Journal of Clinical Pharmacy and Therapeutics

Biologics can be given safely during pregnancy but require suspension at the right time to protect the foetus, The roles of vedolizumab and ustekinumab are vague. The use of most biologics during lactation is safe, but no guidelines recommend vedolizumab. A delay in infants' live vaccination schedule is needed if their mothers are treated with biologics.

The addition of short-term oral corticosteroids showed a clear benefit for use at 1, 2 and 3 weeks in improvement of pain and quality of life in patients with Tietze syndrome. The difference found by adding corticosteroids was maintained at mid-term follow up of patients with Tietze syndrome after treatment cessation. Joint swelling reported by patients with Tietze syndrome does not correlate with improvement in pain symptoms.

Based on the characteristics of biliary and pancreatic diseases, clinical pharmacists have designed path-based postoperative analgesia regimens based on the surgeries included in the diseases (benign biliary surgery; malignant biliary surgery; benign pancreatic surgery; malignant pancreatic surgery).

We reported a 50-year-old woman who was treated with warfarin after prosthetic valve replacement and had a fluctuating international normalized ratio (INR) following the concomitant administration of toremifene. The results suggested when concomitant administration of warfarin and to remifene, the interaction between them is not serious, but the dose of warfarin needs to be reduced.

Among the 70 participants, 47 (67.1%) developed severe neutropenia. The PopPK analysis showed that the typical drug clearance (CL) rate was 37.4 L/h. Age was a significant covariate of CL rate, and aspartate aminotransferase and albumin levels were covariables of the volume of distribution. The AUC estimated using the maximum a posteriori Bayesian method can predict the toxicity of docetaxel in patients with breast cancer. Docetaxel AUC >3.0 mg h/L, platinum and baseline haemoglobin level are risk factors for docetaxel-induced grade 3/4 neutropenia. The AUC of first cycle may not predict the occurrence rates of grade 3/4 neutropenia in later cycles.

In patients with non-small cell lung cancer and metastatic colorectal cancer, more than 40% of them received IBI305 as first-line therapy. Among pre-exposed patients, the majority of them were switched from reference product or other biosimilars to IBI305 within 28 days.

This study investigated the association between asparaginase and diabetic ketoacidosis from the perspective of adverse reaction signal detection and literature review. The reporting odd ratio (ROR) of diabetic ketoacidosis (DKA) caused by l-asparaginase was statistically significant, but there was not a statistical association for DKA caused by pegaspargase. Combined with the results of literature review, we speculated that the asparaginase dosage form may affect the occurrence of DKA.

This double-centre, randomized, controlled study enrolled 120 CKD patients complicated with hyperuricemia (HUA), then randomly assigned to low-dose febuxostat group (20 mg/day) or allopurinol group (200 mg/day) at 1:1 ratio for 6 months. The estimated glomerular filtration rate (eGFR) level was increased at M6, and the proportion of patients with >10% decline in eGFR from M0 to M6 was decreased, in febuxostat group compared with allopurinol group. There was no difference of serum creatinine (Scr) and serum uric acid (SUA) at M0, M1, M3 and M6 between febuxostat group and allopurinol group. Moreover, there was no difference of drug-related adverse events between febuxostat group and allopurinol group. Further subgroup analysis exhibited that low-dose febuxostat presented superior effect on attenuating eGFR decline and lowering SUA level compared with allopurinol in CKD stage-3 patients, but not in CKD stage-2 patients. Conclusively, low-dose febuxostat exhibits a superior renal-protective effect compared with allopurinol in CKD patients complicated with HUA.

This retrospective cohort study reviewed 70 platinum-resistant recurrent ovarian cancer (PROC) patients who received apatinib plus paclitaxel (apatinib plus paclitaxel group) (N = 32) or paclitaxel monotherapy (paclitaxel monotherapy group) (N = 38). The recommended regimens were as follows: paclitaxel (60 mg/m²) administrated once a week with a maximum of 18 weeks; apatinib (250–375 mg/day) administrated until disease progression or patient intolerance. Interestingly, disease control rate was elevated (84.4% vs. 60.5%, P = 0.028), whereas objective response rate only disclosed an increasing trend (lacked statistical significance) (37.5% vs. 18.4%, P = 0.074) in apatinib plus paclitaxel group compared with paclitaxel monotherapy group. Progression-free survival (median [95% CI]: 5.0 [2.5–7.5] months vs. 3.8 [2.4–5.2] months, P = 0.033) and overall survival (median [95% CI]: 21.1 [13.2–29.0] months vs. 14.8 [11.4–18.2] months, P = 0.032) were both prolonged in apatinib plus paclitaxel group compared to paclitaxel monotherapy group, which were further verified in the multivariate Cox's proportional hazard regression analyses (both P < 0.050). Additionally, the incidence of each adverse event was not different between the two groups (all P > 0.050). Collectively, apatinib plus paclitaxel exhibits better efficacy and acceptable toxicity compared with paclitaxel monotherapy in PROC patients.

