants. The risk ratio (RR) of pancreatic cancer in comparison to the non-statin receiving group in statin users in total was equal to 0.75 (95% CI: 0.66-0.86, p-value <0.001), in the cohort studies was obtained to be 0.70 (0.53-0.93), in the randomized clinical trials (RCTs) had a ratio of 0.99 (0.53-1.86), while studies conducted in American countries had a ratio of 0.69 (0.51-0.93), studies in Asian countries had a ratio of 0.73 (0.56-0.97), and studies in European countries had a ratio of 0.88 (0.76-1.02). Furthermore, the study did not detect any signs of publication bias.

Conclusion: The study findings suggest a potential connection between using statins and a lower risk of pancreatic cancer. However, it is important to note that controlled clinical trials did not find a statistically significant association between taking statins and the development of pancreatic cancer. Therefore, it is advisable to exercise caution when interpreting the results of this study.

Background: Sickle cell disease is a severe genetic disorder, and searching for therapeutic strategies is indispensable for prolonged and improved life for people affected by this condition.

Objectives: This qualitative systematic review aimed to highlight the therapeutic potential of omega- 3 (n-3) in people with sickle cell disease.

Methods: The search was performed by combining sickle cell disease and n-3 descriptors in DeCS/ MeSH databases, including Scopus, PubMed, ScienceDirect, Web of Science, and Virtual Health Library. The risk of bias assessment in the primary studies was performed using the Cochrane risk of bias tool for randomized controlled trials. The evidence quality was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool.

Results: From the 187 records identified, seven were selected for data collection. Based on the evidence, n-3 supplementation contributes to lower activation of pro-inflammatory biomarkers, improves the concentration of docosahexaenoic and eicosapentaenoic acids in the erythrocyte membrane, provides better hemostatic response, and helps in vaso-occlusive crisis, pain episodes, and hospitalization reduction.

Conclusion: The findings suggest that n-3 adjuvant therapy favors the clinical and general aspects of people with sickle cell disease.

Background: Rheumatoid Arthritis (RA) is a systemic inflammatory auto-immune disorder chiefly described by synovitis followed by extra-articular manifestations of organ association such as pneumonia in addition to the clinical symptoms that cause long-term joint damage starting from the small joints and gradually progressing to the larger ones. Early diagnosis is considered a major improvement for the most desirable outcomes. Methotrexate (MTX), an antifolate, has been the gold standard therapy in use for over forty years as an anchor drug. This drug started out as an anti-cancer drug in large doses and is now in use to treat rheumatoid arthritis at very low doses. The treatments for rheumatoid arthritis aim to curb the swelling in the body and protect the joints from further damage. Recent research has seen an increase in the use of combination therapies with Methotrexate.

Objectives: In this paper, we present a summary of the current drug in use and its side effects, associated with RA. The paper gives an account of alternate modes of treatment that have been explored for the treatment of rheumatoid arthritis.

Conclusion: Initially designed to inhibit the enzyme dihydrofolate reductase and treat various types of cancer, methotrexate found application as an anti-rheumatic drug in 1984 although suggestions for the same have been made since the 1950s. Since then, a substantial amount of clinical evidence has been obtained to clearly indicate the cytotoxic activity of the drug against the cells responsible for joint inflammation associated with RA. Thus, methotrexate is a clear choice when it comes to treating RA despite the advent of other lines of treatment being explored and implemented.

Osteoarthritis (OA) is a disease characterized by degeneration of cartilage or wear and tear. OA is a cause of disability and health issues. It is a disease that affects more than 500 million adults annually worldwide, of which India accounts for about 22 to 39% of OA patients. The most common type of osteoarthritis is knee OA. Pathogenesis of OA requires evolution in basic science and clinical research to enhance our understanding of the pathogenesis and as well as different treatment options. It is mainly classified as primary and secondary OA. The treatment for OA can only reduce the symptoms and cannot cure the disease itself, including pharmacological treatment, like non-steroidal anti-inflammatory drugs (NSAIDs), acting on COX1 (cyclooxygenase 1) and COX2 (cyclooxygenase 2) enzymes. Non-pharmacological treatments for OA include exercise like walking, and aerobic exercise, diet, weight loss, hot and cold therapy, as well as electrotherapy, which improves muscle strength and decreases joint pain. Surgical treatment is the last treatment option for OA patients, which includes arthroscopy and joint replacement therapy. Thus, necessary precautions should be taken for joints to be healthy and disease-free.

Chronic pain is a byproduct of many diseases and conditions. Along with long-term opioid medication use in chronic pain management, misuse of this vital medication has been a topic of much debate over the last two decades. Abuse-deterrent formulations play a critical role in comprehensive opioid risk management strategies, limiting the attractiveness and drug-liking qualities of an opioid drug by limiting their bioavailability, making abuse of the tampered opioid medication less appealing or rewarding, or impeding the extraction of the opioid drug and thus impeding the administration of the opioid formulation via alternative routes. The present article covers various regulatory actions, expectations in abuse-deterrent formulation approval, and emerging opioid abuse-deterrent formulation strategies, such as incorporating physical barriers, chemical barriers, aversion agents, pH modulating release properties, novel delivery systems, agonist/antagonist combinations, and prodrugs, as potential approaches to encountering the crisis of the opioid abuse epidemic. Looking at the severity of the opioid crisis across the globe now is the right time for various regulatory agencies to come under one roof to save society from the opioid epidemic, define the policy on how and when to prescribe opioid formulations to patients, perform abuse risk assessments, and make more efforts to approve only abusedeterrent opioid medication.

Background: Gabapentin and pregabalin were developed for epilepsy and neuropathic pain. They work via voltage-gated calcium channels and are used for broad-spectrum diagnoses, e.g., epilepsy, neuropathic pain, other chronic pain syndromes, anxiety disorders, alcohol-drug withdrawal syndromes, agitation, insomnia, etc. Especially in a world dealing with the opioid crisis, gabapentinoids were considered safer alternatives to opioid analgesics.

Methods: This review aims to comprehensively search and summarize recent studies concerning the abuse of gabapentinoids published between 2021 and 2022 from various regions around the world.

Results: Studies have highlighted that a history of substance use disorder is a significant risk factor for gabapentinoid abuse. Concurrent abuse of gabapentinoids with illicit drugs can exacerbate drug-related damages. Drug screening and postmortem toxicology tests have revealed an increase in gabapentinoid consumption. In response to the abuse potential, several countries have classified gabapentinoids as controlled substances.

Conclusion: Gabapentinoids are highly abused molecules worldwide. Physicians should be aware of their abuse potential.