Adherence self-report scales are many, thus rendering scale selection a complex process. This review aspires to optimize this process for healthcare providers, especially when dealing with patients with hypertension. After reliability and validity analyses, five scales showed superiority regardless of the lack of gold standards.

Through the search strategy, we could identify 24 articles about various effects of the international economic sanctions on access to medicine and health of the Iranian people.

A single drop of expired topical carboxymethylcellulose sodium eye drops can cause toxic epithelial keratopathy. We discuss an unusual occurrence of bilateral toxic keratopathy caused by self-application of expired topical eye drops.

This study aimed to demonstrate the effects of clinical pharmacist participation in the intensive care unit treatment team on the incidence of drug-induced acute kidney injury incidence and therapeutic outcomes. Our results show that the incidence of acute kidney injury is reduced in patients receiving clinical pharmacy services and these patients with a better prognosis.

This study reports the frequency of CYP3A5*3 and CYP3A4*22 in Egyptian Kidney transplant patients receiving tacrolimus. This study investigates the influence of these genetic variants on tacrolimus dose requirements in Egyptian kidney transplant patients. There was significant association between tacrolimus elevated trough plasma concentrations and genetic polymorphisms in both CYP3A5*3 and CYP3A4*22 in the study population.

There is little information on the onset of hypernatremia after withdrawal of desmopressin. We present a case of an elderly woman with central DI whose serum sodium jumped from 141 to 171 mEq/L after 48-72 h of holding oral desmopressin. Based on this precipitous onset of DI crisis, we recommend not withholding desmopressin for more than 24 h.

In this commentary, we analyzed reports of nervous system disorders associated with ceftazidime/avibactam, meropenem, imipenem, ceftazidime, ceftriaxone, and cefepime in the FAERS database from 1 January 2015 to 31 March 2022. We found that ceftazidime/avibactam showed a relatively stronger sign central nervous system adverse events than meropenem, ceftazidime and ceftriaxone in real world. The poor clinical outcome of these events should attract clinical attention, especially for patients with older than 65 years old and long treatment courses.

Current vancomycin monitoring guidelines recommend the use of area under the concentration-time Curve (AUC₂₄) monitoring in patients with serious Methicillin-Resistant Staphylococcus aureus (MRSA) infections by utilizing either a Bayesian approach or the first-order analytic equations. Several open-access websites exist that allow estimation of vancomycin AUC₂₄ with the use of a single steady-state trough. It is uncertain how these open-access calculators perform against guideline-recommended methods. The objective was to compare AUC₂₄ categorical agreement from open-access calculators compared with the two-point pharmacokinetic (2PK) method. Patients admitted between 2017 and 2021 who received vancomycin therapy and underwent a two-point pharmacokinetic assessment were evaluated for inclusion. Two-point AUC₂₄ values were calculated utilizing the Sawchuck-Zaske method and the modified trapezoidal rule, which was pre-built into an institution created calculator. AUC₂₄ estimates were generated by imputing patient demographics and one single trough concentration into the two online calculators (ClinCalc and VancoPK). These calculators were compared with 2PK by assessing their in-category agreement rates (AUC₂₄ < 400, 400–600, >600 mg*hr/L). A total of 253 patients were included in the study. Rates of categorical agreement for ClinCalc and VancoPK relative to the 2PK method were 68.8% and 80.6%, respectively. In situations of categorical non-agreement with reference method, ClinCalc underestimated the categorical AUC24 more frequently than VancoPK (28.5% vs. 9.5%, respectively; p < 0.001), and VancoPK overestimated the categorical AUC24 more frequently than ClinCalc (9.9% vs. 2.8%, respectively; p < 0.001). ClinCalc and VancoPK yielded categorical agreement rates of 68.8% and 80.6%, respectively, relative to the 2PK method. Institutions should validate these online, trough-only calculators relative to a 2PK method in their patient populations prior to adoption as standard-of-care.

Timely discontinuation of NOAC's therapy before surgery is not always achievable, especially in an emergency setting. This case report proves, with direct blood concentration measurements, the efficacy of CytoSorb hemofilter in apixaban removal during cardiopulmonary bypass for emergency aortic valve replacement.

Follicular lymphoma is a subtype of B-cell Non-Hodgkin lymphoma and is the second most common lymphoma diagnosed in the United States and Western Europe. The role of rituximab in the first-line treatment of low-tumour-burden follicular lymphoma has been supported by a large number of data. However, whether rituximab biosimilars have the same efficacy and safety as the reference drug (MabThera) is still controversial. Electronic databases and the ClinicalTrail.gov website were extensively searched using relevant search criteria. Studies were screened according to inclusion and exclusion criteria. Then the risk of bias of the included studies was assessed using the RoB 2 assessment scale, and the RevMan 5.4 statistical software was used for meta-analysis. Finally, four clinical randomized controlled trials involving 1223 patients were included. There were no statistically significant differences in efficacy and safety between biosimilars and MabThera groups. Our study concluded that the efficacy and safety of rituximab biosimilars in the treatment of low-tumour-burden follicular lymphoma are highly similar to those of the original drug.